ACNE SCAR Q&A / FAQ; LIBRARY of POPULAR THREADS
<If You Have Updates / Hints/ Tips for This Thread, or Questions, Please PM Me> Special Thanks for Contributors : Dan Owner of Acne.org, Dr Davin Lim, Dr Dray, Robertitoo, DeLovely  
Disclaimer: The information below is provided as a courtesy to address general questions. As we are not medical professionals, we cannot be held responsible for the accuracy of this information. By reading this information, you agree not to hold us liable for any damages that may result in your use of this information. This information should not replace information that your Doctor, Dermatologist,  or Plastic Surgeon provides you. Please keep in mind that this is for general information only and results will vary for each individual and their bodies ability to heal.

TABLE OF CONTENTS:

1. SUCCESSFUL TREATMENT THREADS
2. EMOTIONAL / PSYCHOLOGICAL EFFECTS OF ACNE / SCAR
3. WHAT IS ACNE & PREVENTING SCARS
4. DIFFERENT TYPES OF SCARRING
5. TREATING SCARS AT HOME
6. HYPERPIGMENTATION (RED, BROWNS, PIE, PIH), HYPOPIGMENTATION (WHITE), TEXTURE, DRYNESS, & COVERING UP SCARS 7. TEXTURE, EXTREME DRYNESS, & COVERING UP SPOTS, LARGE / SCARED PORES
8. PUNCH GRAFTING & EXCISION
9. HYPERTROPIC / KELOID (RAISED SCARS)
10. SUBCISION
11. FILLER FOR SCARS
12. LASER
13. MICRONEEDLING
14. TCA CROSS FOR ICEPICK SCARS & ACID PEELS
15. WHY DO ACNE SCAR TREATMENTS FAIL FOR SOME PEOPLE 16. LIST OF ACNE SCAR TREATMENT DOCTORS (RECOMMENDED DRs BASED ON FORUM POPULARITY)
17. ANATOMY PICTURES 18. SOURCES
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1. SUCCESSFUL TREATMENT THREADS 
  Scar Treatment Success:   > Proof (Pictures - included) Acne Scar Treatments, Medical Case Studies, Acne Scar Successful Treatments
https://www.acne.org/messageboard/topic/374081-proof-pictures-included-acne-scar-treatments-medical-case-studies-acne-scar-successful-treatments/

> f93d's Subcision, Cross Filler, RF Needling Success, Over Dilute Sculptra for Widespread and/or Fat Deficient Scarring. 
https://www.acne.org/messageboard/topic/376709-subcisioncross-progress-beforeafter/

> slee3 Asian Skin Type, Laser Treatments Did Not Work, But, Treating With Dr Rullan Doing Manual Methods Did!
https://www.acne.org/forums/topic/382190-my-journey-with-dr-rullan-tca-subcision-microneedling-first-session-122018/

> Kazalea - Post Subcision Results w/Picture
https://www.acne.org/forums/topic/354675-post-subcision-results-wpicture/ 

> ScrewScars's Phenol Deep Peel For Surface Textural Acne Scars or A great Way to End Your Treatment Once You Raise the Acne Scar Pit's
https://www.acne.org/forums/topic/381149-phenol-peel/

> SuperBurrito's Acne Scar Treatment Journey RF Needling With Dr Weiner & TCA Cross W/ Subcision & Microneedling W/ Dr Rullan
https://www.acne.org/forums/topic/380014-my-acne-scars-treatment-journey-infini-with-dr-weiner-and-crosssubcisionmicroneedling-with-dr-rullan-pics/

> PCT14 Suction and Subcision Success with Suction
http://www.acne.org/messageboard/topic/361755-my-subcision-saline-suction-treatment/

> MR. Matt Subcision Success
http://www.acne.org/messageboard/topic/232731-man-in-the-mirror-pre-and-post-subcision-photos/

> Boxcar scars improved significantly through subcison
http://www.acne.org/messageboard/topic/323172-my-total-fx-diary-procedure-scheduled-for-120412-updates-to-follow/

> 91baby Surface Acne (Textural), Subcision, Filler throughout cheek (not individual scars), and TCA Peels 
https://www.acne.org/messageboard/topic/364086-justhadsubcision-documentingwphotos

> DC Girl TCA improvement
http://www.acne.org/messageboard/topic/337794-scar-success/

> Success Recell UVB Lamp + Melgain (Decapeptide - Basic Fibroblast Growth Factor)
Fixing Vitiligo, Lightened Scar Hypopigmentation, Loss of Pigment Skin Discoloration
http://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/

> Laser Didn't Fix It alone, Infini RF and  Filler and Subcision Did 
http://www.acne.org/messageboard/topic/322562-my-infini-treatment-for-my-acne-scarring/#entry3301228

> Scared pores/ice picks improvement of as well as a few boxcar scars
http://www.acne.org/messageboard/topic/316133-just-had-ablative-fraxelrepair-and-ultrapulse-co2-with-photos/

>Shei514 From New Zealand: Fibrotic Scars Dr Lim Subcision, Ultrapluse, fractional co2, prp, filler
https://www.acne.org/forums/topic/377615-co2-laser-in-treating-acne-scars-ultrapulse-subcision-of-acne-scars-w-dr-lim/

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2. EMOTIONAL / PSYCHOLOGICAL EFFECTS OF ACNE / SCAR (YOU'RE NOT ALONE)
Many acne scar sufferers live a life of pain from their outward appearance. This often manifests itself with low self esteem or hiding away in the house from anyone seeing them. It can affect one's life in many ways that are not healthy, both physically, mentally, and spiritually. When the acne scar sufferer finds treatment, they often are overly critical of themselves and think everyone else sees them the same way; this is a sub form of BDD - Body Dysmorphic Disorder called Acne Dysmorphic Disorder. 

This can lead to a obsession for perfect skin and finding small faults in them and others. A roller coaster of unrealistic expectations of treatment outcomes and something to save them becomes not realistic. Part of healing from Acne Scars is realizing you will get a small percentage of improvement at a time with each treatment that can take many years in some cases. Glass perfect smooth skin is a goal but often not a reality of severe scarring. Therapy can help get that remaining percentage to live happy and healthy lives. Colleges offer low cost therapy to everyone and now there is a smart phone app even if you cannot leave the house where you can get therapy called Talkspace which has helped many. Acne.org also has a psychological challenges sub forum linked below.

