What's the Best Treatment for Atrophic Scars?

The best treatment for atrophic scars is subcision, fillers (hyaluronic acid like Restylane, Perlane and Juvéderm) used in conjunction with a fractionated CO2 laser to tighten the skin.  The subcision stimulates collagen and will lift the depression.  For those that have darker skin types I recommend the dermaroller because it won’t cause discoloration of the skin and will still create new collagen.
 

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for you question. I think you could be a possible candidate for Bellafill. Bellafill is a FDA approved 5 year filler for atrophic acne scars. If injected properly it gives a great smooth result. Get a consultation and see if your acne scars would be treatable with Bellafill. Best of luck!Dhaval M. Patel Double board certified Plastic surgeon Hoffman Estates Barrington Oakbrook Chicago

Atrophic scars are usually thinner in depth, depressed and crater form.  Fillers such as hyaluronic acid raise them to surface level and last 1 year; silicone, which is permentant is very effective if injected by the microdroplet technique.  Combined with fractional CO2 laser resufacing improvement can be in the 60-70% range.

It really depends on the actual type of scar.  Most acne scars are classified as ice pick, box car, or rolling scars.  Some scars can also be simply lighter in color (hypopigmented) or darker (hyperpigmented).  For rolling scars (ones that look normal if you stretch the skin) you can have a filler substance such as Restylane injected to fill them out.  That is a quick treatment with very little downtime.  A surgical treatment, such as Subcision, can also be used to release the tethering bands of collagen that are pulling the skin down.  Check with a dermatologic surgeon to see which treatment is right for your type of scar.  Best to you.

The best treatment for any scar depends on several factors. If these are acne scars, classification of the scars will help direct therapy. I think in terms of a Palette of Therapies, including liquid injectable silicone, CROSS technique, punch excision, subcision, punch lifting, primary excision with closure, fractional CO2 resurfacing, chemical peels and more.