What procedure is best for this acne scar? Will microneedling be enough? (Photo)

The short answer to this question is that the scar appears to be a large, deep boxcar scar. As such, microneedling as a monotherapy, is not likely to do much at all to improve this. Microneedling, which I have been performing for over twenty-three years, even when professionally performed, is best reserved for a final "polishing" step for scars, to superficially blend the treated area better in both color and texture better with the surrounding normal skin. But, this is best done AFTER other more appropriate treatments for the scars have been done. Subcision, which I have been performing since 1995, on the other hand, is a simple, relatively inexpensive technique for elevating and smoothing boxcar and rolling scars that may be used safely and effectively in all skin types. As a aside, regarding the active acne visible in the photos, it is generally more prudent to treat and suppress the acne breakouts first, before treating the acne scars, so that the breakouts do not impede the progress of the scar treatments. You would be wise to consult an experienced, board certified cosmetic dermatologist who can help not only to control the active acne, but subsequently treat the scars. Best of luck.

Acne scar treatments require precision and attention to detail. There are several types of acne scars, including atrophic, hypertrophic, PIH hyperpigmented, and hypopigmented scars. Depending on the types of scars you have, our office can recommend a Hidef treatment protocol that can recontour existing scars and reduce complexion irregularities. The results are simply life-changing.

As a general rule, we recommend fillers, subcision, acne surgery, RF ablation, and laser ablation to help with atrophic scars. Hypertrophic and keloid acne scars require pulsed dye laser and IIT SC. PIH scars require chemical peels, Melarase creams (AM and PM) and laser.
If you have ice-pick scars, we recommend RF ablation and TCA Cross.
Best,
Dr. Karamanoukian
Realself100 Surgeon

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars.
- Subcision for depressed, tethered scars.
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars.
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring.
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"