Hi 
I live in Germany and I searching for help . At first - sorry for my bad english.
I have acne scars on my right cheek and of course they bother me immensely. I also have a few scars on my forehead and one big scar on the left cheek. All in all, the scars make my face look very restless and it looks so terrible, especially in bad light. Soon the sun will shine again, I love being outside, but I have to think about my scars all the time.
You can certainly understand it.
Two years ago I already did 6 microneedling treatments, but I cant see a difference from before.
Also a few years ago I had 4 treatments with the Fractional Co2 Laser, also without an improvement.
I'm just finding out about hyaluronic acid injections. even if this is of course not long-lasting and very expensive. The problem is that doctors in my area mainly specialize in wrinkle injections, lip injections, etc.
Anyone have tips? I would be very happy.
To me it looks like some light icepicks, rolling scars, one or two deeper depressions. All of these things are not too deep which kind of requires different solutions. All of it is probably contributing to a textural appearance as you describe.
I agree with you that needling 'usually' from what I've read/seen doesn't do a whole lot. I also think laser, especially fractional, is probably not a good choice here.
I mean if I had the time and expertise, I'd probably do an ablative solution on the icepicks/texture area, something like dermabrasion since that area is small, sharp, isolated in one area. The rolling scars might benefit from subscision/fillers, but I'm really not an expert in any of that, I'm still searching for myself. One guy on the thread got a pretty darn good filler/subscision in my opinion for a different scar but same thesis. I think the rolling scars and depressions would benefit from several subscisions/fillers over time because there are no real sharp edges. You untether the binding and fill it, and hopefully it grows a little naturally.
The good news is you don't have a lot of scarring. I'm sure it feels that way in various light like mine, but it's not really that pronounced like others have.
If you want my opinion I'd probably try the easiest first (if others agree), try to subscize and fill the rolling scars and that one depression if you can find a good doctor. You're going to have to find a relatively decentacne scar included plastic surgeon not some spa that only does wrinkle injections.
I think subcision, you could try it with suctionng, I have scars similar to the ones on your cheek but mine are upper cheeks. You need to find a doctor that does subcision well i.e., cuts the the tether, in the superficial dermis which is right below thesubepidermis.
Also I feel you on the microneedling sessions, I got 3 professional ones done with PRP and yep little difference. imo little difference even with only having 3 done. Also, dont likehow they microneedle the entire facewhen I rather just treat the scars.