> Emotional/Psychological Effects of Acne Scarring (Individual stories)
https://www.acne.org/messageboard/topic/360711-emotionalpsychological-effects-of-scarring/

> Emotional/Psychological Effects of General Acne - Sub Fourm for Acne.org
http://www.acne.org/messageboard/forum/10-emotional-and-psychological-effects-of-acne/


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3. WHAT IS ACNE & PREVENTING SCARS




Q: How Does Acne Occur?
A: Sebum overproduction, hyperkeratotic obstruction of sebaceous follicles, and microbial colonization that promote perifollicular inflammation. When the content of a comedone, the mixture of keratin, cell debris, sebum and bacteria, is exposed to tissue due to the breakdown of the follicular wall, inflammatory cells aggregate and counteract these foreign bodies. That is why painful papules, pustules, nodules and cystic acne form. Inflammation in acne is typically a destructive process, reaching deep into the subcutaneous tissue where the follicular structures are situated. It is more destructive for the deeper structures than the superficial. The more manipulation through squeezing, pushing, and pricking, and picking the greater the chance follicles will rupture, and the more severely the acne will inflame. The longer the inflammation persists, the more tissue that will be destroyed and scar. Scarring tends to be genetically linked to an individual's unique inflammation response. Those people with a "secondary inflammatory response" to trauma tend to scar, while those with a "single inflammatory response" to trauma tend not to scar. This explains why some people will scar easily and others maintain a smooth complexion even through moderately severe battles with acne. Prevention is always better than cure.

 
 
 
 
 
 
 
 
 
  
 
Q: How can I prevent my acne from scarring?
A: The best way to prevent scarring is to prevent the acne that causes it.
See http://www.acne.org/regimen.html

Sulfur cream, or Benzoyl peroxide on pimples, and Retin A cream nightly have helped many.

** The newest treatment(s) are called Laser Carbon Peels which clean out the pores and Photodynamic therapy (PDT) which uses a medication which is absorbed by the bacteria and oil glands in the skin, and a light source (blue led) to activate the medication closing the pore after several treatments.  Intense pulsed light that is used for photofacials can also be used to do a PDL type treatment by activating these medications. A vaccine for Acne has been developed but has yet to be released after trials.

For extremely severe, widespread acne, you may choose to see a dermatologist to inquire about Accutane medication which does have side effects.

Many dermatologists contend that scars are really more from picking than from the acne itself.   Occasional popping can often be performed quickly and safely. It is the picking afterward that often leads to the worst scarring. 

Scarring tissue theoretically has no regenerative capacity, and will not grow unless it is hypertrophic or a keloid. Meaning you can improve the cosmetic "look" of the scarred skin but the underlying skin structure is scared excess tissue.

If you have pimples specifically underneath the nose region or in the chin / goatee region, or they could be just near your ears and on the cheeks. These pimples or cysts maybe keep appearing in the same spot(s). This could be due to Staphylococcus Aureus bacteria, do not pop these, ask your dermatologist to swab and send to the lab to culture, antibiotics will be needed. Pimples tend to be all over the face, staph can be more cystic or in a contained region. 

Q: What is the diet I need to heal & prevent acne, acne scars, or hyperpigmentation?
A: Eliminate: sugar, dairy, gluten, start eating fermented foods and bone broths (spice if it's bland), or take gelatin or a collagen supplement, probiotics, and lots of antioxidants such as green tea, vitamin C, and niacinamide. Smoking stops healing as does too little rest. You need animal foods in your diet, especially healthy fats, so don't be afraid to eat fatty meats! If you are a vegetarian eat nuts, hummus, coconut & olive oils, Many with these spot flare-ups mixed with red hyperpigmentation have candida (yeast) and gut health issues. This might need addressing. After antibiotics, this common yeast can cause issues in the body. Lots of fruit and veggies, and avoid the processed foods and bakery goods. Sugar is the biggest no no for healing, unless it comes form a natural source in moderation. Distilled Water helps many people cleanse the body.  Q: What is AMVC - Spontaneous Scaring Condition?
A: This is a rare condition where the suffer get's constant re-occurring scarring. It's most likely related to a auto-immune condition. Please see the below mega-link for more info.
https://www.acne.org/messageboard/topic/259206-spontaneous-scarring-condition-amvc-atrophia-maculosa-varioliformis-cutis/?page=27
Q: What happens to my scars as I age?
A: In ageing skin, progressive tissue laxity worsens the problem of unevenness around scar tissue. Aged skin loses its elasticity and descends under gravity, the scarred tissue and the normal ageing skin behave differently. This difference makes the skin appear more uneven. More Fat loss naturally makes the scars appear much worse, this is why we use fat and hyaluronic acid fillers for ageing augmentation. Aging is accelerated by acne, scarring treatments are needed much sooner than those who age naturally.

Q: What is my Fitzpatrick Scale of Skin Darkness & Type (This Determines Treatment)

Please note non-white skin can hyper pigment with energy devices
source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394


 
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4. DIFFERENT TYPES OF SCARRING

 

source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394

Q: Can you describe the different types of scarring? scar types:
Icepick: Looks like an ice pick has been pressed into the skin. It is generally small in diameter, but can be shallow or deep.

  Boxcar: Looks somewhat like a chicken pox scar with more rounded edges. It can be small or large in diameter and is fairly deep, though not usually as deep as icepick scars.
  Rolling: Looks like a smooth indentation in the skin. These scars can be deep or shallow, but are generally shallower.
  Macules: Pigmented scars, These are most common on the back, chest and arms. They are small areas of hairless scar tissue that will initially be red but will usually fade to pale ivory within 1-2 years. They can be raised (hypertrophic) or indented (atrophic).

There are two basic types of Raised scar types: Hypertrophic scars - are scars that are raised above the skin surface but remain within the boundaries of the original injury. Scarring and can be treated with silicone sheets , liquid silicone, or cortisone injections (provided by dermatologist). Color can be treated with the V-Beam / QuadroStar Pro Yellow Laser. The treatment options include laser ablation, electro - dessication, or surgical excision. Other options for the treatment of elevated scars include injection of bleomycin, cryotherapy, topical application of imiquimod, flurandrenolide, tacrolimus, and silicon gel. Laser steriod drip to the scars. Intralesional injection of botulinum toxin has been shown to reduce scar formation. Pressure, flavonoids, TGF, mannose-phosphate, and IFN25 were also listed as helpful.  

  Keloid scars - which are raised scars that extend BEYOND the boundaries of the original sore, blemish or injury. It is scar tissue gone wild. It can continue to grow. Some people are genetically prone to keloid scarring. (Treatments are the same as Hypertrophic Scars above, with steroid injection & cryosurgery being the number one treatment for the raised texture).   Stretch Marks: From Weight Loss, Pregnancy, Acne Scar (skin stretching), please note this is damaged skin. Treatment at best will give some improvement but often will not fix the skin completely. RF needling is effective, laser, stem cell PRP/PRF, Ematrix Sublative RF, Vascular laser if there is discoloration, fake tanning can be used to mask the stretch marks cheaply at home, another at home treatment is microneedling, a tattoo can hide them or medical tattooing or pigmenting with your skin color. Silicone patches and gels are your friend here, use them long term. If you have hypopigmentation see the below section in skin discoloration for suggestions. 
  
Q: How Do I Treat Early Scars (Scars Under 3 Months Old)
A: Early Scars can be treated easier than scars that have aged and become fibrotic. Some effective treatments are Ematrix - also called Sublative RF, Clear and Brillant (several treatments are needed), Laser Genesis (several treatments are needed), Low Density Fractional CO2 laser 3-7% Density and the highest power, and vascular laser which treats the redness and causes the skin to regenerate (also called V-beam Laser or for ethnic patients Picosure Laser).

