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So acne scarring is a difficult, complicated topic because the scars are all a little bit different. There's several classes of scar, therefore there's no single device, treatment, drug, or injection that is going to take an acne scar patient and make them completely happy. So we need to look at the type of scarring they have and decide which techniques or technologies or procedures are going to be best for those patients.

Younger patients who have not had cystic acne tend to have shallower scars that will sometimes respond to anything from peels to laser resurfacing procedures. Occasionally, we'll even do a subcision procedure although not as often.

People who have more advanced scarring, who had cystic acne and depressed scars where the skin of the scar itself isn't healthy or normal or they have large areas with deep craters or ice pick scars, they'll need to have a surgical procedure first followed by a series of injections and lasers and some other modalities. We just tailor a treatment plan to each individual based on their scarring and their response.

So may practice is situated in Nashville,Tennessee. We're kind of in the middle of a fairly large area where there aren't as many big metropolitan areas, so patients tend to drive a long ways to see me frequently, and they've usually gotten whatever treatment they can where they live. And so often, they get a treatment and before they finish the sentence, I'm thinking, "I know that didn't work. I know that wasn't successful." And the problem is not so much that there are bad treatments, it's having an understanding of how you treat certain scars. If you do microdermabrasion for deeper acne scars, it'll be a total waste of time. If you do certain types of resurfacing, for example, for deep scars, it's going to be pretty much a waste of time. So the key, really, is matching the treatment to the scar, and that's where there's the biggest disconnect.

There are lots of different places to get aesthetic treatments. There are doctors. There's interns. There's people who do a little bit of aesthetic work on the side. There's med spas that do some facials, and they do a little bit of aesthetic work on the side. When it comes to treating acne scarring, it really is important to find someone who does lots and lots of acne scar treatments who doesn't offer just a single approach or a single laser for treating acne scarring. Acne scarring is very complicated, and that's an area where you really need to do your homework. Worst case scenario is you'll end up with worst scarring due to complications. Best case scenario is you spent a lot of money and have not gotten any results.

What Is the Key to Treating Acne Scars?

Dr. Brian Biesman goes in-depth on the nuances associated with properly treating acne scars.