How can I improve severe acne scars? (photos)

I was completely clear of acne or acne scarring until September of 2016, when I was placed under military combat training. It may have been the stress, it may have been the sudden environmental change, it may even have been the water to wash my face. I have no idea. However, what resulted in the four months of training was an EXTREME spout of cystic acne. The resulting acne scars have remained since. Any guidance will be much appreciated.

Doctor Answers 6

Deep acne Scar Treatment

Depending on the level of the acne scars, chemical peels, micro needling, RF laser such as
eMatrix, and Fraxel Laser are all excellent treatments.  The best course for deep acne scars is a combination of V-Beam for redness, fillers such as Restylane for the deeper scars, or Sculptra injections to produce new collagen and Fraxel Laser to smooth the overall skin.  eMatrix is best for darker complexions and acne scars.  For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with all aspects of cosmetic skin care. Best, Dr. Green

You can improve....

Thanks for your question and photos. There are a couple of options for you. Intensif is the newest FDA-approved technology using microneedling to deliver radio frequency energy. Radio frequency triggers the skin’s natural healing process promoting the production of new collagen and elastin as the handpiece is able to evenly target areas deep within the skin. The results are a reduction of deep wrinkles, acne scars, stretch marks, dilated pores and other traumatic scars.The Intensif technology delivers short consistent pulses of RF energy through the tiny microneedles that penetrate the skin. The heat targets the papillary and reticular dermis allowing for skin remodeling. This enhanced heating volume stimulates collagen remodeling providing dramatically improved and consistent results.  Hope this helps.

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

You can be helped

Dear Sangyongee, 
  These are good photos of your skin. I think you must mean 2015. Stress can definitely cause an outbreak of acne. First of all, as someone else below mentioned, you have persistent active acne. From the photos, I intuitively think you would benefit from taking an oral antibiotic and using a topical antibiotic as well. With respect to the scarring, we have the best success with microneedling and dermal filler. I always do subcision when I use filler. Fractional lasers can be used but we've had more success with microneedling. You have post-inflammatory redness and pigment which can be improved with topical products. Some deeper "ice pick" scars can require what is called punch excision where the scar is surgically removed - you may have a few of those on your forehead. 
 Best to you, Dr Norcom

Derek Norcom, MD
Portland Physician
4.9 out of 5 stars 11 reviews

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Acne with scarring

The acne needs control with topicals and possibly chemical peels. Infini is perfect for your skin type and can be done in conjunction with acne treatment. Infini actually will help improve acne because it shrinks the sebaceous glands which are a major contributor to acne. Deeper scars need to be filled with Bellafill. See link.

Steven F. Weiner, MD
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Acne scars

I agree with my colleague that before starting scar treatment, your active acne needs to be controlled, the inflammation needs to resolve, and the scars need to mature.  Know that while there is no "cure" for acne scarring, there are numerous effective treatments and each can produce improvement.  Options include excision of focal scars, subcision of depressed scars, laser resurfacing, needling, and fillers (Belafill!) to name a few.  Start by finding a skin care specialist with an interest in acne care.  Best of luck!

Larry Lickstein, MD
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Acne red scars after military training

Well the good thing is that some of your scars are really just what appears to be active acne. I think if you control your active acne I think your skin can be a lot better.  You do have scars but they're not as bad or nearly as bad as I've seen. I would suggest doing aggressive skin care treatments which we can help you with and see what you have left after you give that a full chance. You also want to see if you can control your diet and see what's triggering the acne possibly.

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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.