I have some scars on my cheeks I would like to get rid of and I am wondering what type of treatment would be best to get rid of them. One of them is a rolling scar, the rest are icepick I believe.
What Type of Treatment Would Be Best to Get Rid of These Scars? (photo)
Doctor Answers 8
Treating acne scars
In my experience, fractionated resurfacing works the best for the atrophic (rolling) acne scars and 95% TCA applied with the sharp tip of a toothpick for the deep ice-pick type scars works beautifully. This is done as a series of treatments, usually 5 at one month intervals.
A live consultation will be helpful to determine the best way to address acne scarring.
Treatment Options For Acne Scars
Keep in mind that your acne scars are made of thickly configured collagen fibers. They have the same composition as the collagen elsewhere on your skin. But the arrangement pattern is completely different.
Lasers for acne scars basically aim to change the collagen structures of the scar tissue. Heat is deliberately applied to the dermal layer, which responds by producing normal collagen. Over the course of several treatments, this collagen fades out the acne scars.
Fraxel Repair works well, however it is recommended for patients with lighter colored skin. Many patients have been quite pleased with the results of Fraxel Dual, which is safe for all skin tones.
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I recommend Subcision and Fraxel Repair Laser treatement of this type of acne scars.
It appears that you have the classic mid-cheek rolling acne scars. In my hands a combination of extensive subcision and Fraxel Repair laser gives me the best results in a single treatment for this type of acne scars.
There are many treatments for acne scars, both surgical and nonsurgical. Liquid silicone injection is a very good nonsurgical treatment and works well due to it's smoothness and permanence but can cause granuloma (scar tissue) formation or lumpiness if not done correctly.
I prefer the surgical approach which includes either laser, dermabrasion, or both. Although these treatments can be considered non-surgical, due to the depth necessary to treat acne scarring, I consider them surgical. I like the Pixel (Erbium YAG) laser with a high setting and multiple passes. It is performed in the office. Afterwards, you will have scabbing and scaling for 7-10 days but I have seen great results. Dermabrasion is performed in the operating room and smooths the edges of the scar so shadows don't show at the depth of the scar as much. It works very well but requires longer recovery.
Acne Scar Treatments
Based on the photos, it appears you have clusters of broad-based and pitted (ice-pick) acne scars on the cheeks. The broad-based (rolling) scars will do very nicely with filler treatment. In my office, I use liquid injectable silicone (Silikon 1000) for these type of acne scars as it is very precise and permanent. I find pitted scars do best with small punch excision. I recommend you consult a board-certified dermatologist who has a lot of experience in treating acne scarring. Feel free to look at our photo gallery of acne scarring cases treated with liquid injectable silicone and light electrosurgery.
I would recommend fillers
From the pictures I think you'd be best to see a good injector and have some filler (Restylane) put in. I've had great success with scarring like yours and Restylane. Though you will need to have the procedure repeated over the years, I think it will smooth out the scarring and alleviate the deep pocking very nicely.