Acne Scars
At DRS Skincare Hamilton, ON
| Treatment | Acne Scars |
| Indications | Acne scarring – ice pick, box car, rolled, hypertrophic, keloidal |
| Treatment Recovery | Varies depending on the presenting clinical condition |
| # Of Treatments Required | Varies depending on the presenting clinical condition |
| Best Results Seen | Typically 3-6 months after the last session |
*estimate of sessions to be determined in consultation
Active acne breakouts take an emotional toll. However, acne can also leave behind distressing reminders even years after effective treatment. Fortunately, DRS Skincare of Hamilton, Ontario, has the onsite expertise, courtesy of Board-certified dermatologist Dr. Rahul Shukla, to effectively treat lingering effects from acne in the form of scars.
Why did I develop a scar in the first place?
Scars come in many different forms. All scars, however, generally develop in much the same way. When the skin is injured, your body naturally attempts to repair the damaged area. As part of the healing process, new and thick tissue is generated to close the wound and repair the damage. Since the tissue is thicker than the surrounding skin, it can appear as a raised area or growth. Scars can also appear depressed or sunken due to excessive inflammation. Those with severe cases of acne or cysts are more likely to develop scarring than their counterparts with more mild forms of acne.
Types of Acne Scars
Acne scars typically present as either atrophic or “indented” or elevated skin lesions.
Atrophic acne scar types typically consist of the following:
- Ice pick scars
- Box car scars
- Rolling scars
Elevated acne scars consist of the following:
In many cases, the above scar types can be present with erythema (aka “redness”) or hyperpigmentation. Note – colour change does not mean a scar is present. Scarring refers to textural change where there is elevation or depression in skin tissue.
How do I manage acne scars?
At present, there is no perfect therapy for acne scars, and response varies from one individual to another. The specific type of treatment recommended depends on the nature of the scar. Just as with acne, treatment for acne scarring comes in many forms. Options include:
- Prescription medications and products
- Guidance on skincare
- Trichloroacetic Acid (TCA) Chemical Reconstruction of Skin Scars (CROSS)
- Laser therapy – Fractional CO2 laser, Fraxel Laser, Excel V laser, Picosure Pro laser
- Biostimulatory molecules such as hyperdilute radiesse, sculptra
- Hyaluronic acid filler
- Microneedling
- Radiofrequency microneedling with the Morpheus8
What treatment may be best for me?
All treatments at our Hamilton, Ontario office start with a consultation. Dr. Shukla and team will account for characteristics such as your skin, the type of scar, and the number of scars to identify an appropriate treatment for you.
With tailored treatment plans, we aim to reduce scars to the best of our ability. It is also essential for us to ensure that your acne is under control. With proper skin care, we ease inflammation and protect the skin from new acne scars over the longer term. Our team prioritizes partnering with patients to ensure their respective treatment plans are making a difference and supporting the skin’s health and a radiant appearance!
In order to take the first step in controlling your acne scarring, contact DRS Skincare at (905) 524-1712 to schedule your consultation today.
The number one misconception patients have when they come for their acne scarring consultation is that they’ll only need one treatment and one treatment modality to get the best possible results. Often, you need multiple procedures done at the same time and multiple sessions to see your best possible results. These may consist of the following: TCA cross, subcision followed by injectable collagen biostimulator, fractional CO2 laser, radiofrequency microneedling, topical application of PRP exosomes, or NCTF boost.
Treating acne scarring is challenging, especially when you’re dealing with ice pick scars, as in this case. We use a multi modal approach to treat these and did quite well over time. This approach consisted of TCA CROSS, which works fairly well for ice pick scars, followed by subcision, fractional CO2 laser, RF microneedling, and PRP, all done in one session. We did four sessions separated by one to two months. Collagen-stimulating fillers such as hyperdilute Radiesse or Sculptra could have been added to further enhance results if the patient desired. Importantly, results vary widely. There is no perfect treatment at the moment. Patience is critical. It does take time to see results. Customization is also key. We will create plans specific to our patients’ skin concerns to get the best possible results.
This is subcision, a treatment we do when managing acne scars to help release bound-down scar tissue. Often it’s followed by collagen stimulator, in this case hyperdilute Radiesse to help build further collagen. The white material you’re seeing on the cheeks is TCA cross to help with ice pick scars. Often we follow this with lasers and microneedling to get the best results. Consultation is key to customize your treatment plan.
Hi guys. Here’s an example of an acne scar patient we treated recently with TCA Cross to help with ice pick and boxcar scars, followed by subcision to help release scar tissue from underneath, and finally, fractional CO2 with PRP to further enhance scar reduction. Keep in mind, this was all done in one session, and the before and afters are taken one month apart, and we expect better results with more treatment and more time. Keep in mind the following principles if you are going to undergo an acne scar reduction journey. Number one, multimodal therapies tend to give you a better result with a strategy than just doing one type of treatment alone. Number two, patience is required. Time is needed to see the best results, and multiple sessions. And number three, responses vary between individuals.
