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Physician Clinical Exchange > Acne Scarring

What really works? I've had success with isolated scars, either excising or doing subscision and filler. Patients with large areas of atrophic scarring (especially "ice pick" type), we decline to treat. I think that C02 laser or true dermabrasion (we do neither) are the best options. Has anyone had success with non-ablative or fractional ablative techniques?

We treat acne scars with a combo of MicroLaser Peel followed by Profractional. I am an esthetician so I do not perform the procedures, just assist. This seems to be the best treatment I've seen so far.

Med Spa Esthetician


Why combine mlp with pfx for acne scarring? What possible additional benefit would it have other than adding 20 microns of ablation which isn't even going to touch a fine line, much less an acne scar. I love how people talk like combining a par for the course fractional erbium with 20 or so microns of ablation is somehow the silver bullet. Where's the science behind it?

01.17 | Unregistered Commenterskeptic

For severe acne scarring subsicion + silikon + resurfacing for the best results (I tend to lean towards C02 or C02 fractional). Ice pick scars need to be closed from the top, resurfaced to address the midpoint of the scar and break up the scar tissue, and then filled to plump up the lost tissue from beneath.

01.17 | Unregistered Commenterskeptic

I have a Cynosure Affirm laser and it works great with acne scarring.

The machine is for sale if there are any takers.

The Cynosure Affirm? Are you serious? Please stop interfering with discussion by trying to hock your junk on us,

01.19 | Unregistered CommenterSay what?

Fraxel laser treatments are impressive in terms of diminishing the scar and improving skin texture.

03.15 | Unregistered Commentercwm214

Fraxel is alright. Not that impressive in our practice. Just provides so-so results. This treatment doesn't completely smoothen the texture of skin with acne scars. I believe 90% TCA peels do the job.

06.22 | Unregistered Commenterysh726

We've been using Fraxel by Solta on dark skin types. But use this with extra caution as there might be hyperpigmentation post treatment.

06.26 | Unregistered CommenterNina

I have seen my patient's scars improve six months post- ablative fractional CO2 laser resurfacing.

07.23 | Unregistered CommenterDD

Fraxel laser treatments offer impressive improvements in skin texture and acne scars. However, there are a lot of companies with fractionated lasers out there. These are pretty expensive devices. But if you have money to burn, why not?

07.24 | Unregistered Commentera. fowler

The Palomar Lux 1540 does a very good job with acne, especially with pinpoint scars.

08.6 | Unregistered Commentermia f.

Acne scarring is very difficult to treat and even the most effective modalities will not produce 100% improvement. With that said, there are a variety of treatment modalities that we provide depending on the type of scarring and skin type. For example, easily "stretchable saucer" shaped scars are best treated with dermal fillers while "Ice Pick" bound down scars are best treated with our Total FX fractional C02 laser. However, in order to choose the most appropriate treatment it would be best for the prospective patient to be evaluated in the office with a complimentary consultation.

Or you might want to consider IPL or light based treatments--these are affordable..and less expensive.

TCA peels works wonders. It's an affordable treatment modality than lasers.

wouldn't it be better if we advocate for early prevention of acne? i saw a terrific post of Dr. Seiler on acne. we should educate our patients first.

09.21 | Unregistered Commentergustavo

I'm curious to know if anyone here has been using blue light to treat acne?

09.22 | Unregistered CommenterLauretta

I've been treating depressed acne scars and icepick scars with laser resurfacing. My patients are happy with the results. So far, no complaints.They've been seeing continuous improvements up to 18 months post procedure.

Light therapy is a tool in our box of options for treating the bacteria. It works well for some but home care is important. The red scars can be treated with IPL or laser.

10.16 | Unregistered CommenterAlthea

Blue light works on bacteria and acne is not a bacteria problem. It is a problem of skin cells building up too soon under the skin. Until you address this issue, you will not clear the skin.

10.18 | Unregistered CommenterAl Akrom

I have used blue light tx. It really helps if the client gets a home use light and uses it 3x a week for 15 minutes daily. In my opinion, healing is slow and requires more or less 12 weeks of treatment to see a difference. I use the telsa high frequency for inflammed acne and see a difference in the scarring and keeps the skin clear.

I use Evado blue Lambertane LED light with wavelength 420 nm for treatment of acne. Patients come to my clinic twice a week for several weeks. They use home treatment to clam their skin. When the active acne has calmed down we use our Hydrafacial for treatment of the scars. The effect is amazing!

