How to treat acne scarring? (Photo)

What do I need to do to remove my acne scarring? I've already had one microneedling session and don't see amazing results.

Doctor Answers 7

Acne Scars treatment

Thank you for sharing your pictures , fractionated CO2 laser treatment would be a good treatment for your scarring. Depending on how you react to the treatment and the result , other additional treatments could be done .

Montreal Dermatologist
5.0 out of 5 stars 4 reviews

Treating acne scarring needs multiple treatments with different modalities

Microneedling is just ok in treating acne scars. The Infini is much more aggressive than the microneedling and is my recommendation. Subcision, Bellafill and maybe PRP are also good at treating scars in combination.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Patience and persitence

Microneedling with PRP is an excellent start, but multiple treatments will be needed.  I treat this from a multi-modal approach.  I use CO2 pixel resurfacing, INFINI RF, direct excision, and Bellafill in combination depending on the individual case.  Either way, it takes 3-6 months to see the results of any collagen induction therapy so be patient and be persistent. 

Guy Cappuccino, MD
Mount Airy Plastic Surgeon
5.0 out of 5 stars 92 reviews

Acne Scar Combination--TCA cross, lasers, microneedling/prp

Acne scars require a combination approach and usually takes a series of treatments. In addition to microneedling, I always add prp to improve results. I also recommend lasers, fillers, TCA cross, punch excision and fillers. See an expert in acne scarring. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Acne Scar Treatment

Sorry to hear that you are having difficulty with your skin. Living with acne scarring is not something you have to put up with thanks to the advancement of aesthetic lasers that are equipped to treat a wide variety of skin conditions. 

There are many options to treat acne scarring, so to achieve the best results for your specific case, consult an experienced specialist with a reputable practice. Lasers are a great way to resurface the skin and reduce scars, particularly the Erbium and CO2 lasers. The Erbium laser is a state-of-the-art laser that resurfaces the skin and reduce scars in under an hour. The results are almost instant, and only about 3-4 days of downtime are required. Another option is the CO2 laser. The CO2 laser penetrates the skin deeper than the Erbium; therefore, the results are a little better, but you would need about 7-10 days of downtime. Also, because this laser is more invasive, you do not need multiple treatments like the Erbium. 

At our clinic we often recommend a series of AFT (Advanced Fluorescence Technology) laser treatments for acne scarring as a starting point, it all depends on the patients current skin condition. AFT is an Intense Pulsed Light (IPL) laser technology targets the surface of the skin where prior acne has made the surface uneven and improves the texture, tone, and appearance of skin with minimal downtime.

A consultation with a board certified cosmetic plastic surgeon or a dermatologist would be the first step in treating your scars! I would highly recommend a high quality medical grade skin care routine that contains ingredients that have been developed to treat acne on the face.

Watch the attached link for more info.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 151 reviews

How to treat acne scarring?

Thank you for the photos. Since you already had one microneeling treatment I would continue and get the full treatment. It is recommended to have a minimum of 3 treatments a month a part and maybe you need 6 treatments to achieve the results you want. The good thing is that there is no downtime and is tolerated very well. It takes the body's healing process to promote the collagen so it takes time. Collagen induction therapy is very effective but you need to give it time and don't give up. Good Luck! 

Bruce K. Smith, MD
Houston Plastic Surgeon
4.7 out of 5 stars 14 reviews

Microneedling Generally Requires Two To Four Treatment Sessions To Achieve Optimal Results

Your history and photos suggests the need to emphasize two important points. For one thing, your treating physician should have emphasized to you that optimal results following medical microneedling treatments generally require a treatment series of two to four treatment sessions. I have been performing medical microneedling for over fifteen years. Only a very small minority people actually see much benefit after the first treatment. Between two and four treatment sessions are typically required to realize maximum benefit. The second, and also extremely important prerequisite for the treatment of acne scars is selecting the appropriate treatment for the scars present. Pit scars, particulary in the photo of your left side seem to be the predominant kind of scarring present. And, for these kinds of scars, TCA CROSS, would be more appropriate than microneedling, which deals better with more shallow scars. . 

Vis-a-vis lasers, I would suggest forgetting the powerful marketing hype that makes lasers, particularly fraxels, come to mind for treating just about everything these days.  In a recent lecture entitled, “Will Microneedling Replace Lasers?” at the 2016 American Society for Dermatologic Surgery (ASDS) annual meeting in New Orleans. a leading laser expert herself reported that "microneedling is already replacing fractionated lasers..." for use in treating " various scars (from acne, trauma, surgery)." For more information on any of these techniques, I suggest you check out the archives of And be sure to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in treating all kinds of acne scars. Best of luck to you and Happy Thanksgiving.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 30 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.