 
Q: How can lighting effect the appearance of acne scarring?
A: Lighting can have a tremendous effect on the appearance of acne scarring. Some women use silicone primers to fill the scar / pore before makeup or blurring creams, serums, and primers you can get from a makeup store. Your scars will look worse with fluorescent lighting and when not moisturized and plump. Night light and harsh lighting can look worse for many, this is why they put HD makeup (which is thick) on at night. Guys can grow facial hair to cover it, put lots of sunscreen, or avoid sports where they get red and it shows the scars. Pure higher weight serum has bigger molecules,... hyaluronic acid makes your skin moist, low weight HA inflames and plumps the skin hiding the scarring. Use a gel moisturizer over a cream, less break out potential though often the thicker moisturizers plump the cells.

Indirect lighting - shows the true scars (scars make shadows, turn out the lights and use a flashlight) . 



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5. TREATING SCARS AT HOME

Q: Is it okay for me to treat my scars while I am on Accutane?
A: New Data suggests it is OK to treat acne scars while on Accutane with manual methods like Subcision and filler for pits, tca cross for icepicks and  ""light"" settings for early scarring (See below). I always suggest one avoid energy devices (unless they are a gentler treatment) while on Accutane. If at all possible unless you can go to a low dose 20mg or less of Accutane, this means one can stop at any time for a few weeks get treatment done and start again as needed after you heal from procedure. The problem with over treating acne scars while on higher dosage Accutane are poor skin quality that is thin sensitive, dry and slower to heal and can cause more side effects. Poor treatment with a energy device during this time will make one loose fat (the skin is already thin and hard to judge the depth),... This is why so many Laser Dermatologists suggest you wait at least 6 months to a year to treat your scars after taking Accutane. Some individuals have reported that they seem to scar more easily while taking Accutane. If you have completed a course of Accutane. 3 month old or younger Early Scars can be treated easier than scars that have aged and become fibrotic. Some effective treatments are Ematrix - also called Sublative RF, Clear and Brillant (several treatments are needed), Laser Genesis (several treatments are needed), Low Density Fractional CO2 laser 3-7% Density and the highest power, and vascular laser which treats the redness and causes the skin to regenerate (also called V-beam Laser or for ethnic patients Picosure Laser).

 
Q: What is the Lemon & Vinegar Method, Painting Scars with Lugol's Iodine, Or Castor Oil Method?
A: This is a method that may improve the appearance of shallow, rolling scars. Drink either Robinson, Lemon Barley Water or plain water with half a teaspoon of lemon juice to a full glass of water throughout the day. It is best to use fresh lemons if possible. Use any diluted vinegar (organic apple cider if possible, malt or white are also acceptable) in warm water to splash onto the face day and night. You may have to experiment to find the right combination of water to vinegar. Try diluting it 1 part vinegar to 4 parts water to start with. First wash your face with your normal cleanser, and then apply the vinegar (dab the solution on with cotton balls and leave on) before other topicals / moisturizers (apply topicals 20 minutes later). You should see an improvement within a week or two. Two other well known ways to treat scars at home before doing the more exstensive treatments are to paint your scar with Lugol's iodine (note it will discolor the skin - but the body absorbs the iodine over time), you paint a few coats of iodine once it dries and do this a few times a week, depending on how your skin reacts. Note it acts like a peel, the skin will probably dry out, and skin will flake and fall off. Another option is to take castor oil and paint it on the scar this uses the bodies healing ability to deal with wounds (you can do this a few times a week).

Q: What can I do NOW (at HOME) to improve my scars without going to the doctor?
A: Retin A topical from ebay or sold Over the Counter at Target Differin (In other countries called tretinorin at the pharmacy) turns over skin quicker. Microneedle the scars we recommend you buy the Derminator (see link below) and use at 1.5mm once per month. When that heals alternate with a Acid Peel (like TCA - Can be bought at "Makeup Artist Choice"). TCA Cross is the best treatment for icepicks, see below for more info on these treatments. Makeup will help guys and girls spot treat their scars and even out color  (all the stars and people on TV wear it) Dermablend at Macy's and Nordstrom was made for surgical scars and tattoos (Unisex). A very cost effective solution is to find a doctor that does Cannula (type of needle) Subcision (see below recommendations) and do the rest of the treatments at home. Subcision is not costly and can be done every 3 months or even years in between for acne scar pits (this is a good first treatment).
https://www.acne.org/messageboard/topic/359068-the-derminator-thread/

https://www.acne.org/messageboard/topic/366754-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-paint-on-phenol-glycolic-salicylic-methods-and-techniques/
A: As mentioned, most people with moderate / severe scarring do not find that topical solutions have a significant effect on their scarring. However, they can help lessen scars if used in the healing stage.

Topicals typically do nothing for scarring. They are a preventative, but Retin A Gel and Vitamin C Serum can help the skin heal and create new collagen. Many combine these with their other treatments like microneedling.

Q: Will Microdermabrasion reduce the appearance of scarring?
A: It is generally thought that Microdermabrasion cannot penetrate the skin deeply enough to affect the appearance of moderate to deep scarring. It is a great method of exfoliation at home using a microfiber cloth or spin brush. Be careful of bacteria. This will only help the lightest cases of scarring. A better treatment now are hydropeels (Drs/ Spa's / Skin Specialists). This clears clogged and dead skin, infuses the skin with beneficial ingredients and AHA BHA acids. Part of the issue with unhealthy looking skin a good Hydro Peel Extraction and improvement can help. They are relatively cheap as well often $100 on special.

Q: What treatments offer the biggest change?
A: Subcision (Cannula type of needle) can help smooth out the skin for those with tethered scars. Filler with subcision to avoid tethering down again if you have atrophy (missing fat under scars), be sure to see a specialist who has done acne scars before, ask how many they do a month - good doctors do many. If they don't do subcision to create a pocket under the scar the tethering will not lift with filler.  For ice picks, TCA Cross to make the ice pick raise and widen. Microneedling for all types of scars makes the skin heal and renew itself, it's a slow process (also breaks up scar tissue), RF needling offers better results but is more costly. TCA peels renew the skin and cause it to refresh what's under the controlled chemical peel (similar to laser without the cost). -- See below detailed subcision section.

Q: Is there anything I can do to optimize my healing responses or Improve My Health Following Invasive scar Procedures or Having Acne Problems?
A: Yes. Through a healthy diet (no sugar, carbs, highly processed foods, lots of fruit, veggies, and greens, lean fat meats, low salt).  Supplementation: collagen, vitamin c, vitamin K, Bromelain,  pure HA serum. Topicals: Vaseline - keep it moist until scabs fall off, don't pick it, vinegar soaks with diluted vinegar water, Arnica Montana for the bruising and red, sunscreen all the time, hydroquinone for bleaching and hyperpigmentation issues. Do not take blood thinning products (i.e. Ibuprofen / Motrin...take Tylenol instead, vitamin E). Spices that thin the blood: cayenne pepper, onion, ginger, paprika, peppermint, thyme, cinnamon, dill, oregano, turmeric, garlic, chocolate, fish oil. ginkgo biloba, ginseng, magnesium, taurine energy drinks. You may take these once your body has healed from the initial surgery (a few days , to a week). Using makeup can cause infection if the skin is not healed fully. Drinking and smoking hinder healing. Make sure to get plenty of rest during recovery, & drink lots of water. Data shows the things that effect sensitivity the most in patients are milk / dairy, sugar, and highly processed cars. Organic Produce can be beneficial if you can afford it or grow it yourself. The raw diet and vegan lifestyles do help some overcome allergies and medical conditions. Your scars and acne could be related to a fungal infection (known as fungal acne or Folliculitus) or skin and food allergies. Worth getting testing for this.  

