What are the best treatments for my acne scars and nasolabial folds? (photos)

Question

Female, early 30s. I had terrible acne through my 20s. I also lost 150 a few years ago. What are the best treatments for acne scars and nasolabial folds? I had a micro laser peel a few years ago that did nothing. I’ve done some research on fat transfers and fillers, but I’m very wary of anything that will make me look “full” or puffy. I really love my thin face. I just want the acne scars and lines gone.

Jason Emer, MD · Answer

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, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, 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.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nima Shemirani, MD · Answer

Hi @ellerk799x! You would be a great candidate for hyaluronic acid dermal fillers in the piriform fossa to help reduce the appearance of the nasolabial folds. In addition, microneedling with PRP is great for acne scars, skin texture, collagen formation. Best of luck. Dr. Nima!

Muhammad Mirza, MD (license suspended) · Answer

Thank you for your question.  When there is weight loss, the skin has a tendency to sag.  Fillers are a great way to correct any nasolabial sagginess.  In regards to the acne scarring,  Bellafill is the filler that is FDA approved to treat acne scars.  However, please keep in mind that Bellafill is semi-permanent and the only method of removing the filler from is through surgery.  I recommend scheduling an appointment with an experienced doctor for optimal results. All the best

Anteneh Roba, MD · Answer

For your Nasolabial folds, fillers like Juvaderm or restylane or Radiesse will help. For scars, depending on the scar type different treatment options in different combinations exist including, laser treatment, RF pixel treatment, RF microneedling, PRP, subcision, fillers ,TCA peels etc...

Shaun Patel, MD · Answer

Hyaluronic acid based fillers like Restylane Defyne could be used to soften your nasolabial folds. There are several different treatment options for acne scars and these treatments are usually combined to get optimal results. The treatment choices depend on type of acne scars (i.e. box car, rolling, icepick). I recommend an in person consultation with an experienced aesthetic physician to determine an appropriate treatment plan for your acne scars. I have referenced a webpage that I have written that covers different types of acne scars and the best treatment options.

What are the best treatments for my acne scars and nasolabial folds? (photos)

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