Combining Fillers with Laser Treatment for Acne Scars

Would temporary fillers combined with laser treatment best for acne scars? I have rolling and possibly ice pick scarring. I've heard subcision combined with laser treatment is an excellent way to treat scars because it allows room for the scar to "correct" itself while collagen is rebuilding, and the skin is healing. Would Restylane or Juvederm injected after a Fraxel:Restore treatment work the same; give the skin room to repair itself correctly and level with the rest of the skin? Or would it just reabsorb over a few months and be pointless? Thanks!

Doctor Answers 4

Best treatment for acne scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Lolou. The"best" treatment for your acne scars might no exist. Rather there may be several great options, which each one offering pros and cons. The program you mentioned with subcision and laser treatments combined is an excellent option.

In the same way, subcision combined with Restylane, Juvederm or Perlane injections allows for collagen development after the fibrous scars pulling downward on the surface of the skin have been release with subcision. The dermal filler than allows for a void to be created where fibrous tissue scar was creating the atrophic (pitted or rolling) scar. Filling this area with Restylane, etc. helps to create a zone where new tissue can develop and help the scars appear less visible.

Other treatments to consider are:

  • Punch Excision
  • Dermabrasion

Good luck.

Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Fraxel re:pair and Fillers for Rolling Acne Scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Lolou,

Having Fraxel re:pair and then following with Restylane or Juvederm for the rolling acne scars is an excellent way to maximize the treatment of the scars for all of the reasons that you cited in your question.

Just make sure to have the injections after the re:pair not before. Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Try Fraxel first

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would recommend going through the Fraxel treatments and then adding filler after all the new collagen is produced. That could be more than six months after the last treatment. Of course, if you want a quicker fix your doctor can inject the filler in between the Fraxel treatments. The fillers do resolve in six to 12 months usually and you may have long term improvement with Fraxel alone.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Fractional CO2 might make more sense

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

While I am a fan of Fraxel Restore for acne scars, it will take at least 5 to make a real impact. You might want to explore the option of Fractional CO2 (Active/Deep FX, Fraxel Repair, Ellipse Juvia and others). These usually give more 'bang for the buck" if you can take the downtime.

Fillers do last longer in acne scars than in wrinkles, but I like them as the final finishing touch after you get the most from a more durable result from ablative laser or dermabrasion.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 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.