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Acne Scarring in Summary – and Treatment using Soft Tissue Fillers

Soft tissue dermal fillers are proven to improve the skin’s hydration and the presence of hyaluronic acid in the fillers gives the skin a structural strengthening. This is particularly important when understanding dermal filler options to treat the appearance of acne scars amongst other acne scarring treatment options.

Hypertrophic acne scars are the depressions or disruption in the integrity of the skin after an acne breakout or after a ‘pimple’ has healed. It is usually a result of acne lesions that remain inflamed for an extended period or become infected. During the process of healing the skin loses collagen in that area giving the skin almost an impression or depression. Not every acne lesion heals into an acne scar. Acne lesions that are scratched, squeezed, or injured are most likely to turn into scars. Hence, it is best for the acne scars to be left alone and heal naturally or by the aid of oral pharmacological agents or non-pharmacological light-based devices.

Once Acne scars have developed, they can be categorised into mild, moderate, or severe based on their appearance. Similarly, the morphology or shape of the acne scar can also give them a categorisation of:

  • Rolling type
  • Boxcar type
  • Ice Pick type of acne scars

Acne scar treatments are dependent on the type of acne – and the more sever the acne lesions – the deeper the scars can be. Although the different kind of acne scars may have individual treatment approach, the basic principle of acne scars treatment remains the stimulation of collagen in and around the scar area for the skin to become plump and visually look better.

Not all acne scars are permanent. Mild to moderate acne scars may resolve considerably own their own with the passage of time. However, sometimes the moderate to severe acne scars are the long-term ones leading into a permanent condition.

Acne scars may prove to be tricky when it comes to treating them for cosmetic reasons. There are various factors involved, and hence a multi-modality approach is ideal. A good treatment plan starts with a detailed consultation with your aesthetic practitioner.

The integral components of the plan include a careful and individualised skin care routine focusing on the skin regeneration and avoiding further acne breakouts, personalised skin hygiene measures based on individual lifestyle. Furthermore, a good diet that involves exclusion of acne stimulants, light-based energy devices like lasers or phototherapies, collagen stimulators that may include Platelet Rich Plasma (PRP), Skin Boosters, Bio-stimulators or Bio-remodellers and last but not least, soft tissue fillers. We at Pavilion Cosmetic Medicine (PCM), believe in a holistic approach and believe that no one size fits all. Hence, it remains important for that initial consult to lay out the plan with the right treatments and a regular follow up with visual documentation to assess the progress and tailor the treatment if needed to achieve the best outcomes.

Soft Tissue Fillers remain important to improve the appearance of acne scars is the use of soft tissue fillers. These fillers can be mechanical fillers like Hyaluronic Acid (HA) based or Biostimulators such as Poly L-lactic Acid based products.

The concept remains, the aim is to stimulate collagen in the scar with the benefit of achieving plumpness to raise the base of the scar. Using HA based soft fillers in the acne scars gives them a fuller look with HA improving the skin quality above the scar.

A soft filler with minimal cross linking of HA molecule is used to raise the depressed scars. As the filler is placed under and around the scarring tissue in the skin, so the appropriate filler must be chosen as using a firm filler may result in lumpiness. 2-3 sessions are needed depending on the severity of the scar.

As we age, we lose collagen in the skin overall. As collagen keeps our skin plump, hydrated, and youthful so the age-related collagen loss causes the skin to become dull and loose its elasticity. This deterioration in the overall appearance of skin may cause worsening of the acne scars as they are affected by the loss of collagen support from the surrounding tissue. So based on this principle, the use of soft tissue fillers in the facial volume restoration and restructuring can play a minor role by improving the collagen support underneath and around the acne scars. This approach can be used in combination with focal acne scar filler treatment to enhance the treatment outcome.

Any lifestyle or personal choices can have an impact on the appearance of the acne scars. As discussed earlier, acne scars are loss of skin collagen in the scar area. It is a structural deficit that needs restructuring. Collagen destroyers such as sunlight, smoking, chemicals, stress, sugar, and other unhealthy dietary choices can worsen the acne scars although the initial process of acne scar formation has stopped. Similarly, some days the acne scars may look worse than other days, based on the hydration level of the skin that has an impact on the skin plumpness.

