Acne scars: How much improvement should I reasonably expect? Which procedures should I undertake? (Photo)

Hello, I have awful acne scars on both cheeks and I would like to have an honest opinion: could you, please, give me the pourcentage of improvment I can reasonably expect. I know that there might be a margin of error but it is still important for me to know it. Furthermore, I have absolutely no idea how to treat my scars. There are many procedures and I am a bit lost... Thank you!

Doctor Answers 4

Certain Simple Acne Scar Treatments Can Help To Significantly Improve The Appearance Of Acne Scars

Since acne scars come in different varieties, it is not surprising nor unreasonable that "one size fits all" solutions, such as fraxels, radiofrequency devices and ulltrasound equipment are unlikely to achieve the desired degree of improvement. Simpler, less expensive, options, that address the various kinds of acne scars present in your photos and yield overall more consistent and gratifying results that are typically present in the photo, include a combination of subcision, medical microneedling, and The TCA CROSS. Volumization of the skin in selected areas may also help to stretch the skin and make the scars appear more shallow, less visible, and diminish the distressing "craters on the moon" shadowing. The actual extent of improvement can only be best determined after a in-person examination and palpation of the lesions.

I have been singularly underwhelmed by the results of quite a few of the energy-based treatments being heavily hawked out there, finding them to often yield inconsistent and variable results, and in general, to be far more backed by device manufacturer supported marketing hype than hard science.

Best to seek a consultation with a board certified aesthetic physician with experience and expertise in all forms of acne scar treatment and certainly have a healthy dose of skepticism about any place that may be pushing the use of its new "next best thing to come along" device. For more information on any of the above, check out the archives of RealSelf.com.


New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Acne scar treatment

I agree with Dr. Novick. 

Few additions:

1- Before undertaking any acne scar treatment, your acne needs to be in remission. Otherwise, the progress will be "two steps forward, one step back."
2- Since different scar patterns respond best to different modalities, expect to need not only more than 1 session, but more than 1 device/treatment.
3- Practically, I would begin by addressing the large "crateriform" or "boxcar" scars first with either a fractionated laser (e.g. Fraxel) or microneedling.  There are newer forms of microneedling that have combination radiofrequency energy, making them more powerful (e.g. EndyMed Intensif).
4- After 2-3 sessions of above, I would turn to the smaller scars, the small but deep ones we call "ice pick scars."  I think TCA CROSS is a reasonable approach here, as Dr. Novick mentioned.  2-3 sessions would be needed.

At the end of the day, realize this process will take several months but you can expect at least 50% improvement.  Make sure your doctor has handy multiple modalities.  If you don't have a device, you can't use it.

Be well!




Estee Williams, MD
New York Dermatologist
5.0 out of 5 stars 10 reviews

Best treatment options for acne scars

Indented acne scars can be improved with a combination of Ematrix RF, fillers, subcision, and fractional co2 laser resurfacing. 

Best, 
Dr. Karamanoukian 
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

You might also like...

Best Acne Scar Treatments

I have treated many patients with acne scars such as yours. There are times when it takes more than one modality to treat these scars. I have had s great deal of success with both Fraxel and EMatrix laser. It is best to consult a board certified dermatologist who has experience with lasers for the best cosmetic results. Best, Dr. GreenĀ 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.