Acne scarring isn't one condition — it's several. Rolling scars, boxcar scars, and ice pick scars each have different underlying structures, and they respond to genuinely different tools. Our approach to acne scar revision is built around this reality from the very first visit: comprehensive imaging, a hands-on assessment of exactly what type of scarring you have, and a personalized combination plan built from a wider range of technology than most practices offer. It's an approach few practices anywhere take the time to do this thoroughly.
Step One: Comprehensive Skin Analysis
Every acne scar revision plan starts with high-definition imaging using VISIA and AURA, the same advanced facial analysis technology used for our full skin consultations. This gives us a detailed, objective picture of your skin beneath the surface — not just what's visible in normal light, but the underlying texture, sun damage, and skin quality that inform how your scars will respond to treatment.
Step Two: Identifying Your Scar Type Under Multiple Lighting Conditions
Scars don't all look the same, and they don't all reveal themselves the same way under standard lighting. We examine your skin under different lighting angles specifically to identify which type or types of scarring you have — boxcar, rolling, or ice pick — since each one has a different underlying structure and responds best to a different combination of treatments. This step is what allows us to build a plan around your actual scars, rather than a generic acne scar protocol.
Step Three: A Personalized, Combination Treatment Plan
Once we know exactly what we're treating, we build a plan drawing from a full range of technologies — often combining more than one in the same series, and adjusting as your skin responds. Depending on your specific scarring, your plan may include any combination of:
- TCA Cross — a precise, higher-concentration acid technique applied directly into deep ice pick scars
- Subcision — releasing the fibrous bands responsible for rolling and tethered scars
- Biostimulator injections — stimulating your own collagen production to rebuild volume beneath depressed scarring
- BBL (BroadBand Light) — supporting overall skin tone and collagen remodeling across the treated area
- Moxi — gentle, non-ablative fractional resurfacing for texture with minimal downtime
- Halo — hybrid fractional resurfacing combining ablative and non-ablative energy for more significant textural renewal
- ProFractional — fractional ablative resurfacing for deeper textural correction
- Contour TRL — a deeper resurfacing option for more advanced scarring
- RF microneedling — sometimes added to combine microneedling's collagen response with radiofrequency energy at a precise depth
Most patients aren't treated with a single one of these — they're treated with a sequence built from several, matched to the specific scars identified in your assessment.
Follow-Up Refinement: Filler Directly Into Pitted Scars
At follow-up visits, once initial revision has progressed, we sometimes use dermal filler placed directly into individual pitted scars — gently popping the base of the scar up to sit level with the surrounding skin. This is a targeted refinement step for scars that remain visibly depressed after the core revision series, adding immediate, precise correction alongside the collagen-building effect of your earlier treatments.
What to Expect: Timeline and Results
Multiple treatments. Most patients need more than one treatment to see meaningful change. A well-executed revision series typically produces fifty to seventy percent improvement in scarring, built progressively across a planned series rather than a single visit.
Why results keep improving for a full year. Every technology in this protocol works by rebuilding collagen and remodeling the scar tissue itself, not just treating the surface. Collagen lives on roughly a twelve-month cycle, which means your results continue to improve well after your last treatment — your true final result isn't visible until around the one-year mark following each procedure.
Patience is part of the process. Because every modality in this plan is working toward the same underlying goal — genuine collagen remodeling, not a temporary surface fix — sticking with the full series and the full year of healing is what produces the most complete result.