Q: How do I get multiple doctors opinions for treatment "FREE"?
A: Post a few pictures of your scars using indirect lighting (scars make shadows) like below on http://www.realself.com . Some doctors will give you their opinion. Be aware sometimes their treatment recommendation is a canned response (the "laser" they own or are sponsored by).  Post treatment recommendations for a second opinion on the forum here. Start with Non- Energy treatments first. 

Also people go on sites like RealSelf to Complain about treatments (they do not go there to talk about positive experiences). Marketing teams can often be involved with positive reviews. It is in your best interest to personally contact those who leave a review or members on here to ask questions (don't just read the reviews). Get 2-3 Consultations even if you pay $150 you will be able to find the best doctor for yourself (you will spend thousands on treatment). If you cannot find someone to do subcision (see our below suggestions) or find a school that teaches dermatology, they often do this procedure. One can get filler done locally by a expert injector or find a overly common laser Dr for other parts of their treatment.


 source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394

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6. HYPERPIGMENTATION (reds, browns and other colors, PIE, PIH), Hypopigmentation (white), TEXTURE, DRYNESS, & COVERING UP SCARS


  Q: Where do I start?
A: Hyperpigmentation takes a long time to heal. You can try to simply wait it out...but it never hurts to try and heal your spots naturally: Aloe vera gel + honey and vitamin K (gets rid of bruises and red) keeps the spots moist creating quicker healing.
OR You can use Emu oil or triple antibiotic cream to keep your wounds moist (Note: this breaks out some people so please spot test). In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation. Fresh lemon has helped some people fade their spots and also topical green tea. Topical Vitamin C serum can help some fade their reds and browns and in others it has irritated their skin. Always wear sunscreen. In the morning you use cool water to cleanse your face. Use diluted white vinegar and pat (not rub) the face to sterilize it. Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation. These spots can take months to heal being irritated wounds, the remnants of acne or other skin issues.
If this doesn't work stronger treatments are below>>

 
 
 

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WHAT IS: POST INFLAMMATORY ERYTHEMA (PIE)
     - red spots that turn white after being pressed on

 
  

 

Q: What Is Post Inflammatory Erythema (PIE)? 
A: Post Inflammatory Erythema (PIE) describes pink to red discoloration after an inflammatory acne lesion. Patients with lighter skin types (I-III) the post-inflammatory dyspigmentation is often not hyperpigmentation, but instead discrete erythematous macules (PIE). Acne may not be the only cause of post inflammatory erythema, as any resolving cutaneous inflammatory process may have residual erythema. Treatments (ranked most effective to least): V-beam, or IPL, or Excel V, or 1064nm (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), steroid creams from the derm,  Retin-A Cream, Bactroban cream, Silicone Sheets and topicals (known as scar gels), 2.5% hydrocortisone twice per day (only for a weeks time - it thins the skin), triple antibiotic. Some find light (%) peels helpful like Salicylic Acid or Glycolic (Acne.org has an excellent one in the store)... Your skin must not be raw, overly thin, or any allergy to aspirin (Sali) . Please do not use Scrubs, Harsh Soaps or Exfoliants that prolong the wounding. Emu Oil, Honey, Aloe Vera, and Green Tea are soothing / healing. Visine aka red reducing eye drops temporarily reduces the red and concealer (makeup), while you heal. Sunless Tanner helps mask discoloration (higher % the darker, can do application over 3 days), use alcohol based toner over the area first to get off oils and residues, wear gloves, moisturize boney parts as they pick up tanner more.   Picosure is a great treatment (non - ablative). IF you have Ethnic Skin (Asian, Indian, Mediterranean, Black/African,etc...), it works well because you have more collagen in your skin. Works perfect for your skin type. This promotes new collagen, is a alternative to vascular laser for lighter skin types, and gets rid of the PIE.
How to care for Erythema
First, get your skin completely clear from active acne. This way you are preventing any future Erythema. Once you are clear, you can try a Erythema treatment above to reduce the marks you might have. Topical treatments are the first choice for treating Erythema. The treatments most commonly prescribed by dermatologists are Steroids.

  Erythema is common among people of Caucasian descent. Erythema can also occur in darker skin, albeit less frequently. UV light – the light from the rays of the sun – can make Erythema worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase6 and decrease7 acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of Erythema and allow any Erythema you currently have to heal as fast as possible.

How to prevent Erythema
Picking at acne lesions is the worst culprit when it comes to creating Erythema. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping Erythema skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.

The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any Erythema that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option.

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    WHAT IS: POST INFLAMMATORY HYPERPIGMENTATION (PIH)
    - brown spots or red that stay after being pressed on
 
Q: What Is Post Inflammatory Hyperpigmentation (PIH)? 
A: Post Inflammatory Hyperpigmentation (PIH) is related to brown spots, and permanent red spots. The discolorations are caused by an excess production of melanin. Vitamin C, Glycolic, Hydroquinone (skin bleaching cream) are all great tools for inhibiting melanin which will fade the discoloration. PIH is more common in darker skin types (Fitzpatrick IV-VI), although it is not limited to any skin type. Treatments ( ranked most effective to least): V-beam, or IPL/ photofacials, or Excel V, or 1064nm, or QuadroStar Pro Yellow Laser (vascular laser can help these areas quickly by making the body dissolve the trapped red blood / surface veins), Alpha Hydroxy Acid peels: glycolic * good also for smaller pores, TCA, Mandelic (Acne.org has an excellent one in the store), Skin bleaching creams (aka hydroquinone or Kojic cid w/ Arbutin), Retin-A Cream for cell turnover, Vita-K cream for Blotchy Skin . Sunless Tanner helps mask discoloration (higher % the darker, can do application over 3 days), use alcohol based toner over the area first to get off oils and residues, wear gloves, moisturize boney parts as they pick up tanner more.   Picosure is a great treatment (non - ablative). IF you have Ethnic Skin (Asian, Indian, Mediterranean, Black/African,etc...), it works well because you have more collagen in your skin. Works perfect for your skin type. This promotes new collagen, is a alternative to vascular laser for lighter skin types, and gets rid of the PIE.

How to care for hyperpigmentation
First, get your skin completely clear from active acne. This way you are preventing any future hyperpigmentation. Once you are clear, you can try a hyperpigmentation treatment from above to reduce the marks you might have. Topical treatments are the first choice for treating hyperpigmentation. The treatments most commonly prescribed by dermatologists are hydroquinone (HQ) and retinoids.

