Is there anything that will get rid of these scars? (Photo)

Question

I have a cluster of scars, some more deep than others that I cannot seem to get rid of. I have tried *More than 10 microneedling sessions *Chemical peels *nanoneedling *Scar ablation *1 morpheus 8 laser treatment NOTHING WORKS, in some cases it got worse. Is there anything that will get rid of these scars or at least make them not very noticeable?

Anna Chacon, MD, FAAD · Answer

Scarring, especially when clustered and of varying depths, can be very challenging to treat, and it is not uncommon for scars to persist even after multiple procedures. Unfortunately, no single treatment can completely erase scars, but there are ways to improve their appearance and make them less noticeable.

Since you have already tried microneedling, nanoneedling, chemical peels, scar ablation, and Morpheus8, the next steps often involve more advanced or combined approaches, such as:

Fractional CO₂ or Er:YAG laser resurfacing – tends to be stronger and more effective than microneedling or RF devices for deeper scars.

TCA CROSS (trichloroacetic acid focal application) – useful for deep, pitted scars.

Subcision – a minor surgical technique that helps release tethered, deep scars and is often combined with filler or PRP to elevate the area.

Dermal fillers – temporary but can soften the appearance of deep atrophic scars.

Punch excision or grafting – for very deep, resistant scars that don’t respond to other methods.

It is also important to note that multiple modalities, done in stages, usually provide the best results. Improvement can be significant, but complete removal is generally not possible.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

From the photos provided, it is unfortunately difficult to come to a precise diagnosis. However, these scars appear consistent with what has been called "papular acne scars," although the resolution of the photos does not permit distinguishing these from sebaceous hyperplasia bumps.  Papular Acne scars are most typically found on the chin and nose, but much less commonly can be located anywhere on the face, as can sebaceous hyperplasia papules.. 
Manual microneedling (no need for the added expense and risks of RF microneedling) is best reserved for treating very superficial color and texture irregularities, so no surprise this didn't work for you 
Regarding RF & laser devices, my regular followers can tell you that I have been cautioning them for years to exercise a whole lot of "buyer beware" caution when being hawked these expensive smoke and mirrors treatments. So, again no surprise at the lack of success there. And the disappointment with the chemical peeling is likewise not surprising, as peels are better for addressing texture and pigmentary issues..
Light electrocautery, however, can be quickly performed to flatten and smooth numerous leasions in a matter of minutes. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

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