Best Dermal Fillers for Acne Scars: Which One is Right for You?

Types of Acne Scars That Dermal Fillers Can Treat

Atrophic scars are indentations in the skin caused by incomplete or improper restoration of the skin. These scars form below the skin layer and make the face rough.

There are 3 major types of atrophic scars

• Ice pick scars: These are narrow, deep, and pointed scars. They resemble deep pores
• Boxcar scar: This is broader. It has a flat base and defined borders.
• Rolling scars: These are uneven scars with indistinct edges.

Fillers usually work best on rolling and boxcar scars. It is less effective on ice-pick scars as they are deeper in the skin. Certain boxcar scars can also be problematic because of the depth and defined borders of some of them.

The deeper the scars, the less effective the dermal fillers are on them. This is why they don’t work so well for ice-pick scars.

Most Common Dermal Fillers for Acne Scars

Dermal fillers are very popular in the US. Because they are minimally invasive and have little risk, they are a choice treatment among many patients.

Here are some very popular dermal fillers:

1. Hyaluronic acid-based fillers

• Hyaluronic acid: Hyaluronic acid occurs naturally in the body. It is why the skin looks hydrated and supple. It is key in wound healing and progressively decreases as you get older. 

The common hyaluronic acid fillers include:

• Juvederm
• Restylane
• Belotero
• RHA

Hyaluronic acid dermal fillers can also stimulate collagen production. By this, it heals and fills up the atrophic scar.

Hyaluronic acid fillers are transparent and malleable. This means they are easy to smooth out, and there is less risk of clumping. The skin will look natural following the procedure.

 Pros

• Transparent gel and easy to manipulate
• Smooth results
• Natural-looking results
• Can remove when the desired result is not achieved
• Rarely causes reactions

Cons

• No long-term result
• This could lead to swelling and bruising

2. Calcium Hydroxylapatite

Calcium Hydroxyapatite (CaHa) fillers (brand name Radiesse) are also used to fill the depression from the acne scars. They are biocompatible and contain CaHa microspores in an aqueous gel. 

It contains calcium and phosphorus, which occur naturally in the body. It stimulates collagen production.

Calcium hydroxyapatite is usually diluted with anesthetics and is thicker than hyaluronic acid.

Because it is thick, there is the fear of clumping and nodule formation after some time. It is also not easily reversible. For this reason, it is not commonly used by professionals.

Pros

• More radical results
• Longer lasting
• Better for deeper scars

Cons 

• Not easily reversible 
• Whitish appearance
• Possibility of nodule formation

3. Polymethyl-Methacrylate (PMMA)

Polymethyl-methacrylate, called Bellafill, is a collection of microspores that give semi-permanent results when used as fillers. When injected under the skin, it stimulates collagen production. It can be used for treating acne scars, but like Radieese, it is not reversible if nodules or unanticipated results form. The results can last up to 5 years.

Pros

• Causes collagen production
• Semi-permanent result

Cons

• Not reversible and long lasting if happy
• Possibility of nodule formation

4. Poly-L-Lactic Acid (PLLA)

Poly-L-lactic acid can be used as a dermal filler. It is a synthetic filler and builds back lost collagen.

It takes about 6 weeks for results to appear, unlike most other fillers that are instant. However, the results can last over two years. The most popular brand of PLLA is Sculptra. It can work well for filling rolling scars.

Pros

• Restores collagen production.
• Filling produced by your own body

Cons

• Possibility of lump formation
• It cannot be dissolved

5. Autologous Fat Transfer

Autologous fat transfer, also called fat grafting or microlipoinjection, is a natural dermal filler treatment procedure.

Fat is taken from your own body and used to fill the depressions of the acne scars.

The first step is to harvest the fat from other body parts via liposuction. The parts of the body good for fat harvesting include:

• Belly
• Buttocks
• Thigh
• Hips

After harvesting the fat, it is purified and injected into the acne scar area. This may or may not give long-lasting results depending on viability and vascularization of fat cells transferred. Usually, fat cells are degraded in the ultra-filtration process to make them safe/non-lumpy for superficial placement. There’s also a longer recovery time because of the liposuction done.

