HI, I am in my 20's & only had a small bout with acne, for about three months. Although the acne has long cleared. I have been left with 2 rolling scars on my right cheek & 3 pitted scars on my Left cheek. I have had Total Fx on my left cheek for the pitted scars & saw only 30% improvement. I also received IPL treatments on my whole face & really saw a plumping of the skin which helped with the appearance. Will subcision work on the rolling scars? Will do TotalFx again for pitted scars. Thanks.
Rolling Acne Scars on Right Cheek, Would Subcision Work? (photo)
Doctor Answers 6
In our practice and I’m sure every practice has their own way of treating acne scars. We have laser treatments and or a mini facelift to stretch out the skin. We have Profractional laser treatment and micro laser peels. Those procedures will improve your acne scars dramatically. If you want the least invasive and no down time with mild correction a Vipeel can help with that as well.
Rolling acne scars
I recommend a multimodality approach. I would consider punch excision, subcision with fillers, and facial resurfacing for best results.
Acne Scarring Treatment
If you can stretch your skin and see the rolling scars disappear, then they will respond well to fillers. Total FX can improve these scars by both tightening the skin and by producing collagen beneath the depressed areas. Acne scarring is difficult to treat. I think that 30% improvement is about what I would expect although this varies significantly according to laser settings.
If the pits are "ice pick" type scars, they will need to be punch excised prior to laser. If the pits are more shallow and broad based, my experience is that they do very well with fractionated CO2 resurfacing.
Hope this helps.
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Treatment of Acne Scars
It is difficult to assess from the pictures which are blurry, but rolling scars tend to do very well with injectable fillers. In our practice we use liquid injectable silicone, which is a permanent filler (used off-label). It is excellent for acne scarring because of its permanence as well as its precision. Regarding the pitted scars, I personally think fractionated laser is a lot of hype (and temporary swelling!0. There are other treatments that give better results and cost less such as punch excision, subcision and light electrodessication. Most importantly, you should consult with a board-certified dermatologist experienced in treating acne scars.
A combination of treatments works best for acne scars!
Laser treatments do take 3- 6 sessions to get better results, but adding on subcision / dermabrasion/ platelet rich plasma - these are all options to improve the outcome.
Acne rolling scars - I would treat with multilayered approach
I would treat your rolling scars with some type of filling and laser resurfacing. Your scars are not that bad as I have seen so being conservative would be important.