Dr. Nina Patel
Cosmetic Dermatologist, MD, Board-Certified Dermatologist
Acne scar treatment is best approached with a multi-modal strategy since different scar types respond to different treatments. For ice pick scars (deep and narrow), TCA CROSS (chemical reconstruction) or punch excision works best. For boxcar scars (wider with defined edges), fractional CO2 laser or subcision provides significant improvement. For rolling scars (broad, wave-like), subcision combined with filler or microneedling is effective. Most patients benefit from a combination approach: subcision to release tethered scars, followed by a series of fractional laser treatments (3-5 sessions) and microneedling with PRP. Expect 50-80% improvement over 6-12 months of treatment. Complete elimination is rare, but significant improvement is achievable for most patients. Start with a dermatologist who specializes in scar revision to create a personalized treatment plan.