Acne Scar Treatment

Top Treatment Options for Acne Scars

The Dermatology and Laser Group, located in the heart of New York City, offers a variety of treatments targeting different types of acne scars, including:

• Laser therapy
• Chemical peels
• Microneedling
• Subcision

Each treatment is designed to target specific types of acne scars, such as ice pick scars, rolling scars, and boxcar scars, which require unique approaches to achieve the best results.

The best treatment plan for each individual’s acne scarring will be determined together with the patient at the consultation.  We will discuss the history of your acne, the scarring, your general internal and skin health, and your goals.  Some of our best acne scar improvements are achieved by combining two or more treatments together.  Treatments we use to treat acne scar include:

Fractional Laser Treatment

Fractional Laser Resurfacing improves acne scarring by creating tiny channels in the skin with laser energy.  This activates the body’s wound healing pathway producing new collagen to support the elevation of the depressions, and resurfaces the skin to make the skin texture and tone more uniform.  We have a variety of ablative and non-ablative fractional resurfacing lasers in our office.  The most powerful Acupulse CO2 laser for Laser Skin Resurfacing in NYC has the benefit of fewer treatments needed to achieve results because of its high energy, but can cause up to 2 weeks of downtime.   Our fractionated application of a picosecond laser, the PicoWay Resolve will only cause mild redness for a few hours, but would require many more treatments to achieve the same results. A non-ablative fractional resurfacing laser such as ResurFX is a powerful option with 2-4 days of redness following treatment.

Laser therapy has shown to diminish discoloration and promote collagen remodeling, making it a potential acne scar treatment permanent solution for some patients.

There are a varitety of other lasers we use for the redness and hyperpigmentation seen in acne as well. Each acne scar laser treatment targets specific issues related to acne scarring.

Chemical Peels

Chemical Peels involve the application of an acid to the surface of the skin.  This acid denatures proteins in the skin, starting an inflammatory cascade that leads to collagen remodeling and superficial resurfacing of the skin.  This can not only help with hyperpigmentation on the surface of the skin but it can also help generate collagen to help with atrophic scarring. One particular application of chemical peels is called TCA CROSS (chemical reconstruction of skin scars), where a very high concentration of acid is placed in the center of ice-pick scars to induce the remodeling of collagen in the walls of the scar. TCA CROSS has become less popular in recent years as advancements in other techniques have developed.

We also use chemical peels for ongoing mild to severe acne treatment.

Microneedling Treatment

Similar to fractional laser resurfacing, medical microneedling is used to create tiny pokes in the skin to activate the body’s wound-healing pathway to generate new collagen and resurface the skin.  With microneedling thousands of tiny wounds are safely created with stainless steel needles that are thinner than a human hair in diameter.  Microneedling has the advantage that it can be used in darker skin tones where laser is not desirable, and it can also be used to microinject into the skin any fluid that can boost results.

To treat acne scars in our NYC office we often combine microneedling with either PRP (platelet-rich plasma) or AnteAGE Growth Factor Serum.  Both of these substances introduce growth factors into the skin, further signaling to the body to activate the process of generating collagen.

Plasma Pen Treatment

Plasma pens use very high heat to create a wound in deeper acne scars to induce remodeling of collagen from the inside out.  This technology can be useful for isolated deeper scars when used in conjunction with other procedures such as fractional laser resurfacing or medical microneedling.

Punch Microsurgery

Punch microsurgery can be combined with the procedures above to tackle the deepest of acne scars that are unlikely to have satisfactory improvement from collagen remodeling alone. A small device is used to remove the scar surgically and sutures are placed to close the skin.  Once healed the removal sites can be resurfaced along with the rest of the skin.

Subcision

For certain types of scars we insert a needle under the skin with the purpose of releasing the fibrous tissue tethering the skin down.  As new collagen develops some will develop under the acne scars without reforming a depression.

Fillers

Dermal Fillers can be injected under scars to elevate them and add a temporary benefit as we wait for more permanent benefits from other treatments.

Biostimulator Treatment

Certain fillers can be diluted and injected under acne scars with the purpose of stimulating collagen synthesis.  Used this way the benefits of fillers are more long lasting or permanent.  In early 2023 we are expected to have new biostimulating agents FDA cleared with the purpose of stimulating collagen synthesis without adding volume, giving us more options to boost our results for acne scarring treatment.

Treatment of Erythema

Redness, or erythema in acne scars is another complicating factor that can make the appearance of acne scars worse.  We have lasers that specifically deal with redness and eliminating the dilated blood vessels associated with some acne scars.

Treatment of Hyperpigmentation

Hyperpigmentation, or darkening of skin, is another complication of acne scarring that can be very distressing for patients.  Hyperpigmentation is typically more common in darker skin tones.  Lasers, microneedling, and chemical peels can all help reverse hyperpigmentation.

Special Considerations for Hypertrophic (raised) Scars:

For raised scars, in addition to the above treatments to improve skin texture we would also inject the scar with triamcinolone to reduce the size and thickness of the lesions.

Treating Acne Scars on Darker Skin Tones

Treating acne scars on darker skin tones can be challenging, as not all treatments are suitable for every skin type. However, microneedling, chemical peels, and certain lasers are all viable options for reversing hyperpigmentation and improving acne scars in darker skin tones. These treatments can be carefully tailored to each individual’s unique skin tone and needs by a skilled dermatologist. For example in darker skin tones we may favor using medical microneedling with Growth Factor infusions.

In addition to the treatments mentioned above, other topical options, such as azelaic acid and alpha hydroxy acids (AHAs), can also be effective in reducing post-inflammatory hyperpigmentation. By working with a board-certified dermatologist experienced in treating acne scars on darker skin tones, patients can achieve a significant improvement in their skin’s appearance and overall health.