I would like to have my acne scars/pits removed! I'm interested in laser treatments, fillers, and sanding. (Photo)

I suffer horrible from acne scars/pits. I still get acne today, but it is not as bad as it was when I was a teenager. I am now 20 years old, and I still get occasional pimples, but luckily they do not leave behind dark spots, scars/pits. I would like to get rid of these pits for good.

Doctor Answers 5

Acne scar

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There are alot of treatments that are out there but majority like lasers and needling would not NOT do anything to improve your scars.  NO chemical peel would improve this neither.  It would be a waste of your money.  A combination of proper fillers and dermabrasion NOT micro would help AND ONLY in hand of someone experienced in doing this treatment over many years of maybe 7 to 10 years.  Hope that helps

Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 58 reviews

Acne Scarring in Darker Skintypes & Skin of Color

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Acne scarring in dark skintypes should be approached carefully in conjunction with a cosmetic board certified dermatologist. There are many treatments for acne scars, depending on the type of scar, but some are better suited to individuals prone to developing post inflammatory hyperpigmentation.

My suggestions on the lower cost end would be to do some microneedling (I use Eclipse Micropen) at a relatively deep setting, say 2mm. You would most likely require 4-6 treatments, spaced about a month apart to see some significant improvement. (In California, treatments of this depth require an RN or higher level to render this treatment, it is not the same that you might get from an esthetician in a medspa) Downtime is minimal, easy recovery over a weekend, microneedle on Friday, back to work on Monday, maybe using a little cover makeup for the mild tracking (I recommend Oxygenetix, but only 24 hours after the needling)

Advancing up the tech and cost ladder, I would most likely next use a RF device by Lutronic called Infini. I am seeing very good results in skin of color in my practice to resolve acne scarring. This treatment puts hundreds of needle holes in the surface of your affected skin, usually requires 3 passes, and then, when the needles are at full depth, administers RF energy to tighten and rebuild collagen in the treated areas. It is very safe, even for dark skin types...there is some discomfort, so you may need a nerve block, but an experienced dermatologist or plastic surgeon can easily give you good blocks.

Fractional laser, in my experience, runs the risk of inflammation and therefore pigment, esp in darker skin people, so as long as you accept that risk, it would be a good option as well. Fractional erbium as well as the latest laser by Sciton called Halo is available in my practice. I am seeing results and improvement with moderate to severe acne scarring using Halo.

Finally, once you have done all the laser you think you want to do, I would then contemplate using injectables in combo with needle subcision. Bellafil is my preferred filler of choice because it was recently FDA approved for rolling boxcar type scars and is long lasting (many years) If there are some particularly troublesome icepick scars, small individual punch excisions are a good option, and the minimal scar that occurs easily gets blended in with time and the combination of treatments we discussed above.

Wish you the best, and, just a word of wisdom here...remember...it all doesn't have to be done at once...most of my patients end up using a combo approach to reach their goal.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

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You need a cosmetic dermatologist who specializes in acne scarring/pigmentation and does a combination of treatments including: surgery, subcision, or TCA cross for deep or pitted "ice pick" scars; fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars; Eclipse Micropen for all types of scars and improvement in texture and tone; lasers such as co2 laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Venus Viva to improve the scars and give long term collagen production. There are many options but you want someone who can customize a regimen for your short and long term goals based on your individual situation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Acne Scar Treatment and eMatrix

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With the type of scars and skin I would suggest you consult a physician who has expertise with eMatrix.  eMatrix will take 5 treatments to improve these deep scars and you need to avoid the sun during this process.

Acne Scar Treatments

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There are several new treatments which I believe are going to revolutionize the treatment of acne scars. These include the Precision TX laser which is used underneath the skin with no external healing and exhibits 80% improvement in severe cystic acne scars. This can be used in combination with ICON external laser with a 1540 wavelength with very minimal downtime. Other lasers include the Fraxel and Erbium lasers 

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 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.