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Acne Scarring

Acne scarring is a very common complication in patients with acne. Scarring can be disfiguring, leading to embarrassment, and can be emotionally devastating, affecting self-esteem. 13% -19% of adolescents suffer with depression from the negative impact of acne scarring which can lead to a diminished quality of life. Acne scars also become more noticeable as we age.

Acne scars are best treated with combination therapies including lasers, chemical peels, fillers and resurfacing. Lasers smooth out the scars. Fillers fill the scars. Some of these therapies can also address the discoloration from acne scars. Dr. Devorah Shagalov offers many state-of-the-art options to improve acne scarring depending on the type of scar and the severity of the scarring. She will ask you about your aesthetic goals when determining the best treatments for you. The choice of treatment will depend on the type of your scars.

There are several types of acne scars characterized by how they look on the skin. Generally acne scars are depressed scars. They appear as small indentations in the skin caused by a loss of tissue and too little collagen. They can look like rolling scars, ice pick scars or boxcar scars. Raised scars are the result of excess tissue formation during healing and are more common on the chest and back. Acne can also cause discolorations that are not scars and usually fade over time.

  • Rolling scars appear as a wave-like pattern and can be shallow or deep. They are typically caused by cystic acne. Rolling scars are usually treated with dermabrasion or laser resurfacing.
  • Boxcar scars are one of the most common types of scarring caused by acne. They are characterized as depressed areas with sharp edges and often appear in clusters. Boxcar scars may be shallow or deep but can generally be treated effectively with dermal fillers, subcision, punch excision, or laser resurfacing treatments and other techniques.
  • Ice pick scars are narrow, deep scars that look like a puncture wound. They form when clogged pores become inflamed and break down the deeper layers of skin, resulting in a textural defect. Icepick scars cannot be filled with collagen or other fillers. They must be removed surgically or with laser treatments.
  • Hypertrophic scars are large, raised bumps caused by an overproduction of collagen during the healing process.

Treatments for acne scarring vary depending on the type and severity of the scarring. Some treatments may be used to reduce their appearance, while others can help improve skin texture and color.

Acne scar surgery

Subcision involves using a fine needle to break up the fibrous bands that cause scarring. Punch excision involves cutting out the scar and closing up the wound with stitches.

Chemical Peels

Chemical peels remove the top layer of skin and are used to treat shallow scars. When the skin regenerates the surface of the skin is smoother and less marked.

Dermal Fillers

Fillers like Bellafillâ, Sculptraâ, Restylaneâ and Juvédermâ can be used to treat moderate to severe acne scarring to improve the appearance of depressed acne scars. Fillers works to instantly add volume which lifts the scar tissue to the level of the surrounding skin to blend the scar. Some fillers also stimulate collagen production to fill the scar for longer lasting results.

Steroid injections

Steroid injections can sometimes improve the appearance of raised scars.

Botox injections

Botox injections can improve puckered scars by releasing the surrounding skin. Repeated treatments are needed to maintain benefits.


Dermabrasion is used to treat severe scarring. According to the Mayo Clinic this procedure involves the use of a device to remove the top layer of skin. Surface scars can be completely removed, and deeper scars can be improved. There are risks. Speak with Dr. Shagalov about this option.

Laser Light Treatments

Laser treatments work by using light energy to penetrate the skin, causing collagen production and ultimately resulting in smoother texture. This can dramatically reduce wrinkles, scars and acne scarring depending on the type of laser used. For optimal outcome, multiple sessions may be necessary.

Laser skin resurfacing

The procedure involves the use of high energy light to remove damaged skin and recontours the edges of acne scars, making scars less noticeable. It also stimulates production of new skin cells and collagen resulting in a more even complexion and smoother texture. It is often recommended when there is widespread scarring.


Microneedling is also called collagen induction therapy because it stimulates production of collagen to fill in depressed scars.

Radiofrequency therapy

This method utilizes heat energy to target the deeper layers of skin and stimulate collagen production, resulting in smoother skin texture and reduced scarring. It can also be used to reduce redness, discoloration, and wrinkles associated with acne scars.

If you’re suffering from acne scarring contact Miami’s leading dermatologist, Dr. Devorah Shagalov. She is a board-certified dermatologist and dual board-certified Mohs surgeon and cosmetic dermatologist. She can help improve your acne scarring to improve your appearance and help to restore your confidence and self-esteem. Biscayne Dermatology is located in Midtown Miami on the border of Edgewater and Wynwood a few blocks from the Design District, Miami Beach, and Downtown Miami.

At a Glance

Dr. Devorah Shagalov

  • Double Board-Certified Dermatologist
  • Fellowship-Trained Mohs Micrographic Surgeon
  • Recipient of numerous dermatology awards
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