Treating Acne Scars With Dermal Fillers

Dermal fillers, commonly known as a ‘liquid facelift’ are a popular, non-surgical cosmetic treatment. These injectables plump skin and lips, smooth wrinkles and restore lost volume with natural ingredients. What you may not know, is that dermal fillers can also be used to address acne scars.

What Are Acne Scars?

Acne scars are indentations on the skin where cystic acne once was present. The skin-colored marks are not normally red or brown, but their texture can make them appear highly visible. Acne scars can extend the embarrassment and discomfort associated with cystic acne, long after the acne itself is cured.

What Causes Acne Scars?

Cystic acne alters the skin’s cellular structure by damaging collagen fibers underneath the surface layers of the skin. Once the inflammation of a breakout subsides, the skin can at last attempt to repair itself. But when new collagen is formed, it’s generally not as even as it was before, which results in scarring.

Scarring is more likely to be prevalent if you squeeze or pick at your acne. While acne scars on the face are normally indented, acne on the back or chest can form keloid scars, which are raised or lumpy.

Treating Acne Scars with Fillers

Dermal filler treats acne scars by plumping underneath the depressed tissue. While your skin will not look ‘perfect’ after treatment, dermal fillers do have the potential to dramatically reduce the appearance of scars, and may spur a more accelerated natural healing process.

How is the Treatment Performed? 

Acne scar treatment with dermal fillers commonly uses hyaluronic-acid based fillers such as Juvederm or Restylane. Your doctor will first cleanse the area to be treated, and then review which scars will be filled. The amount of filler needed depends on the severity of your scarring, and the number of areas to be treated. A tiny needle is then inserted into the scar, and the area behind it is plumped with filler.

What Results Can I Expect?

Results should be immediately visible, although you may have some minor swelling or redness at the injection site. While your skin will not look exactly as it did before your acne, you should see improvements in overall smoothness.

Are Results Permanent? 

Depending on the type of filler, dermal fillers last approximately 3-6 months before becoming reabsorbed by the body. However, hyaluronic-acid fillers are known to boost the body’s natural collagen production. Thus, treatment with dermal fillers may help break up scar tissue, resulting in long term improvements.

To keep prolong filler results, periodic (maintenance) injections are recommended every 6 months.

Can Dermal Filler Treat All Types of Acne Scars? 

Dermal filler works best for isolated (versus widespread) scarring, and may work better for some types of acne scars, although all types can be treated. Fillers may be used on any area of the body, not just the face.

Rolling Scars: Rolling scars are wide, circular, depressed areas of the skin and respond best to treatment with dermal filler.

Boxcar Scars: Boxcar scars are circular or square shaped indentations with a more clearly defined border than rolling scars. These too, respond well to dermal fillers.

Ice Pick Scars: Ice pick scars are deep, triangular shaped indents that are often the results of picking at acne. While they can be more difficult to treat with dermal filler, it is possible to see favorable results.

Macular Scars: Macular acne scars are red or hyperpigmented, but generally flat. Dermal filler will not change the color of these types of scars, nor reduce their appearance. Alternate treatments are suggested.

Keloid Scars: Keloid scars are raised, lumpy scars which results from the body over-repairing an area with scar tissue. Because these types of scars are already raised, alternate treatment is suggested.

Mixed Acne Scars: Most commonly, people have a mix of the above types of acne scars. Mixed scarring responds well to combination treatments, in which dermal filler is combined with a complementary scar revision method.

Alternate Acne Scar Treatments

For best results, dermal fillers may be combined with alternate acne scarring treatments. Common alternate treatment methods include the following:

Laser Skin Resurfacing: There are two main types of laser skin resurfacing, ablative and non-ablative. Ablative lasers remove the top layer of the skin, while non-ablative lasers stimulate collagen by targeting deeper layers of the skin. Which type works best for you depends upon the type of scarring you have, and your tolerance for down time. 2-5 treatments are suggested for best results.

Microdermabrasion: Microdermabrasion is an in-office treatment that works best for minimal scarring. The in-office procedure exfoliates the top layer of skin to remove dead skin cells and stimulate collagen production. It can also help prevent new acne from forming. 2-5 treatments are suggested for best results.

Chemical Peels: Chemical peels smooth skin by promoting skin cell turnover and collagen growth. A chemical peel can also help with scar-related discoloration, something which dermal fillers cannot do on their own. 2-3 treatments are suggested for best results.

Microneedling: Microneedling uses a roller or a pen-like device to deliver thousands of miniscule pin pricks to the skin’s surface. This stimulates collagen production for a skin-smoothing effect. This method may be more effective for darker skin types.

Surgical Scar Removal: Surgical scar removal is a possibility for raised keloid scars, and is also effective for deep ice pick scars. Typically, surgery is followed by one of the above methods at a later date.

If your acne scars are bothering you, there are several treatment options available. Consult with your dermatologist to find out if your scars are well suited for a dermal filler treatment, another method, or a combination of approaches.

Dr. Malini Fowler is a Board Certified Dermatologist that completed her undergraduate studies and graduated summa cum laude from the University of St. Thomas in Houston, Texas. She is a fellow of the American Academy of Dermatology and member of the American Society for Dermatologic Surgery. Dr. Fowler enjoys providing medical, cosmetic and surgical dermatology at our new San Antonio office.