Thank you for your message! It is difficult to fully answer your questions without seeing pictures. I would definitely recommend a consultation with a provider in your area so they are able to assess the scarring in person. Microneedling is a great option for scarring, though typically requires multiple treatments. Microneedling, also called collagen induction therapy, is a minimally invasive skin-rejuvenation procedure that involves the use of a device that contains fine needles. The needles are used to puncture the skin to create a controlled skin injury. Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin. Through this process there is improvement in skin texture and firmness, as well as reduction in scars, pore size, and stretch marks. You can couple microneedling with PRP (platelet rich plasma) for quicker results and a faster healing time.
Acne scars are treated differently depending on their appearance and structure. Sometimes there is no actual scar at all, but just a dark spot from inflammation. These spots usually improve on their own if you protect them and keep them out of the sun. In the meantime, to control the inflammation and acne breakouts, topical retin-a cream with intermittent salicylic acid peels can dramatically improve your skin tone and frequency of breakouts. Once the acne is controlled and you continue to do have remaining scars due to permanent dermal injury from acne, a variety of treatments can be performed to remodel the scar from energy-based lasers and radiofrequency devices to mechanical disruption of the scar with microneedling. Deep wide scars can be released and filled in with subcision and a filler such as Bellafill which is specifically designed for divets and depressions left by acne. The very thin or deep ice-pick scars are best treated by excising them completely. I especially like a combination of a chemical peel for the hyperpigmentation and acne control, microneedling with PRP for texture and collagen building, and PIXEL fractionated laser or RF to resurface and build even more collagen. I would use the subcision with Bellafill for the individual deeper scars. I recommend at least 3 treatments of microneedling with PRP as one treatment is often not enough. Not everyone is a candidate for all the treatment options however as certain skin types can get worse from certain treatments. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!Johnson C. Lee, MD Board-Certified Plastic Surgeon