Key benefits

  • Quick procedure, immediate noticeable results.
  • Low downtime.
  • Lasting up to 16 months.
  • Soft tissue dermal fillers stimulates collagen in and around the scar area for the skin to become plump and visually look better.
  • Improves the skin hydration and structurally strengthens the skin.
  • Soft tissue fillers can be used in combination with other treatments for enhanced outcomes.


  • Soft tissue fillers, like Hyaluronic Acid (HA) based Dermal Fillers or Biostimulators, may be used to stimulate collagen to improve the appearance of acne scarring in the scar itself and raise the base of the scar.
  • Using a soft filler with minimal a cross-linking of the HA molecule may be effective to raise the depressed-looking type of scars.
  • Dermal filler treatments to improve acne scarring appearance may last somewhere between 12-16 months based on individual factors.
  • The use of soft tissue fillers in facial volume restoration and restructuring can improve the collagen support underneath and around the acne scars and can be used in combination with focal acne scar filler treatment to enhance the treatment outcome.
  • A multi-modality approach is ideal for acne scar treatment, and the plan should start with a detailed consultation with an aesthetic practitioner, including a personalised skin care routine, individualised skin hygiene measures, a good diet that excludes Acne Stimulants, Light-Based Energy Devices like Lasers or Phototherapies, and Collagen Stimulators like Skin Boosters, Bio-stimulators and/or Bioremodelling Injectables.
Treatment Details

What to expect

Pre-treatment consultation process prior to acne scarring dermal filler procedures

Patient evaluation: As a patient, your Cosmetic Doctor will evaluate your skin type, the severity of acne scarring, overall health factors and medical history in general – including any medications currently being taken

Treatment options: Your Cosmetic Doctor will discuss various treatment options with you as the patient, including but not limited to soft tissue dermal fillers. Your doctor will take steps to explain aspects of dermal filler treatment and what you should be prepared to expect in terms of results from the dermal filler injectable procedure.

Risks and benefits: Depending on your personalised treatment plan, your Cosmetic Doctor will explain potential risks and benefits of using soft tissue dermal fillers to treat and improve the appearance of acne scarring. Items to be discussed include potential side effects, such as swelling, redness, and bruising, as well as any potential complications.

Pre-treatment instructions: Instructions will be provided to prepare for the procedure, such as avoiding certain medications or products, or refraining from smoking.

Dermal filler procedure to treat acne scarring

Preparation: The area to be treated will be thoroughly cleaned and prepped for the injection.

Pain relief: Depending on the preference of the patient and the location of the acne scars, numbing cream may be applied to the area and/or amongst other pain relief options may be used to minimise discomfort during the dermal filler procedure.

Injection: The cosmetic doctor will use a fine needle or cannula to inject the dermal filler directly into the acne scars. The number of injections needed will depend on the size and depth of the scars.

Massage: After the injections, your PCM Cosmetic Doctor may gently massage the area to distribute the filler and ensure a smooth appearance.

Assessment: Your Cosmetic Doctor will assess the results of the injections to determine if additional filler is advised or if the desired outcome has been achieved.

Follow-up: The patient may be asked to schedule a follow-up appointment to evaluate the results and determine if any additional treatment is needed.

The entire process typically takes less than an hour and patients can usually resume their normal activities immediately after the procedure. The effects of the dermal filler will typically last for 12-16 months, depending on the type of filler used and other individualised factors such as the patient’s metabolism.