Hyperpigmentation sun exposure
Hyperpigmentation is common among people of African, Asian, and Latino descent, as well as other forms of non-Caucasian skin.1-5 Hyperpigmentation can also occur in Caucasian skin, albeit less frequently. UV light – the light from the rays of the sun – can make hyperpigmentation worse and cause it to remain longer. However, it is not clear whether UV light worsens acne itself, as research studies have reported that UV radiation can both increase and decrease acne. Regardless, for all skin types, it is important to take appropriate steps to protect your skin from excessive sun in order to avoid worsening of hyperpigmentation and allow any hyperpigmentation you currently have to heal as fast as possible.

How to prevent hyperpigmentation
Picking at acne lesions is the worst culprit when it comes to creating hyperpigmentation. Absolutely do not pick at acne lesions. Properly pop a pimple only when it is ready to be popped, and then leave the lesion alone. Also, while it may seem intuitive to scrub marks away, harsh scrubbing will only prolong their duration and should be avoided. Be sure to wash gently. Next, as mentioned, keeping hyperpigmented skin out of the sun when possible is a huge help in allowing these marks to fade as quickly as possible. Wearing a sunscreen is important as well.

The best way to prevent hyperpigmentation is to treat the acne itself, thus preventing future acne lesions and any hyperpigmentation that they might leave behind.10 Acne is treated the same regardless of skin color and responds extremely well to proper topical treatment with benzoyl peroxide. When acne is severe, widespread, and deeply scarring, Accutane (isotretinoin) is also an option.

Hydroquinone 


Hydroquinone is the first choice of treatment for hyperpigmentation.12 It is normally used at a concentration of 4%. In higher concentrations it can cause "spotted halos," which appear as lighter colored ring around marks. Hydroquinone treatment results in a marked improvement or complete clearing of PIH in 63% of the patients.4 The efficacy of hydroquinone may be increased by the addition of a retinoid and a low potency corticosteroid, such as hydrocortisone.13 Side effects of hydroquinone include burning, redness, and itching in 30% of the patients.12 The addition of ascorbic acid (Vitamin C) to a topical hydroquinone treatment may help minimize side effects.2-3 Hyperpigmentation starts to subside after 4 weeks of hydroquinone treatment, but maximum results usually require 8 to 12 weeks of treatment. Be certain to work closely with your physician or dermatologist if you decide to use hydroquinone to ensure proper dosage and reduction of side effects.

Tretinoin/Adapalene/Tazarotene/Differin



Tretinoin (Retin-A®), Adapalene (Differin®), or Tazarotene (Tazorac®). Retinoids are vitamin A analogues that are typically used together with hydroquinone. Retinoids are topical treatments that can help fade marks and treat acne at the same time. According to the Journal of the American Academy of Dermatology, “Of particular significance to skin of color patients is the ability of retinoids to treat both acne and PIH. By increasing epidermal turnover, these agents facilitate melanin dispersion and removal.” A study published in The New England Journal of Medicine on people with skin that was darkened by hyperpigmentation showed that daily retinoid treatment resulted in “much lighter” skin in 53% of participants and in “somewhat lighter” skin in an additional 33% of patients.

If retinoids are used alone and not in combination with hydroquinone, dermatologists often prescribe a topical corticosteroid in order to reduce the irritation and potential worsening of PIH that retinoids can cause when they are used alone. An expert opinion in Skin Therapy Letters sums it up: “The use of retinoids as monotherapy is not recommended as an irritant reaction may cause inflammation that induces paradoxical hyperpigmentation; a similar concern exists over the use of HQ as monotherapy at very high concentrations (i.e., 8-20%).”

Retinoids typically take 8 to 12 weeks to produce maximum results. The frequency and concentration of retinoid therapy depends on the severity of hyperpigmentation and should be determined by a dermatologist.

Niacinamide, also known as Nicotinamide.


Niacinamide is a B vitamin that can be administered topically, and is currently being investigated as a potential therapy for hyperpigmentation. A study published in the journal Cutis in 2015 showed that a topical cream containing 4% niacinamide in combination with the other pigment-lightening and anti-inflammatory compounds arbutin, bisabolol, and retinaldehyde reduced hyperpigmentation due to melasma by 34% over a period of two months. Melasma is a common skin problem where brown marks appear on the face due to pregnancy or sun exposure.15 To date, there exists no published research that has investigated whether niacinamide is also effective in treating PIH, but studies are currently in progress.

Azelaic Acid


Azelaic acid is another topical acne prescription that is sometimes used for PIH that works by slowing down the production of melanin. It is a gel that doctors normally prescribe in 20% concentration for PIH, applied twice a day. Azelaic acid is safe and effective for the treatment of both acne and PIH conditions in darker skin types. Common side effects include mild redness, scaling, and burning.16 Due to the mechanism of action of azelaic acid, results are not seen for the first few months of azelaic acid treatment, but results are eventually seen after six months.

Gentle Chemical Exfoliation


Over-the-counter glycolic acid products are available in strengths up to 10% and can provide gentler chemical “peeling,” which is better described as gentle chemical exfoliation. At lower percentages in over-the-counter products, glycolic acid does not cause the skin to visibly peel off in sheets like professionally administered chemical peels do, and instead provides exfoliation of only the surface cells of the skin. This is a slower and safer way to achieve the skin turnover required to reduce hyperpigmentation and can be used on a more frequent basis when compared to chemical peels. Most people find that they can tolerate over-the-counter 10% glycolic acid products every two or three nights, or every night when mixed ½ and ½ with moisturizer.

Acne.org AHA+ & Alpha Hydrox Enhanced Lotion

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   WHAT IS: HYPOPIGMENTATION 
     - white spots (loss of pigment)

Q: What Is Hypopigmentation? 
A: Hypopigmentation is: Vitiligo, pigment loss due to burns, scars, skin discoloration. Sunless Tanner helps mask discoloration (higher % the darker, can do application over 3 days), use alcohol based toner over the area first to get off oils and residues, wear gloves, moisturize boney parts as they pick up tanner more.  Treatments: XTRAC Excimer Laser at 308nm or Light Box phototherapy treatments UV-B lamp, Melgain (Decapeptide - Basic Fibroblast Growth Factor), and microneedling at home. Clinics use costly Recell which only has a small percentage of working on scars. A new spot treatment is LATISSE (bimatoprost ophthalmic solution) to darken the hypopigmentation and and cause "some" pigment to slowly return. Checkout the link below for how a member fixed his hypopigmentation. If nothing works there is medical tattooing http://basmahameed.com/paramedical/surgical-scars.php Read More here: https://www.acne.org/messageboard/topic/352685-recell-for-hypopigmentation-burn/?page=5




 
 
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7. TEXTURE, EXTREME DRYNESS, & COVERING UP SPOTS, LARGE / SCARED PORES
 
Q: How do I improve my large pores, and orange peel texture?
-- Please See the Filler and Subcision Section below for a detailed description for scars.

