What is the Truth About Acne Scar Treatments?

Hi. I am a 21 year old caucasian female looking to get acne scar removal for ice pick and shallow scars. My scarring is not severe. My dermatologist recommended a combination of microlaser peel and profractional laser. However, almost all reviews I have read state no improvement & a recurrence of acne resulting in more scars. When I had microderm a few years ago I broke out in cystic acne & ended up with more scars. Do you think it is therefore likely that the laser treatments will do the same?

Doctor Answers 5

Ice pick scars

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For ice pick scars, I prefer CROSS treatments (chemical reconstruction of skin scars).  This involves pinpoint application of 100% TCA (trichloracetic acid) directly into the ice pick scar.  This injures the scar tissue and provokes a healing response and smoothing of the scar.  Multiple sessions typically give the best results.  There is only minor discomfort during treatment and about a week's worth of microcrusts where the TCA was applied.  Lasers do not work well for ice pick scars.  Shallow boxcar scars can be improved with lasers such as the profractional laser.

Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Truth about Acne Scar Treatment and for Ice Pick Scars

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Lasers can be a long road to improvement. I think you really need to do some ancillary procedures before laser resurfacing. The ice pick scars need TCA CROSS method and then a multilayered approach.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Fraxel For Acne Scars

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To really understand the best option for treating acne scars, it is important to educate yourself on how they are formed in the first place.

Many people don't realize that acne scars are made of the same collagen fibers as the rest of your skin. The only difference is in how they are arranged. Scar tissue, as you can tell is irregular. And this is because of it's thick collagen configuration. 

Lasers like Fraxel work to change the collagen structures of the acne scars. This occurs after applying heat to the dermis which induces it to form normal collagen fibers. Over the course of several treatments, these fibers override the collagen in the scar tissue.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Truth about acne scars

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The truth about acne scars is that they are not an easy problem.  One can expect improvement, but never complete eradication.  Acne scars come in various types and combinations of types sometimes. 

We employ a multi-treatment approach including needle elevation, excision and laser resurfacing for the types of acne scars that you mention above.

I have had good success with Microlaserpeel combined with Profractional resurfacing with our patients.

Laser peeling does not stop acne, so, you can still get acne after laser, which may lead to scarring.

You should get your acne under control first, if possible.  Accutane is the only medication that cures acne.  However, Accutane is not without side effects - see your Dermatologist for options to treat your acne.

Another option we use for acne is our SkinTyte infrared device - it works similarly to Smoothbeam to stop acne for several months or more.

One more thought, you may have acne Rosacea which is often made worse by microdermabrasion.

Good luck.

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

Many Options Available

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There are many options available for treating acne and acne scars.  While is it true, some people may break out from treatment, most people do not.  The procedure we use most often in our office is the Smoothbeam laser.  It may be something to consider as it help both acne and the scarring.  If someone has darker skin, there is a risk of pigmentation, but it sounds like you might be an ideal candidate.  It is a series of treatments.  You should also be using topical acne remedies, such as Retin A, or similar products, as these can also be helpful for acne and the scarring.

Lisa Benest, MD
Burbank Dermatologist

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.