Treatments for Acne Scars

Watch Dr. Irwin's short video on treatment options for acne scars
  • Subsicion – in combination with fillers and lasers for scars from acne
  • Fraxel – better for mild acne scars
  • Fractional CO2 Resurfacing – best for deep acne scars
  • Punch Excision – best for deep acne scars

Learn more about treatment options for brown spots from Dermatologist Dr. Irwin:

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Video Transcription 

Dr. Brandith Irwin:
Welcome to I’m Dr. Brandith Irwin. We are going to provide you with expert unbiased advice on skincare and cosmetic dermatology. Today I’d like to talk about briefly acne scarring. First of all, most acne scarring, maybe I might even say all now is preventable. So if you have inflammatory acne that is persistent, very inflamed or cystic, please, please, please, see your dermatologist and get the appropriate medication so that you will not develop acne scarring. Again ninety percent of the time now or more acne scarring is completely preventable. If you do have acne scarring from whatever, you know, your teens or and whether your thirty years old or fifty-five years old, it’s really nice to get that treated. And there are quite a few options now in terms of what is available.

So I’m going to talk mostly about lasers and acne scarring, but I’m going to talk briefly about another technique, which is called subcision. Subsicion is used in many offices and sometimes in our office we will still use subcision in combination with different lasers. Sometimes we do that one the say day sometimes we dot hose procedures on different days. That’s actually more common. So with subcision with skin is numbed and the scars the areas of scarring are marked. The areas are then numbed often with a little bit of injectable lidocane. And then a special needle is taken and inserted underneath the scar and moved around in all directions under the scar to break up that fibrous tissue that is a scar. That what that does is it creates a little pocket under the skin that’s invisible and the pocket fills in with new collagen, which pushes the base of the scar up. Usually one treatment is not enough, but each treatment will improve it. Then again we will often use subcision in combination with lasers. Another common technique for acne scarring is to inject a little bit of a filler substance into the base of the scar. Sometimes that’s a little tricker than it sounds because the way scar tissue is under the skin, the filler doesn’t always move evenly into the area under the skin. A lot of times what I like to do is create a little pocket with that special subcision needle and then put a little filler into that pocket, which is more which is a little more accurate. But it can be done on its own and for mild acne scarring that may be a perfect, inexpensive way to treat acne scarring. Again it’s effective and lasts usually six to nine months even sometimes up to a year.

The best way to treat acne scarring in my opinion is with a combination of techniques.  Again a laser perhaps sometimes a little bit of filler. But the lasers we have now for acne scarring are vastly improved. Though sometimes a laser may be enough and other techniques may not be needed. So if you have a little bit of acne scarring, a Fraxel laser might be the perfect choice for you. Those have to be done in a series, but there is very little downtime. You can get those done on a Thursday or Friday and be back at work with makeup usually on a Monday. The other choice is the carbon dioxide laser. If you have deep acne scarring or a lot of acne scarring, expert a week or so of downtime. Even with the carbon dioxide lasers they heal much faster than the old what are called ablative carbon dioxide lasers you might read about on the web. Make sure when you’re doing research on these lasers that you distinguish between the old ablative carbon dioxide lasers and the newer fractionated ones. The risk of complications is so much less with the fractionated ones. And a carbon dioxide fractionated laser may need to be done in a series and sometimes I’ll recommend two treatments or sometimes even three with the carbon dioxide laser to get the best result if there’s a lot of acne scarring or its deep. There are also techniques for very deep scars where they can be what’s called punch excisions where they can actually be punched out and then resurfaced over the surface to create a smooth contour. So there are lots of different options again see a really great cosmetic dermatologist who is experienced and I think you’ll get wonderful results and be very pleased. Please see our guide to acne scarring on and I hope you enjoy our site.

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin, and I believe that consumers need and deserve a medically trained and unbiased skincare advocate.

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