Meet Subcision, a technique we use to help improve acne scars. Typically, when you have an acne scar, there’s a fibrotic band pulling down on your skin, giving your skin a depressed appearance. With Subcision, we help break apart that scar tissue, lifting your skin back up to normal. In this procedure, we enter the skin via needle, break apart the scar tissue, giving you that lift. Often, we’ll combine it with lasers, radiofrequency microneedling, and filler products such as Radiesse or Sculptra to give you even better results.
Before and After Care
- Prior to visiting had numerous microneedling treatments with minimal success
- Challenging case combining ice pick, box car and rolled scarring
- Utilizing a combination of subcision, biostimulatory molecules – in this case hyperdilute radiesse, TCA cross, radiofrequency microneedling (morpheus8), fractional CO2, and PRP, we are appreciating significant improvement over a series of treatments
- We are anticipating further improvement as she progresses through the rest of the treatments
- Combination therapy utilized optimal results consisting of the following treatments done together over a series of treatments
- Subcision
- Biostimulatory molecule – hyperdilute radiesse to help build collagen and elastin
- Devices: Radiofrequency + fractional CO2 laser
- Significant improvement using a combination approach consisting of the following done at the same time:
- Prescription therapy – isotretinoin
- Subcision
- Devices: radiofrequency combined with fractional CO2 laser
- Over time significant improvement in her scars has occurred
Frequently Asked Questions (FAQ)
How can prescription treatments help improve acne scars?
Prescription skincare can help improve acne scars, but results are often modest. Topical retinoids may help improve skin texture, pigmentation, and collagen remodeling over time, but they rarely correct deeper scarring on their own.
For best results, prescription treatments are typically used as part of a broader acne scar plan that includes in-office procedures.
What role does proper skincare play in minimizing acne scars?
A consistent skincare routine helps protect the skin barrier and improves the results of professional acne scar treatments. Key basics include:
- Gentle cleansing
- Regular moisturizing
- Daily broad-spectrum sunscreen (SPF 30+)
- Avoid picking or squeezing active acne
Your dermatologist can recommend scar-safe products to reduce discoloration, support healing, and improve long-term skin quality.
How does TCA CROSS work for deeper acne scars?
TCA CROSS (trichloroacetic acid chemical reconstruction of skin scars) is a focused chemical technique designed for ice pick scars and narrow boxcar scars. A small amount of TCA is placed directly into the scar to stimulate collagen remodeling.
Over multiple sessions, scars may become shallower and less noticeable as the skin gradually rebuilds collagen.
Which laser therapies are effective for acne scar reduction?
Laser treatments can improve acne scarring by stimulating collagen remodeling and improving surface texture. Depending on your scar pattern and skin type, treatment options may include:
- Fractional CO₂ laser (texture + deeper remodeling)
- Fraxel® (texture + pigment support)
- PicoSure Pro® (texture and discoloration support with minimal downtime)
- Excel V® (redness/post-acne vascular marks, not texture scars)
Treatment is customized based on scar type, skin tone, downtime tolerance, and goals. Multiple sessions are usually required for optimal improvement.
How do biostimulatory injectables like Sculptra® or hyperdilute Radiesse® help with acne scars?
Biostimulatory injectables can improve acne scars by stimulating collagen production beneath the skin. They can be helpful for widespread rolling scars, volume-related contour irregularities, and overall improvement in skin quality.
Results develop gradually over weeks to months and are often used alongside lasers, subcision, or microneedling for a more comprehensive outcome.
When are hyaluronic acid fillers appropriate for acne scars?
Hyaluronic acid filler can be effective for select scars, particularly rolling scars or shallow boxcar scars, by lifting depressed areas closer to the surrounding skin level. Results are immediate, and fillers can also be combined with other acne scar treatments for enhanced improvement.
As fillers are temporary, maintenance treatments may be needed over time.
What are the benefits of microneedling and radiofrequency microneedling (Morpheus8®) for acne scars?
Microneedling improves acne scars by creating controlled micro-injuries that stimulate collagen and elastin production. Radiofrequency microneedling (such as Morpheus8®) adds heat energy to remodel deeper scar tissue and improve firmness.
These treatments are often well tolerated, suitable for many skin types, and typically require a series of sessions. Improvements continue gradually as collagen rebuilds over time.
Our unique approach to acne scar treatment
Acne scarring is complex and often requires combination therapy. At DRS Skincare, we customize acne scar treatment based on your scar type and goals. Many patients benefit from using multiple modalities in the same session, repeated over a series of visits, to achieve the best possible improvement.
