What is the best treatment for this type of acne scar? (photos)

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi @qwert678. I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting.

Best of luck,

Dr. Nima

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars.
- Subcision for depressed, tethered scars.
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars.
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring.
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Close-up photos would have been additionally helpful. However, there arppear to be quite a few ice pick scars and some rolling/boxcar scars, as well. If this is indeed so, then for the ice pick scarsTCA CROSS, which has over a two decades track record for efficacy and safety in all skin types, would be a very reasonable and cost-effective approach. And subcision, another relatively inexpensive technique that has nearly a three decades track record for efficacy and safety for boxcar/rolling scars in all skin types would be a very reasonable approach. You would be wise to consult with an experienced, board certified cosmetic dermatologist with extensive scar treatment experience and to be very cautious when offered the supposedly "next big thing" expensive fraxel laser or RF treatment, since these are far more backed by marketing hype than hard science. Hope this helps and best of luck.

Hello, I really like to use PRP combined with micro needling for this type of scarring. Sometimes subcisons are also needed to help lift scar tissue. This will take a series of treatments each spaced one month apart. Each session will keep enhancing the tissue and allow for remodeling of the scar. I have a before and after on my page if you would like to see.