Acne scars can be frustrating because the skin used to be smooth. Then there was inflammation, the area healed differently, and a dip or uneven texture was left behind. Some scars are tethered by deeper fibrous tissue, while others come from lost tissue in a different pattern. That's why I don't think of scar treatment as simply polishing the surface.
How can inflamed acne leave a depression?
Inflammation can damage the normal skin structure and collagen. As the area heals, some tissue may be lost and certain scars become pulled downward. The result can be a visible hollow, especially when light hits it from the side. But not every acne scar is tethered in the same way.
First: is there a tether that needs releasing?
For suitable rolling scars, subcision may help release fibrous bands beneath the skin. I see it as one possible part of a plan, not something that should be done to every scar on a face. Ice-pick and certain boxcar scars can require very different thinking.
Second: what can we do about the remaining skin texture?
After considering any tethering, we still need to assess the tissue and surface texture. There may be a role for further treatments depending on the scar type. Products such as PN/PDRN or so-called liquid thread should not be assumed to replace established methods; their place depends on the exact preparation and case. Our clinic does not currently offer laser treatment for acne scars.
Will it take several sessions, and will the skin look 100% normal?
I never want to promise that every scar will disappear. Improvement is a more realistic goal than perfect restoration. From what I've seen, some patients need several sessions—sometimes around three to five—but the number isn't a rule or a guarantee. We should judge each step before deciding whether to continue.
Active acne needs attention too
If new inflamed spots keep appearing, new scars can form. That is why controlling the active acne belongs in the discussion alongside any scar treatment.
One face can have different types of scars
A person might have shallow rolling scars on one cheek, narrow deep scars elsewhere and a few dark marks over the top. Treating the entire face as if every mark were the same wouldn't be fair to them. I prefer to explain the different areas and what each treatment is meant to address.
Common questions
Will subcision remove every acne scar?
No. It is a technique considered for certain tethered scars, not every scar shape.
Do you offer acne-scar laser treatments?
Not at present. We can explain the treatments we do provide and when another option may be more suitable.