A: At Home Retin-A - Increases Skin turnover production. BHA (Glycolic acid peels) like you find from Acne.org store above or MUAC (Google It).  Microdermabrasion Microneedling (Derminator - Dermastamping)  The Ordinary or Paula's Choice 10% niamincide booster. Niamincide has been proven to thicken skin and shrink pores. There is a cream called Benefit Cosmetics "Pore"fessional that blurs these spots, used as a primer under makeup or by itself. TCA Cross using 35% (multiple coats 10X), you need a very tiny way to either get into the pore and not hit the walls doing a little at a time until they heal. Some have used a shaved down toothpick to fit inside pores or ice picks. For a larger area you can spot treat with TCA full peels (spot treatment on your scars 35% and under, start at 15% and move up, do a test spot to see how your skin reacts before going crazy - see peel section below). Always degrease with acetone or rubbing alcohol and a pre-peel jesner / glycolic peel  before.  You can do a few at a time, so you can cover with makeup.
Doctors treatments For Surface Texture and Large Pores: TCA Cross to individual pores.  RF Needling shrinks pores Fraxel 1927nm high density is especially good for scarred pores, Clear and Brilliant, Fractional CO2 laser, Laser Genesis (pores and surface texture). Punch Floats or Excision (pores - see below for description). The Most costly is a deep sedated Phenol peel, this should be your last solution if all else fails, ... the doctor must go deep enough to get under the scars (surface texture). Fully Ablative Erbium laser Resurfacing Also known as a Deep Laser peel (surface texture - this is not fractional laser). Filler injected throughout the cheeks (field subcision) not specifically for the scars (broad filling to plump the skin). Over Dilute Sculptra is great for this (pores and surface texture). Skin Boosters help some also called Meso. This benefit does not last long before a top up is needed. This hydrates and plumps the skin a bit but will not work for all but the most shallow/ small scarring (pores and texture).   Sublative (ematrix) is good for surface texture takes many treatments, results are subtle like laser genesis (pores and surface texture).. PDT (Photo Dynamic Therapy) using led blue light and medication to shrink pores Microneedle .05mm followed by botox to the pores superficially shrinks them.
 

Q: Can Guys Do Anything to Cover Their spots and Help with Self Esteem?
A: Guys you can be as manly as you want and wear makeup (the ladies have had this tool for some time).
Hear me out. Movie stars, news anchors, models, musicians, Youtubers, and even politicians wear makeup. Buy a concealer for just your acne scars and spots (spot treat them). You want it to match exactly your skin color and not be shiny ("matte"). My favorite is sold at Sephora (they color match you) Makeup Forever Camouflage Concealer, this looks extremely natural on the spots. Dermablend is sold at Macy's and Nordstrom. This is used for medical scars and to cover tattoos (they match your color) and it's very thickly pigmented. Ben Nye Cover All Wheel and Bill Nye Concealer Wheel sold on Amazon and Ebay (it has various shades), this is used in the theater.  Other options include tinted sunscreen. Benefit Porefessional blurs pits and pores with no coloring. Sunless or Spray on Tan can hide acne scars and issues quite well. Beards and facial hair. For the body tattoos cover scars or medical tattooing is pigment to match your skin color. Also Sunless tan products.  




 
Q: What can I do for extreme dryness, bumpy or bad texture, small wrinkles, or marks?
-- Please See the Filler and Subcision Section below for a detailed description for scars and the orange peel and large pore section above.

A: Moisture with a pure 100% Hyaluronic Acid Serum, this avoids skin irritation or ...

Skin boosters or Meso Treatments (very popular in Europe and Asia) like Restylane Vital, Juvederm Hydrate or other HA products are not crosslinked like what is used in filler and much more superficial (just under the epidermis). Filler provides lift; but boosters are different making a bunch of small injections to provide intense hydration, minor skin correction, and small textural improvements. https://www.acne.org/messageboard/topic/357406-skin-boosters-restylane-vital-hyaluronic-acid/ Sculptra Filler Injections is well known for collagen production Cerave moisturizers, Vaseline/ Aquaphor (but this can clog pores so use in a emergency or post procedure).  Omega 3 Fatty Acids, Fish Oil, Coconut Oil, Nuts, Salmon, Eggs, Oilve Oil, Flaxseed, Fish, Kelp. Silicone primers and Benefit Porefessional blurs imperfections.  Sunless or Spray on Tan Retin - a / Tretinorin / Differin products You may have fungal acne creating this texture, have your Dr check or try a sulfur soap. Repair Moisture Barrier (often by those who over exfoliate or have to many laser procedures and get rid of the epidermal protection of the skin, Google It) Acid Peels (See Section).
 
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8. PUNCH: GRAFTING, ELEVATION, & EXCISION

Q: What is Punch Excision & Dermal Grafting?
A: Punch Excision is a procedure whereby a doctor will use a tool to punch out the scar and then sew the remaining skin together. Dermal grafting is a procedure whereby a doctor removes skin from a different part of your body (usually from behind the ear) and places it into the scar. Ice picks are often treated this way. Dermal Grafting has lost favor with dermatologists because the fat is surgical with variable results  and we have fillers now. Acne Scar suffers heal poorly, so there is a high outcome of poor results using this method. Floats are raising box cars to a higher level on the skin. If you pick this treatment find a highly experienced specialist and try to minimize a small amount of scars it is done on to avoid complications. All of these treatments depend how you heal, keep that min mind if your sensitive or a slow healer. The cheeks respond better than other places on the body.

** If you have only a few smaller surface scars or a few scared pores this may be a good option, ... one must resurface after you have the excisions (laser or peels for the texture). Please note this makes a thin line (depending on the scar size instead of a scar so it does not work well for large scars or deep defects.

It can work well on a few large pores or body scars  if you have a few of them (because filler does not work here), one must do laser and steroid drip in this case (body only) as well. Punch Excision: The scar is removed with a punch biopsy tool and the site is sutured. Punch Grafting: The scar is first excised and discarded as with circular punch excision; in its place, a full-thickness skin graft is positioned, taken from an inconspicuous site, such as the postauricular scalp or behind ear. The grafts were placed slightly elevated above surrounding skin, with ablation or resurfacing performed later  to correct any residual surface abnormalities. Punch Elevation (Float): The punched-out scar is elevated to the level of the surrounding skin and secondarily heals like a graft.
Important Notes:
There is a good chance of a small scar after punch excision so you are trading one type of scar for another (indentation vs a small light linear scar).



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9. HYPERTROPIC / KELOID RAISED SCARS

Q: My scars are raised (hypertropic), not indented (atrophic). How can it be treated?
A: This is called hypertropic (aka keloid) scarring and can be treated with silicone sheets (OTC - Walmart, Walgreen's, CVS, Boots), liquid silicone, or cortisone injections (provided by dermatologist). Color can be treated with the V-Beam /  QuadroStar Pro Yellow Laserlaser. The treatment options include laser ablation, electrodessication, or surgical excision. Other options for the treatment of elevated scars include injection of bleomycin, cryotherapy, topical application of imiquimod, flurandrenolide, tacrolimus, and silicon gel. Laser Steroid Drip to the Scars.

