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Treatment of Acne Scarring

The treatment of acne scarring depends on the depth of the scarring. The depth of acne scarring varies and therefore the treatment of acne scarring varies. There is no one single fix-all treatment for acne scarring. Or any type of scarring, for that matter. Acne scarring is mostly a combination of actual scarring (collagen deposition) and volume loss due to tissue destruction.

Acne scarring can be divided into superficial, mid and deep acne scarring. This division corresponds approximately to upper dermis to mid dermis scarring, mid to deep dermis scarring and deep dermis to subcutaneous fat scarring. A single person with acne scarring will most often have more than one type of acne scarring and will therefore require more than one type of treatment.

Acne scarring treated with skin needling
Skin needling for superficial scarring

The treatments below are arranged from superficial to deep treatments. Whatever the treatment options for a given patient, multiple treatments are almost always required.

Upper dermis to mid dermis scarring/volume loss treatments:
Creams and lasers that affect brown and red spots (in cases where there is no volume loss, only color change)
Needling or Percutaneous induction of collagen
Fraxel laser
Fraxionated Co2 laser (especially of skin laxity is a problem, as in older people)

Mid to deep dermis scarring / volume loss treatments:
Subcision – fewer lesions
Hyaloronic acid fillers – multiple lesions

Deep dermis to subcutaneous fat scarring / volume loss treatments:
CROSS technique – smaller lesions
Punch excision and elevation – smaller lesions
Hyaloronic acid fillers – larger lesions
Excision – larger lesions
Fat fillers – larger lesions

11 thoughts to “Treatment of Acne Scarring”

  1. Hi Dr Louw

    I have ben using you as my dermatologist since 2009, my acne is gone but the problem is the scarring it has left especially at the back and chest. to make it worse last month i had chicken pox, now i have more spots in my body. I need something to clear all of this, i am getting married in 4 months.

    thanks Doc

  2. Dear doctor.

    I really need your help. I see that all the above concerns have to do with their faces. My concern lays at my knees. When I was young I was quite active, therfore that left a lot of scarring. I am a coloured girl. The scars appear as a brown mark. It’s embarrassing. I am willing to pay any amount. I would like to know if one of your procedures would cure my current situation. I don’t want to spend a lot of money on a consultation if you can not help me.

    I really do hope that you will be able to help me. Help build my self esteem too 100%.

    Kind regards


    1. Dear Shannon. I’ll only be able to tell what you require once I have seen the TYPE of scars you have. The treatment and cost of treatment, depends on the type of scars. Come in and show me, if you can. That is the first step….

  3. Hi dr Anthony
    I have bad acne scars. I’ve had acne since my teenage years, I’m 26 now. I’ve tried microdermabrasion and all kinds of products. I’m currently using a bleaching cream I got from my dermatologist but he said it could take a while to see results. At this point I’m willing to try anything. I’ve been going to different dermatologists since I was 14, I’ve tried roacutane, I’ve tried it all. Is there any way of removing acne scars for good. Il even try anything surgical.

    1. Dear F. The treatment of acne scars depends on the exact type of scar you have. Bleaching creams will only help for areas of darker pigmentation. Look on the website for all the options. It will be best to come and show me. I’ll then be able to advise you better.

  4. Hie Doc

    I have been really procrastinating about seeing a dermatologist. I have dark African skin which is quite sensitive. It used to be quite smooth then I had large pores and heat induced rush. It was really unpleasant and got a proscription of hydrocortisone and later of betamethasone. The former seemed to work for a while even lightening my skin a little while introducing smoothness. Since I discontinued use of both my skin is very dark and gets easily irritated. I have tired a bunch of facial creams but none really give desired results. My face has become a battlefield of cosmetic wars and I have spent a fortune on them. Please help.

    1. Dear Anthony. Come and show me. I’ll need to make a diagnosis first, before suggesting any treatment.

  5. Dear Doc… What is the best cosmetic/beauty product on the market…
    Going into a store like Stuttafords a person is bombared by all the dif… products…. r they really that effective!!!! I have premature ageing skin and went through the whole beauty counter and still no results….

    1. Dear Sam. There is no such thing as “the best cosmetic product”….as you have discovered. Premature ageing is normally sun-induced. So start with a good sunblock that you apply twice a day for 2 months. Then go and see a dermatologist that might suggest a Retinoid containing cream, laser therapy or whatever else is relevant to the specific skin problems you have.

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