Pros

• Self derived
• More natural look
• Possibly long lasting if vascularizes 

Cons

• Not suitable for superficial scars
• Requires liposuction
• Longer recovery time
• More invasive
• Possibility of non-reversible lumps 
• Volumizing

How to Choose the Right Filler for Your Skin

How do you choose the right filler for your skin? Here are things to consider when choosing the filler to use:

• Skin Type: Here’s something to consider when choosing the filler to use. Different fillers work differently with thick vs thin skin types. Also, with the amount of fatty tissue under the skin.  Knowing your skin type and what filler will work best for you is vital!

• Severity of Scar: The depth of the scar will also matter. Deeper scars will require a different filler type than shallow scars. At certain depths, you may need to consider other treatment options

• Longevity and Cost: Knowing how long you desire the filler to last will help you choose the right filler for you. Your budget is also a strong consideration.

A consultation with one of our experts at Cosmetic Injectable Center Medspa will help you make the best choice of filler for you. They will explore your desires and guide you toward the right filler choice.

Procedure & What to Expect

The treatment starts with a consultation session with our experts. We will explore your desires, show you the potential risks, and ensure you’re a good fit for the treatment. We will also present the pros and cons of alternative treatments compared to fillers. 

During the treatment, the applicator will clean the treatment area and inject the filler under the skin.

It is minimally painful. For those with lower pain thresholds, a numbing gel is applied.

Risks and Side Effects of Dermal Fillers

Some common side effects of the Dermal Fillers procedure include:

• Bruising
• Swelling
• Tenderness
• Discoloration
• Pain
• Lumps

In rare cases, dermal fillers can produce serious side effects. This happen due to recipients immune abnormalities, piercing through a nerve, or if the filler is injected into a blood vessel. These include:

• Permanent scarring
• Stroke
• Visual impairment
• Keloid
• Numbness

Alternatives to Dermal Fillers for Acne Scars

Other treatment options are available for treating acne scars. They include:

• Microneedling: This is a minimally invasive treatment option that treats several skin conditions by stimulating skin, collagen, and elastin regeneration. It treats atrophic acne scars well. It fades scars and evens the skin tone and texture.

• Morpheus8: This treatment combines microneedling with radio frequency (heat) treatment. It triggers more collagen and elastin formation which helps in tissue repair and regeneration. It can fade acne scars as much as 50% by stimulating cell turn over. 

• Peels: Chemical peels shed a layer of the skin and cause skin remodeling. This triggers collagen formation and treats acne scars.

• Laser:  Fractional ablative and even non-ablative resurfacing lasers treat acne scars by vaporizing old tissue or heating/irritating it enough to elicit regeneration of skin. The micro-injuries in and under the skin trigger collagen formation. They work well for boxcars and rolling scars.

• PRP, PRF or EZ Gel Injections: Platelet-rich protein injection also treats acne scars. A concentrated portion of the platelets is injected into the treatment area, which also stimulates skin regeneration. 

There are some cases of acne scars when dermal fillers are not the best option. They include:

• Raised scars
• Hypertrophic scars/ Keloid scars
• Ice pick scars
• Active acne
• Hypersensitive skin

Some treatment options can be combined. Here are some of them.

• Laser with microneedling
• PRP with microneedling
• Radio frequency with Microneedling 
• Peels and PRP

Using combination therapy can enhance result efficacy and help reach goals faster.

Final Thoughts & Recommendations

Dermal fillers are an effective solution to acne scars. Through multiple approaches—volumizing the depressions and stimulating collagenogenesis—it resolves some of the issues of atrophic scars.

When done correctly, risks are minimal, and the recovery time is quick.

Book a consultation with one of our experts. They will help you create realistic desires and choose the best treatment option for you. The time and texture of your skin will improve, and you will be more radiant and confident.