Intralesional injection of botulinum toxin has been shown to reduce scar formation. Pressure, flavonoids, TGF, mannose-phosphate, and IFN25 were also listed as helpful.

Keloid scars, different from hypertropic, are scars with tendencies to invade the peripheral tissue, expanding in size, and growing persistently. Keloid scars should not be treated by way of surface destruction.



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10. SUBCISION



Q: What is subcision? Will it improve my scars? Should I use filler?
A: Subcision is a method whereby a doctor uses a "Cannula" blunt needle to break up the scar tissue underneath the surface of the skin. It is said to be best for rolling scars that are bound down. If your bound-down scar tissue looks smoother when the skin on the sides of the scar is pulled tighter apart you're a good candidate. Some people's scarring has improved by this method, others have had minimal or no improvement, and others have had their scarring deepen (though this seems to be more rare). Please see your dermatologist for further information on this procedure.  We recommend doing filler after subcision (you must wait a week(+) for the swelling to go fully down for consistent and instant outcomes (only if you have a pencil eraser or more in scar depth - otherwise do suction and saline)...

You do not need to get filler at the time of subcision, you can also get it done before it re tethers to your skin (typically a month after). I don't mean the swelling goes down from subcision (This is not tethered). When it is tethered again, you cannot stretch it and make it go away (the scar). Subcision simply means to make a pocket. Various people heal at different intervals. Many do several subcisions when the filler needs a top up again. 

Subicision is the act of making a pocket, and filler, saline (cheap - water - does not last) or prp growth factors can be used as a spacer. Prp does not last as long as filler but can make you heal better as it stimulates the body to heal. You can do both if you wish, or just the filler. They can fill you with filler it donuts and they also subcise the donuts. What maters most is they are a expert injector who has filled scars before and you state clearly you do not want a doughnut. HA can be dissolved also. They must be exceptionally good when doing a cannula subcsion which can create swelling and bruising. If they put to much filler under swelling it can create a bump (which can be fixed). Some injectors need the skin to not have swelling when injecting and this makes the best results.

You will know where your scars are located post subcision. They will more than likely be bruised or have a diffrent texture. You will have a deficiency in your skin volume (remember the swelling goes down) and need filler in that spot. Find someone who is meticulous.

Eventually after a few times of cannula subcision, they "can" do more filler at your local expert injectors office. Filler is needed naturally as we age and loose volume.

A master injector is meticulous, knows on your face where you need volume, know anatomy (nurses know this), has a plan how to fill you, ... you trust. Know the products and works with your budget. They have experience injecting others with acne scars and are informational. This does not mean they are acne scar specialist but they know facial anatomy and can fix deficiency effectively. They feel the skin and not just inject.
 
Most doctors. They charge a initial office fee and treatment cost. Then the cost goes down as you pay for a package or do ongoing treatments. Filler of course makes the cost of the subcision go up from just saline (water), or prp-growth factors. Sub with filler costs more than sub with prp. Some doctors give cheaper pricing after the initial consultation. 

PRP does not last as long as cross linked filler which can last 5 months up to 1.5 years depending on your body and material. You can again do both if you wish or just subcision with the filler elsewhere or do filler on your last subcision treatment. There are longer lasting fillers like Bellafill/ Artefill but I would never do them until doing HA fillers (naturally found in the body & can be dissolved)a few times first. Micro Fat is another option, but it's very expensive and takes 3 sedated operations to maintain the volume (does not work well to fill small spots unlike HA filler). 

PRP is a spacer, saline is a spacer (sterile water), botox is a spacer, etc. Blood is  a spacer with cupping. The question is the only one who lasts the longest with volume is filler because it's cross linked. You can just do PRP and see how you do (everyone is different).

UPDATE: Filler and Subcision is now the standard for acne scar revision for rolling and box scar scars that are sunken (fat deficient). Fillers typically used are Perlane also known as LYFT, Ultra, Belotero, and permanent solutions you should only try if satisfied from filler are Aretefill / Bellafill, Fat. Note, if your doctor does not subcise the scar to make pockets for the filler and release the scarring, it will doughnut around the bound-down area and do nothing (this can be fixed with subcision after to fix it). Fat Grafting or Fat Transfer is used for those with large acne scars where it would take several syringes to fill one scar. Drs perform Subcision in several ways

IF you have extremely fibrotic thick scars that bend needles , they may not use a Nokor (scalpel needle - instead using a normal needle, or a blunt cannula, or possibly a different technique. Do what you have available nearby your location (many Drs don't know about suction or saline injections - see below).

Q: What is Vacuuming / Cupping / Suctioning After Subcision (Prevents Re-Tethering)?
This is the cheapest option if you cannot afford Fillers, ask the doctor to inject saline (sterile water) after subcision . Otherwise you can just cup at home, the Dr will be clueless about this.

The role of suctioning is to prevent re-tethering, induce repeated hemorrhage (bruising), delay healing. IF your scars are less than a pencil eraser in depth (filler could create bumps) then you would do Saline injections (basically purified water - much cheaper) at the time of your subcision, followed by 3-4 weeks of Chinese Cupping (Amazon/eBay) when the injections go down 3 days to a week after. You should begin suctioning 24 - to 48 hrs after your procedure if you don't have saline (this depends on your healing capability, some are still to tender to do it at this time period, and it's ok to wait). Depending on how you heal you will want the wounds to be closed enough that you don't break them open when Suctioning.

 You rest the suction for several seconds over the scars to create blood flow to the area (it will bruise so use light pressure). A Hematoma under the skin, this is the goal. for the Hematoma to "fill" the tissues with your own collagen. Rings from cupping go away and probably mean the suction was to much for that spot.

You will continue this 8 times a day for 4 seconds OR you can also do it 3 times a day (3 sets a time of 15 seconds, or however long you can stand it). ""Light"" pressure not full strength! Overlap to cover the area. When I say a '''set''' that means all the scars on your face covered (for some they will need to overlap the cup to make sure the whole scar is suctioned). Use as small of a cup size as possible to cover the scar. Many will suction for a month's time. You won't be able to start doing cupping until the scabs have fallen off from the subcision, for some this is a few days or a weeks time. 

If you get any raised bumps, stop everything immediately, massage the area, and use ice, or a antihistamine like Benadryl, no harsh soaps or scrubs, you can continue when the skin is not raised again (A few days sometimes). Do less suction (with less force) to avoid over stimulating the area in this case only. If your susceptible to Keloids (raised scars- very rare) then have the Dr do dilute steroid injections.Do not take blood thinners, pain meds, and avoid other drugs that could induce this, check with a Dr pre-subcision. This is why people use filler, you avoid bruising and these possible complications. 

 This will enhance the results of your subcision. You will get possible bruising after subcision because of the hemorrhage creating filler under the scar and in the pocket wear make-up over this.  If the area becomes hard and permanently as a raised bump after treatment, your body is susceptible to Keloid scars (extremely rare). 

