What are recommended treatments for severe acne scars if derma rollers and CO2 fractional lasers are ineffective? (photo)

Doctor's Answers (2)

Dr Chin Yee Choong

"Dedicated to the ethical practice of Aesthetic Medicine"

For severe acne scars, treatment results tend to be poorer.

You may consider the following strategies:

  • Opt for more aggressive Fractional CO2 laser treatment parameters.
  • Consider combination treatments such as subcision, scar excision. 

Fractional CO2 Laser Treatment is effective for treating most kinds of atrophic acne scar and has a downtime of 5 - 10 days.

Subcision is when a small needle is used to release the fibrous scar tissue beneath the scar. As the area heals, the new collagen also helps to push the base of the acne scar up.

Scar excision involves using a tiny hole-punch like device to cut out the acne scar. The wound is then sutured closed, with the stitch removed within a week 

For severe acne scars, sometimes only 20-30% overall improvement may be achieved.

 For your acne scars, personally I would recommend:

  • Subscision
  • Fractional CO2 Laser Treatment (you will most likely require stronger settings as Dr Chin has mentioned)
  • TCA CROSS for some of your ice pick scars. Ice pick scars respond greatly to Chemical Peels, TCA Cross.

Dermal Rollers will not have effective results. Dermal Rollers are treatment tools with microneedles that are used to create micro punctured holes so that the skin will secrete collagen to the micro punctured holes in order to repair the damaged skin cells. 

I think there is definitely still room for improvement so do not lose hope yet.


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