11.10 | Unregistered CommenterFlorijn

C02 resurfacing does well in improving scar appearance. however, there is a risk of dyspigmentation.

11.15 | Unregistered CommenterMDceyak

we've been seeing superb results with fraxel and patients have been coming back but this procedure is extremely pricey.. this works well w/ asians, without the dyspigmentation.

I choose not to use Laser but prefer IPL as an option. I agree that a more aggressive treatment is necessary for the scarring depending on the type of scars. But I also like the gentleness of the LED. It's a more progressive approach to healing.

12.5 | Unregistered Commentergabak

Peels are very effective in halting or slowing down the problem of acne.

I have been using blue light therapy, It would also be great if the patient has a home use light and use it 3x a week for 15 minutes daily. It is a progressive treatment, rather slow and takes approximately 3 months to see a difference. I use the telsa high frequency for inflamed acne and see significant results. Skin appears to be clear on the first visit.

01.9 | Unregistered CommenterD.O.

Hydra facial is awesome. I saw it at the show in Chicago but wasn't able to get it because of the limited budget.

01.28 | Unregistered CommenterErica B

A Led is 1 100th of a jl, so scarrring will be better addressed with a more powerful light. I have used IPL and Laser to improve the pigmentation issues from acne scars .

02.17 | Unregistered CommenterDVM84

We bought Vbeam a year ago. We were surprised that we can treat rosacea but also scarring with this! Remarkable results, I tell you.

Our treatment of choice is microdermabrasion then alternate it with TCA or Jessner peels. Results are very consistent and don't disappoint.. For deep scars, we refer our patients to dermatologists for dermarolling/needling.

04.27 | Unregistered Commentern.imsi

Fraxel is widely known as the best treatment for acne scarring. We use it in combination with hydroquinone, normally 4%. At least 4 treatments are needed for best results.

05.8 | Unregistered Commenterkristi

Using the premise that out skin is mostly collagen, elastin & water, I want to infuse these into their skin to retain their moisture and avoid drying out with BP. I find the collagen & elastin gels + LED red light help promote faster healing from the inflammation & scarring.

05.17 | Unregistered Commentero'sullivan

We sometimes use retin A home treatment combined with Dermaroller. However, prior to dermaroller, the client is advised to stop retin A for a few days. Post procedure, we advise them to stop Retin A for a week, then resume Retin A thereafter.

05.26 | Unregistered CommenterKBaker

The best options are laser treatments with the V-beam and pearl lasers or peels.

08.18 | Unregistered Commenterd.k.

Interesting discussion panel.

You brought up a lot of good techniques.

In truth, there is no "one" treatment that is the best for acne scarring. I pick and choose the best treatment or combination of treatments for each patient. We perform TCA Cross 90% acid, punch excisions, elevations, and grafts, fractionated CO2, microlaser peel, profractional, Erbium ablative, subscission, Belotero dermal filler, Sculptra, and other procedures for acne scarring.

I recommend you seek a doctor that is experienced in many techniques and can give you a comprehensive evaluation.

Hope this helps.

09.14 | Unregistered CommenterMichael L

I use Fraxel repair or Fraxel dual depending on my patient's needs and skin type.

11.7 | Unregistered Commenterazevedo

What do you use on your clients with deep acne scarring?I'm thinking of peels and microderm for resurfacing the skin and suggested home care products.

04.22 | Unregistered CommenterJames B.

James B., Fraxel treatments work well. Microdermabrasion, retin-a, and VI peels help too.

05.1 | Unregistered Commenterem

Microneedling with Rejuvapen seems to be one of the best technologies right now. Adding a vitamin A based product along with some growth factors for home care and you'll see a great improvement in scarring.

05.5 | Unregistered CommenterSchwidtz

Definitely microneedling. Whatever your method, the protocols recommend the use of a viable Vitamin C and Retin A or clinical strength Retinol to help thicken the skin. I also like to include growth factors for wound healing. These are used in between recovery times and the Retin A is stopped 1 week prior to procedure and restarted 1 week post procedure. I like the Dermapen but tattoo needling is highly effective and for certain types of wrinkles and scarring I think more effective then any other tool currently on the market. Make sure you're legally allowed to do this procedure as I have heard of infections from people who are legally allowed to do this procedure. Just saying if you do it illegally and have infections could be a potential legal problem for you. It's not a benign procedure.

05.7 | Unregistered CommenterJenny

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