How Safe is Fillers for Acne Scars and What is the Worst Situation Possible?

I am considering fillers. They suggested pdt laser too. Apparently, they thought surgery was out of the question. I got many scars, mostly mini ones but, one scar is pretty big enought to effect my confidence. I hear fillers are around $1000 and not exactly pleasant. Juvederm a good choice? With my skin tone, I don't think laser is a smart choice, plus, it is very expensive.

Doctor Answers 11

Acne Scar Treatment And Fillers

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Juvederm and other hyaluronic acid products are excellent fillers for acne scar treatment. FIllers work best for shallow rolled scars. Sometimes, these injections are combined with a localized subcision procedure.

The most common side effects of fillers are bruising, swelling, discomfort and bumps. Sometimes a bluish discolorations can be observed if the filler is injected too superficially. These side effects, in general, are self limited and easily managed. More rare side effects are infections, persistent swelling and skin breakdown (if the filler is injected into a blood vessel). Again, infections and swelling can be easily treated. The risk of skin breakdown resulting from the filler hitting a blood vessel is unlikely with acne scar treatment and usually occurs if the fillers are injected much deeper into the skin.

Austin Dermatologic Surgeon


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Dear joejoe,

Thank you for your question. 

Acne scars are common, but with advancement in technology, thankfully it is not something you have to live with.

Acne scars are the result of the breakdown of collagen and elastin in your dermis. They frequently occur at sites which were acne prone in the past, namely your temples, cheeks etc.

Acne scars are 3 dimensional, hence submitting a photo will not do justice to your scar. It requires real time examination (touch and animation), combined with lighting from various angles. That is why you may notice your scars differently in the bathroom mirror and in the dressing table mirror.

Dr Daniel Chang’s 3 STEP ACNE SCAR Treatment Formula: 

1- Control acne

2- Treatment – Fractional laser + skinboosters ( to promote collagen growth)

3- Maintainence with lasers ( to optimise collagen stimulation)

STEP 1: CONTROL YOUR ACNE. (Refer to this page on acne for more information)

Achieving good control of your acne is the important principle towards helping your acne prone skin. This prevents new scars from forming, which is a big step forward. Dont be too worried about your existing acne scars. Focus on prevention first.

STEP 2: Treatment based on scar type. Below are the 4 main types.of atrophic scars.

Ice pick scars =>    can be treated with TCA CROSS, Fractional and Microneedling

Rolling and box scars scars => are best treated with a combination of  RF Microneedling, PRP, fractional lasers and subcision

Hypertrophic scars can be treated with

  •  Microbotox
  • Intralesional steroid

Atrophic scars -> A combination approach is what I would recommend to improve the appearance of such scars.

  • Laser Resurfacing +/- RF microneedling 
  • Subcision
  • Dermal fillers – Skinboosters – Please refer to my Page on Skinboosters 
  • Intralesional saline – ( Latest evidence from Journal of Dermatology Sept 2016)

Fractional C02 used to be the industry gold standard for treatment of acne scars. Current studies point towards combination therapy, as I have outlined above. In addition, As collagen takes 3 months to grow, multicentre studies show one would require at least 4 sessions to see results. 1 session is unfortunately not enough.

You have atrophic scars, so the combination approach above would help you. Fillers are safe, and Bellafill is FDA approved for scars.

I hope you find this helpful.

Daniel Chang, MBBS
Singapore Physician

Fillers for Acne Scars

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Fillers are quite safe for acne scars, but it would be good to subcise the scar before filling it in. The worst situation possible is the filler going down too quickly.
Good luck!

Acne Scars and filling them with fillers

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Fillers can be a good way to elevate the depressed scars. Now most of the fillers are showing collagen production with restylane being the more recent filler to show this scientifically. A multilayered approach is the best way to treat acne scarring. Co2 resurfacing is usually the very last treatment that I do.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Dermal fillers for acne scars

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depending on your skin type and nature of your scar, various treatment modalities or their combinations can be used safely. Use of dermal fillers is only one of several approaches that include laser resurfacing, dermabrasion, surgery and even medications. Consult your dermatologist to determine the best option for you

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Fillers for acne scars

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Fillers are a great option for acne scars.  Juvederm works great however it is not a permanent filler. You will have to redo the treatment most likely every 9-12 months.  I have found that small droplets of silicone work great for acne scars and this is a permanent filler.  The treatment costs around 500-1,000 per treatment and are not very painful.  Fraxel laser is a great option to compliment fillers for scne scars.  However, in your skin type you need to be very careful. Make sure you see a dermatologist who is trained in Laser surgery.  Dr. Halem


Monica Halem, MD
New York Dermatologic Surgeon

Treating Acne Scars with Fillers

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Treatment of acne scars with injectable fillers is safe and effective.  However, there are different types of acne scars, necessitating different treatment modalities. In our practice, we use liquid injectable silicone for filling of acne scars, in addition to other treatments such as punch excision and light electrodessication, depending on the types of scars.  I recommend you consult with a board-certified dermatologist for evaluation and discussion of treatment modalities. 

Channing R. Barnett, MD
Boca Raton Dermatologist
4.1 out of 5 stars 8 reviews

Fillers for acne scars

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Fillers can be a good choice for some acne scars. The worst scenario would be that you are disappointed or do not like how it looks and will have to wait until it dissolves or have it dissolved. I think that if your expectations are realistic and you have a good doctor doing this you will be happy. One thing that can be done to see whether scars can fill is to have the doctor inject normal saline first. That will disappear within the day. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Fillers for Acne Scars

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Fillers can work well for acne scars as long as you do not have ice pick type scars.  The ideal scar for fillers would be one that is shallow and distensible.  The hyaluronic acis fillers such as Restylane or Juvederm would be the fillers of choice; however you do have a risk of bluish discoloration if the material is injected too superficially. 
As far as the worst possible situation, that is hard to predict.  These fillers are very safe, but bruising, swelling, and occasional lumps are the most common side effects.  Very rarely the filler can be inadvertantly injected into a blood vessel leading to an ulceration with possible scarring.  The cost of fillers is extremely variable, but please go to an experienced injector.  Lasers might not be an optimal choice for you.

Sheri G. Feldman, MD
Beverly Hills Dermatologist

Fillers fine for Acne Scars

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Fillers are quite safe for acne scars since they are not injected into any of the danger zones of the face such as the glabella. Juvederm Ultra would be the best one of the fillers available in the US. Treating acne scars with a hyaluronic acid filler will last longer than fillers injected into areas of tension such as the lips or naso-labial folds. So, the duration should be at the high end of the spectrum, probably 16 months or so. Do consult with someone with experience, a plastic surgeon or dermatologist, since these injections are superficial and risk the blue discoloration of the Tyndall effect. The cost is actually significantly less than $1000 and should be 1/2 or even 1/3 of that price. 

Some might advice a fractionated laser, however, if you have numerous acne scars. Generally, fillers are best for a few scattered acne scars.

Finally, you must mean PDT ( photodynamic therapy) with an Intense pulsed light or red light device. This is not a true laser. Also, as far as I know, it is not particularly effective for acne scarring, though it is a great modality for active acne. 

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

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.