How can I treat my acne scars? (Photo)

Question

Hi, I am a 33 year old Indian female (5'6" and 65 kgs with brown skin ) and I had acne struggles since my teenage years. As a result, I have deep acne scars on my cheeks now though my acne has subsided. I have attached some pictures below as well. Could you advise me on how to treat them? I have tried moxi lasers and had minimal improvement. Is subcision a good option? Looking for guidance on how to improve my skin.

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Nelson Lee Novick, MD · Answer

I really feel so bad whenever I read about another person who is suffering from the severe emotional pain of acne scars who has wasted his/her hard earned money on heavily marketed fraxels, RF devices or other "bells and whistles."  Regular followers of my answers know well that I have been trying to alert the public that these kinds of supposedly "next big thing" devices are far more supported by device manufacturer marketing and social media hype than hard science. These devices are typically faddish, 
and here today and gone tomorrow. Truly sorry. On the other hand, there are relatively inexpensive techniques, such as subcision for elevating and smoothing boxcar/rolling scars and TCA CROSS for treating ice pick scars and dilated pores, both of which have stood the test of time--decades of use worldwide--and have both a proven safety and efficacy track record in all skin types. Going forward, you would be wise to exercise a very healthy dose of "buyer beware" when offered another supposedly latest and greatest device treatment and instead consult with an experienced, board certified, cosmetic dermatologist acne scar specialist. Best of luck.

How can I treat my acne scars? (Photo)

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How can I treat my acne scars? (Photo)

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Our mission is to create a world where every investment in modern beauty is Worth It.