Using dermal fillers is one of several ways to restore form and function to acne scarred skin. It is important to note, however, that using filler for acne scars does represent an advanced treatment technique and is considered an off-label use of these products.

• Juvederm: Choosing a hyaluronic acid based filler is a great way to quickly improve the appearance of acne scars. We prefer using Juvederm Ultra for this since its very high water affinity allows me to use a very small amount of filler in the acne scar, typically 0.01-0.05 mL, and allow the water uptake of the filler to do the rest of the work. SkinVive by Juvederm is also an option, but I still prefer Juvederm Ultra for acne scars. The treatment is fairly painless when used with topical numbing agents and you can walk out of the clinic with results the same day.
• Sculptra: This biostimulator is made of PLLA or poly-L-lactic acid and when injected between the dermis of the skin and superficial fat layer allows one to mechanically disrupt the scar, a process called subcision, then place the Sculptra where the path of the needle or cannula was. This stimulates natural collagen production which can restore a plumpness to your skin over time. Acne scarring in the dermis creates areas of thinning and Sculptra will gradually thicken up the dermis of the skin to achieve smoother skin with improved collagen and elastin content at the site of the acne scar.
• Diluted Radiesse: This biostimulator made of Calcium Hyrodxylapatite practically performs a very similar function as Sculptra for acne scars. The difference is the mechanism of action between the two treatment options, and when Radiesse is diluted to specific ratios, it can provide a more immediate result than Sculptra since it gives an immediate lift as well as collagen and elastin stimulation long term.
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Why would someone choose fillers to treat acne scars?

Your skin is like a smooth road. When acne happens, it’s like a pothole forming. If the road crew (your skin’s repair system) doesn’t fill it correctly, you end up with either a dip (atrophic scar) or a bump (hypertrophic scar). An acne scar is a mark left on your skin after a pimple heals. It happens when your skin tries to repair itself, but doesn’t quite do it perfectly.

When you get a pimple, it’s like your skin has been injured. Your body sends a team of cells to fight off bacteria and heal the damage. But during this battle, the deeper layers of your skin (the dermis)can get hurt. If the damage goes deep enough, it leaves a permanentchange in your skin’s structure, which is what we see as a scar. They can be red, discolored, raised or pitted scars on the face and body.

Fillers can be used for acne scars that have left a depression or pit in the skin. When HA fillers or Radiesse are used you can see an immediate result unlike when one uses energy based devices like laser, radiofrequency microneedling, or traditional microneedling.
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Injectable fillers also facilitate subcision to be performed simultaneously which mechanically releases the scar from below the skin which further leads to more immediate results.

Although filler or injectable biostimulators are effective for improving acne scars, we sometimes combine them with laser or RF microneedling to achieve long-term skin improvements.

How much do fillers for acne scars cost?

Depending on where you are treated, filler can range from $650 to $1250 per syringe. Most practices will sell a full syringe whether you use it all or not because they can’t be reused. So if you don’t need the full syringe, ask your provider to use the remaining filler in another location of choice.

What is involved in the process of getting fillers for acne scars?

The first step is finding a provider who specializes in this type of treatment. Because this is not an “on-label” use for fillers, it may be harder to find a provider who is comfortable with the treatment. Furthermore, the techniques employed for using these products for acne scars are more nuanced than a standard injection technique and therefore should be performed by providers with experience in using these products specifically to treat acne scars.

In the consultation, ask your provider what their experience is with this treatment. Once you feel comfortable with the provider, they will numb you for about 20 mins with a topical numbing cream. Depending on the comprehensive treatment plan, your provider may also use a technique called acne scar subscision, which involves a small needle being inserted underneath the acne scar pit to physically separate the scar tissue and create room for the filler to be placed in the right plane.

After treatment, follow the specific aftercare instructions from your provider.

Are there risks involved?

As with any filler treatment, there is the possibility for bruising, swelling, redness or pain for several days post-procedure. There is also a slightly higher risk of skin breakdown if the filler is injected improperly, underscoring the importance of seeing someone qualified to perform this treatment. Talk to your provider for a comprehensive understanding of risks based on your treatment plan.

What are some alternatives to fillers for acne scars?

Because acne scars can take many forms, filler may not always be the best option. Even with acne scar pits, a combination approach may be the best treatment path for ideal cosmetic outcomes. In my clinic, we love multi-modal treatments to increase the efficacy compared to results with any one treatment alone. At the consultation, we’ll discuss what the right treatment plan is for you specifically. This may include subscision, fillers, radiofrequency microneedling for texture and firmness, laser resurfacing for texture and color improvements, or broad band light (IPL) for redness or brown pigment correction.

For personalized recommendations, schedule a consultation at SOM Aesthetics to find the perfect filler treatment for your acne scars.

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