What treatment for this type of unusual acne scarring? Please help (Photo)

Ive had acne since 13. tried subcision twice with no results. im 21 now and after 2 accutane courses im currently on retin a hydroquinone and minocycline i dont get acne but have scarring. my whole family has smooth skin so i dont get it no one had acne but me. i have severe nose scarring, bumpy texture both sides a lot of raised bumps. also have a fat lump near mouth area . PS told me it was natural fat from volume loss but i nevet heard of that. my girlfriend thinks its scar tissue. HELP ME

Doctor Answers 4

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This type of scarring requires a series of treatements including bellafill injections, subcision, lasers.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Grade IV Acne scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From you photos, it seems you have Grade IV rolling acne scars - scars that are evident at social distances greater than 50 cm (greater than 20 inches or more than 4 feet) and is not covered easily by makeup or the normal shadow of shaved beard hair in men. If this is the grade of your scars, then this means your scars are pretty deep.  Choice of treatment for rolling scars is subcision. In this technique, the roots of your scars are cut underneath the
skin.  However, subcision alone has a high degree of relapse because the raw ends of the cut scars can easily re-attach themselves. When combined with a buffer such as fillers to prevent the raw ends of the cut scars from re-attaching, subcision can be successful. Subcision can also be combined with skin suctioning to decrease the chance of recurrence. Fractional lasers, full field laser resurfacing and needling devices can
improve the texture of your skin from rough to smoother.  Each of these technologies has their pros and cons. However, the dents or sink holes cannot be improved by these devices. The dents need to be released from their anchor, then puttied in with a buffer so
that recurrence is minimized.

Cynthia M. Lopez, MD
Fresno Physician

Acne scarring treatment

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I think that there is some lost volume from the scars and that would benefit from Bellafill. I also think that the smaller scars would be helped with Infini, a radiofrequency microneedling device. Please see the link.

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

Acne scarring

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the photos. It looks like you have wide flatter acne scars (boxcar and rolling type scars) that can benefit from both microneedling as well injection of a dermal filler such as Bellafill to fill the depression. Microneedling breaks the scar tissue and allows the skin to regenerate collagen into those areas. It can also help with your irregular skin texture around your nose and mouth. Microneedling has about 3-5 days of downtime and will require a few treatments spaced out over a few months to see long-term results.  Hope this helps!!
Johnson C. Lee MDPlastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 17 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.