Does Sculptra Help with Rolling Scars?

"​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. ​"

As acne scars do not all have the same appearance, it stands to reason that different treatment approaches are used to obtain best results.  Some scars respond best to subcision, some to excision, while others respond best to laser therapy.  Subcision can be performed either superficially or deep, depending on the nature of the scar.  I treat a large number of patients with acne scarring and I do find that there is a role for Sculptra in some of these patients.  I tend to use it as a "finishing' type of agent once maximum improvements have been achieved with other techniques as I find that the increased collagen production leads to improved aesthetic appearance of certain scars.  As has been stated by others, Sculptra must be injected at the correct depth to avoid complications.  Only experienced injectors should attempt to use Sculptra to treat acne scarring.

Acne scars are usually treated by a combination of treatments, such as topical creams, subcision, excision, fractional CO2 lasers, and fillers.  Sculptra is a filler that stimulates collagen and is used to improve hollows and wrinkles.  However, when injected superficially, there is a risk of nodule formation.  The best thing to do would be to see a board certified dermatologist to discuss treatment options. 

I love sculptra for deep dermal defects often left behind after bad acne - and accentuated by chanegs of aging - but for more superficial scars usually a laser such as fraxel works best to stimulate collagen remodeling and smoothing of the skin. A series of treatments is needed for best results.

There are many methods of treating acne scars but Sculptra is not among my preferred methods. Because acne scarring occurs in the skin, I believe fillers that are placed in the skin, rather than beneath the skin, are much more effective treatments. Hyaluronic acid gels like Restylane are injected in the skin and are therefore my first choice for treatment of acne scars. Sculptra is injected more deeply, beneath the skin, to generate more volume. I believe that Sculptra will not work nearly as well, will require more treatments, and will be significantly more expensive then Restylane. Many other treatments can be with combined filler injections such as subcision, punch grafting, fractionated lasers, and eMatrix treatments.