Best treatment for acne keloid scars? (photos)

I just completed my second course of Accutane and my face has mostly cleared up. However I'm left with severe keloid scarring along my jawline. What medical or cosmetic treatments are available for a condition like this?

Doctor Answers 4

Keloid Scars on Jawline

If these are all firm and hard scars, then the best treatment would likely be intralesional injections of Kenalog.  Alternatively, fluorouracil can also be injected into these scars, but usually I like to start with Kenalog.  The injections soften and shrink the scars.  Pulsed dye laser can be useful for any red scars. 


Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Acne keloids on jawline

In my opinion, depending upon your skin Fitzpatrick color type, a combination of intralesional injections with cryotherapy utilizing liquid nitrogen is usually the first choice. Should you have darker skin, verapamil and 5-fluorouracil would be the choice. The liquid nitrogen has the ability to enhance any keloid injection treatment. It also works well on its own. Laser therapy with the pulsed dye laser is excellent if the scars are still red. I would be careful with excision of keloid scars on the jawline. They most likely will recur. Find a physician  with  experience in treating acne scars. Ask to see photos. Hope this helps. Good luck.

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
4.6 out of 5 stars 38 reviews

Acne Keloid Scars

The best treatment for these types of scars would be a combination of intralesional cortisone injections and eMatrix laser.  Please make such that your acne is all healed since some of these look like acne cysts which should have been treated with your Accutane treatment.  All the best, Dr. Green

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What to do ?

Your issue is not unusual.  The bumps may be scar tissue or they can be residual cysts that remain because they cannot drain the stuff inside despite being on accutane.   You will need to see a physician to see which one it is.  Depending on which one it is you can try cortisone injections or maybe excision or both.  The answer would come after an evaluation of your skin.

I strongly recommend a strict skin care program tailored to your needs which change when you are on accutane to a different regimen after accutane.  If you were not on accutane everything would be a lot worse.  Good job making it through accutane!

George Orloff, MD, FACS
Burbank Plastic Surgeon
4.1 out of 5 stars 11 reviews

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.