Treatment options for my Severe acne scars? (Photos)

I'm seriously considering on travelling abroad just to get my acne scars fixed. What are your suggested treatment plans given my type of scar. How much improvement can i expect, in terms of percentage please. How long is the treatment plan. I'm based from Singapore and I'm running my own company, so there's no problem on downtime. I can have a 1-month break. Then probably just return for a follow-up. Thanks!

Doctor Answers 4

Treatment of Severe Acne Scars

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I personally believe that the treatment of acne scars should include three basic considerations.  (1) Filler or fat to correct dermal and subcutaneous atrophy if present (2) Subcision to release tethered and bound down scars if present (3) Use of an energy based devices to stimulate the formation of new collagen and elastin in the dermis. Clinical judgement should be used to select the proper filler and energy based device (RF or Laser) depending on the patients age, skin type, type of scar and lifestyle. Best of luck.

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Acne scars- skin type, scar type, down time...

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The bad news? You have extremely difficult to treat acne scars in Ethnic skin type- this makes treatments a little harder but achievable. Good job for taking angled lighting, as most patients take non- shadowed direct light, which does not tell the entire story. 

Firstly, you have multiple scar types- rolling, atrophic, tethered, and box car scar. The tethered scars will be your rate limiting factor. You will need subcision. Multiple treatments, followed by non-laser energy devices such as INFINI RF ( In my opinion this out performs fractional CO2, as in your skin type RF INSULATED micro needling will not give you post laser skin darkening or PIH). You will require 3-4 sessions. 

Shallow box car scars, ice pick- easy. TCA CROSS. 

Some of the atrophic scars will come good with INFINI, but as suggested by Dr Ridenour, you will need filler- fat transfer ( I prefer filler as it is more predicable, and gives the finesse I need). 

See the attached 21 min video in the web reference to understand the whole process of scar revision. If you look at my B and As, no two patients are alike, scar revision has to be tailored the patent. 

All the best

Dr Davin Lim 
Laser and Aesthetic Dermatologist
Brisbane, Australia. 

Acne Scars – Combination of Treatments Needed

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The best treatment for acne scars depends upon an individual’s skin type, age, ethnicity, sun exposure, overall health and most importantly, the type of acne scars present (ice pick scars, boxcar scars, rolling scars, hypertrophic scars and variable degrees of hyperpigmentation). In order to give you an accurate treatment plan, a consultation is required to properly assess your skin. An important step for all skin types is sun protection including the use of daily sunscreen, sun hats and sunglasses, all of which help prevent aging and sunburns.  When it comes to acne scar treatments, a combination of treatments are available including cosmeceuticals (medical grade skin care products specific for acne including ZO® Skin Health or ZO® Medical, Skinceuticals® or Glo-Minerals®), advanced laser resurfacing procedures (CO2 laser, Er:YAG laser, Fraxel DUAL®, PicoSure® FOCUS Lens Array), chemical peels (light, medium, deep including the blue peel), dermabrasion, augmentation/fillers, excision and/or subcision, punch techniques, microneedling/rolling, injections (corticosteroids, 5-FU), cryosurgery, electrodesiccation and microdermabrasion.  These are advanced techniques so be sure to get an experienced dermatologist or plastic surgeon consultation for recommendations and treatment options.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 16 reviews

Severe Acne Scars and Treatment

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Your scars are best treated with a combination of fillers to replace the lost volume and lasers.  There is no single treatment, particularly with your skin type to treat you in one session.  This is a process and cannot be corrected "overnight". Please consult an expert.  Best, Dr. Green

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.