Post-care and After-care following dermal filler treatment to improve acne scarring

After a dermal filler treatment to improve the appearance of acne scarring, there are some post-care instructions that the patient should follow to ensure the best possible results and minimise the risk of complications. These instructions may include:

  • Avoid touching or rubbing the treated area for at least 24 hours after the procedure.
  • Avoid exposure to sunlight, intense heat, or extreme cold for the first 24 to 48 hours.
  • Avoid drinking alcohol or taking aspirin or other blood-thinning medications for at least 24 hours.
  • Apply cold compresses to the treated area to reduce swelling and bruising.
  • Keep the treated area clean and dry.
  • Avoid strenuous exercise or other activities that may cause sweating for at least 24 hours.
  • Avoid wearing makeup or other cosmetics on the treated area for at least 24 hours.
  • Follow any other specific post-care instructions provided by your Pavilion Cosmetic Medicine (PCM) Cosmetic Doctor.

It is important for the patient to follow these instructions carefully to ensure the best possible results and minimise the risk of complications. Your PCM doctor may also schedule a follow-up appointment to monitor the patient’s progress and ensure that the treatment has been successful. If the patient experiences any unusual symptoms or side effects after the procedure, such as severe pain, redness, or swelling, they should contact Pavilion Cosmetic Medicine immediately.

Pre and Post-care documentation and contacts for the PCM clinic will be provided on the day of treatment.

Your Questions Answered

Frequently asked questions (FAQs)

How many dermal treatments are needed to see the desired results with acne scar improvement?

A minimum of 2-3 sessions are recommended, spaced at 4 weeks interval.

What does the dermal filler procedure involve to improve acne scarring?

The first step is skin cleansing, followed by application of topical numbing ointment for 30 minute to minimise the discomfort associated with the treatment. Use of soft tissue fillers is performed with a needle or a cannula based on treatment goals.

Is there downtime associated with dermal filler treatment to improve acne scars?

Patients may experience mild to moderate bruising and swelling post treatment that can last for 2-3 days. Hence it is best to plan the treatment when you have no scheduled social commitments. The treated acne scars may appear lumpy, swollen and raised for 24-72 hours, which typically settles down in 2-3 days post treatment.

How long does the dermal treatment last to visibly improve the appearance of acne scars?

The treatment itself can last somewhere between 12-16 months based on individual factors. Soft tissue filler treatment for acne scars work best when combined with other treatment regimens and modalities. An improvement of one’s own collagen in the scar area has a longer lasting effect and soft tissue filler enhances that effect and supports the longevity of the treatment effect.

What does the after-care involve?

Avoidance of sunlight for 2-3 days is advised, followed by a well regimented sun protection skin routine. Avoidance of exercise, gym, sauna, swimming pools or any other possible infection-causing environments. No make-up should be used for 24 hours post treatment. Skincare with active-ingredients such as Retinol should be avoided for 72 hours.

Can I do something to reduce the possibility of bruising?

Bruising is undesirable but at times can be an unavoidable side effect of the treatment. This being said, bruising from dermal filler treatment typically resolves in 3-5 days, however, one can use topical anti bruise application to enhance the process of stubborn bruises after consulting with your treating physician.

Do I have to prepare my skin for the treatment?

With soft tissue filler treatment to regions of acne scarring, there is generally no pre-requisite for preparation. However, it is advisable to avoid any blood thinners for 3-5 days prior to the treatment. The major ones to avoid include:

  • Fish Oil
  • Krill Oil
  • Alcohol
  • Blood thinning medication should be avoided if appropriate (consult your treating physician)
Can Fillers improve the ‘acne marks’ as well?

An important point to understand is the difference between acne scars and acne marks.

Acne marks are flat, brown, or red discolorations in the skin that result due to vascular or pigment changes after an acne lesion heals.

Acne scars on the other hand are disruptions in skin integrity, thus leading to structural irregularities.

Acne marks typically require topical applications or laser therapies if they do not resolve spontaneously.

Soft Tissue fillers will only be beneficial in the treatment of a structure deficit in an acne scar.

How long does the dermal filler treatment to acne scars last?

After the first three [3] treatment sessions, the dermal filler treatment typically needs repetition in 8-12 months. An ongoing daily skin care routine is recommended to keep the effect lasting longer.


Interested in Soft Tissue Fillers to treat Acne Scars?

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