What would you classify my type of scarring, how would you treat my acne scars & can I achieve 90%+ results? (Photo)

I've had 2 Vbeam Perfecta and going in for my last in a week before a 'real' treatment around April/May. Vbeam has helped even out my skin tone a lot. My knowledge is that I have a mix of rolling and boxcar scars and a round Subcision + an Ablative laser such as Total FX would create wonderful results. Then maybe a 2nd touch up of both or just subcision down the rode. Also, are touch ups at a discount generally offered at every practice? Opinions?

Doctor Answers 4

Treat your acne first, then revise scars... read more.

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You still have active break outs, and I would not encourage treatment until your acne is under control and in remission. Scar revision with active acne is like 'chasing your tail', namely if you still have acne, it may scar...consult a expert dermatologist for effective acne treatments. 

Good to know that you are happy with V Beam- this laser can help with red acne scars, but collagen remodelling is minimal with V Beam (in comparison to fractionally ablative lasers).

90%  is a high mark for scar improvement, I would say given your scar types (Box, ice-pick-shallow, mixed and atrophic) you will require multiple treatment methods over months. 

I would perform TCA CROSS first to raise deep scars, followed by subscision and fractional CO2 (same session), followed by eMatrix RF. Having good baseline photos and realistic expectations are essential if you plan to undertake acne scar revision. 


Dr Davin Lim 
Laser and aesthetic dermatologist

Acne Scarring

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For treatment, you really need an acne scar expert.  To start, subcision with laser resurfacing  (any co2 laser if performed by someone experienced!) can give a significant improvement.  But to a few of the deeper scars, TCA cross and/or a few punch excisions would do a huge improvement.  I suggest going to someone who does these types of "bad" scarring cases for an evaluation.  There will be a few treatments required but you can get 75%+ improvement if you see someone with experience.  Fillers are sometimes required after everything is said and done to balance out the results.  But again, that will be individualized based on the approach taken.  I wish you the best, Dr. Emer.

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

Nothing will achieve 90%+ results with acne scars

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You are doomed to be dissatisfied if you expect that success rate. I would consider 40 to 50 percent more realistic. To me, the Infini is the best for acne scars. Vbeam is good for the redness associated with the scars as well as acne. Multiple treatments is considered norm, and I wouldn't consider any follow up treatments as touch ups because the results of scar treatments are permanent and each treatment is just additive. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

What would you classify my type of scarring, how would you treat my acne scars & can I achieve 90%+ results?

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It appears that you still have active acne from your photos. I would strongly encourage you to get your acne under best control, before investing on any cosmetic interventions to address your acne scaring.

Gabriel J. Martinez-Diaz, MD
Chicago Dermatologic Surgeon

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