Several microneedling treatments - what's next for rolling acne scars? (photos)

After 1 Fraxel in January '16 and 5 microneedling with PRP since (dermapen not home needling), I find myself still frustrated with my acne scarring. While there has been improvement I'm trying to find the next best step. Should I continue with microneedling or look into subcision? I am not interested in further Fraxel because of complications. Photos aren't the clearest but the pigmented areas are rolling scars. Both are the same side but the other side is slightly less severe. Scars are shallower.

Doctor Answers 4

Subcision and filler.

Acne scar revision is a specialised field. For the best results, one should target the acne scar type with ideal treatments. For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgery. In YOUR case, using angled lighting we should be able to improve things with subcision and fillers. 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars.

All the best,

Dr Davin Lim.

Laser, surgical & aesthetic dermatologist.

Brisbane, Australia.

Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

On the right track--microneedling/prp, lasers, subcision and fillers for acne scarring

A combination approach would be best. I recommend microneedling/prp for acne scars combined with lasers, subcision and fillers. I recommend getting a formal consultation with an acne scarring expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Infini and Bellafill next step for acne scars

I don't promote microneedling with PRP as a great breakthrough for acne scars. I think its overhyped. I would try Infini +/- Bellafill for the acne scars. You clearly have volume loss that needs filling with the Bellafill. It is the only FDA approved filler for acne scars. It usually takes at least 2 treatments to get improvements.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Acne scars

If you acne scars are deep, they may require deeper treatment with an ablative and fractional laser.  I suggest you get an opinion from a different physician, either a board certified Plastic Surgeon, or Dermatologist.  As there are several ways to treat acne scarring, physicians trained and familiar with the skin will best help to decide which modality will be ideal for you.  If your doctor that did the laser does not have a deep laser to manage these scars, I suggest you get another assessment and opinion.

Samuel Shatkin, Jr., MD
Buffalo Plastic Surgeon
4.9 out of 5 stars 24 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.