 > Success PCT14 Suction and Subcision Protocol
https://www.acne.org/messageboard/topic/361755-my-subcision-saline-suction-treatment/



source: https://books.google.com/books?id=47HGBAAAQBAJ&pg=PA394

 

 
 
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11. FILLER FOR SCARS

In Depth Thread on Subject:
https://www.acne.org/messageboard/topic/360849-discussion-acne-scar-fillers-injections-brands-augmentation-new-techniques-fat-atrophy/


 
Q: What are injectable fillers and how can they reduce the appearance of scarring?
A: There are many types of injectables used for augmentation. It has been shown that once they are injected into the skin, they can raise the surface of the scar. Unfortunately, most of the injectables widely available are not considered permanent. In addition, some are not available in all countries. Always try non-permanent fillers before you go the permanent route. Here is a list of some of them to get you started in your research: Juvederm Ultra or Perlane / LYFT HA Filler: <12 Month (If you're lucky) Filler / Cheaper / Lots of Lift: http://restylanelyft.com/ Juvederm Volluma - Lasts 1.5 years (less for some, more for others), for very fat deficient cheeks and temples Juvederm Volbella: Softer filler, can be used near the surface in the upper Dermis with subcision, great for under eye area.  Beletero: HA filler, softer dermal filler, shorter lasting period great for thinned-skinned areas, no water hydration from surrounding tissue http://www.belotero.com/ Restalyne: Shorter lasting period: HA, cheapest Emervel Teosyal Various HA fillers from your country  
Semi-Permanent / Permanent Sculptra (Semi- Permanent) this stimulates collagen production in those with major fat loss or widespread scarring. First used on those with HIV who had fat loss of the face. It works great in combination with rf needling which stimulates it. It is injected throughout the area of concern deeply (over dilute 19ml of saline to a vial) one a month (vials) for 3 months or for acne scars sometimes only one treatment is done with a vial. It has a slow effects which takes 6 months to see in full, and lasts 2-5 years before a top up is needed (See Below Sculptra Section). Collagen stimulator not a individual pit volumizer. I often reccomend this for widespread scarring and fat loss with subcision (can be done in the same session unlike HA filler - you wait till the swelling goes down from the subcision).  Fat (harvested from your own body - only some survives, may be lumpy and need a few surgeries, some is longer lasting). This is used for scars that are large (over 10mm) and would take several syringes of filler costing more than the fat grafting surgery itself which is a few thousand dollars - See your doctor for further info. This procedure is outdated. 3 invasive surgeries are needed, fat is often absorbed in 3 years $$,$$$, it can be lumpy, and you can get the same results for a cheaper price with Sculptra, Voluma, or Bellafill (do not do permanent till you 100% like temporary fillers).  
Not Recommended but some users have success with these (our skin ages and changes, fat is lost, so long-term use outcomes are unknown - yet they are permanent). We heal poorly as acne scar sufferers or we would not have scars so it's a gamble... ArteFill / Bellafill, FDA approved - Microspere beads that are permanent, can migrate or cause grandulomas or fibrosis around the material. This is the number-one recommended permanent filler for acne scars right now. Silicone Microinjections, Not FDA approved - off label usage (Must be an experienced doctor who has done thousands of these), can migrate or cause grandulomas or fibrosis around the material, also infectious biofilms. Very Few Drs do this for a reason, complications. Q: How Much is Enough Filler - As You Can See Sometimes Little Filler is Purchased So Little Results Are Achieved.  If You have to do a "large" area (your whole cheek is covered in scars), with lots of fat loss, consider Sculptra, and spot fill the pits on the last subcision session if needed with a HA filler. If you have a few pits or minor fat loss, a HA filler alone should be fine. We are filling for a spacer and to have your body replace the filler with your own collagen after subcisions, not for overall volume like Aesthetic work.  Q: What is Sculptra Used For? What Can I do for fat loss and early aging due to my scars?
Here is a thread on various types of fillers:
https://www.acne.org/messageboard/topic/360849-discussion-acne-scar-fillers-injections-brands-augmentation-new-techniques-fat-atrophy/



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12. LASER

In Depth Thread on Subject:
https://www.acne.org/messageboard/topic/357373-discussion-all-things-laser-new-laser-technologies-treatments-updated-laser-link-o-rama/  


 
 

Q: When is laser best used?
A: The last step when there are no others options, you have exhausted and done all the pre-resurfacing work to improve your scars (making them monomorphic or on the same level as possible), you know the risks and side effects (discussed below), and you have someone who specializes in the laser's use specifically for acne scars. There are many bad Drs who own lasers with pre-set settings.

Infini RF has gained more acceptance for acne scars (used in  fractional manner than laser for a earlier collagen producing treatment). 
Latter on fully ablative erbium laser resurfacing - no grids to get under the scars - mainly for texture after you have done all other treatments to improve volume issues and raise the scars to the surface. A deep peel (see the peel section below for a how to and more info) can be performed that does the same thing with less side effects (than laser and easier to find Drs). These are performed by a experienced Plastic Surgeon or Dermatologist. Peels are for slight surface texture, not pits, holes or divots. One can do a test spot or only treat the scarred areas to make sure the good skin is not effected. One thing to note with full laser is that it is important to ‘chase the scar’. For permanent pore reduction, laser needs to go below the widest opening of pore otherwise it can open up the scar (looks larger).

Q: My doctor says to get laser, will this fix my scarring quickly {NO IT WONT!}?
A: Run, the doctor wants you to pay for his or her $110,000 new toy. They tell everyone it can slice and dice and do miracles light-based treatments of acne scars, patients are often encouraged to receive a greater number of treatments to get more satisfactory results but are seldom told that the clinical results are good for only 2 years (see the harmful side effects below an Dermabrasion which is permanent).
If you have uniform scarring that is relatively shallow (Ie. Orangepeel or Monomophic scarring), you can do Fully Ablative Erbium resurfacing (not fractional at the end of other treatments not the beginning), but I recommend TCA and Phenol Deep peels over this as they are more controllable, easier to find, and have less side effects. A deep phenol peel by a doctor is much more effective than a laser procedure if the doctor gets under your scarring once other work has been done to raise them as much as possible. Laser does not work on pits and is made for surface texture (filler and subcision does).

Start with non-energy devices: your diet, hygiene, topicals such as Retin A, Accutane, Food allergy or allergy test from beauty products, acid peels, tca cross for those ice picks, microneedle, subcision to lift the tethered scars w/ filler to keep things plump. As acne scar sufferers we heal poorly, or we would not have the scars to begin with. Next step is move onto the big guys - energy devices that have high side effects (fat loss, healing worse) and only possible rewards. V-Beam / QuadroStar Pro Yellow Laser is safe for discoloration and most lasers are for surface texture only (acid peel also do this), it will not make fat appear or magical new skin. Laser smooths and softens texture and makes scars wider (the rough sharp edges).

Q: What are the side effects of laser?
A: I go into this in-depth in the below post... Burns, additional scars, hypopigmentation, hyperpigmentation, thinning of the skin, long-term redness, scar worsening, bacterial infections, breakouts, fat loss, blistering, scabbing, crusting, months of down time, demarcation lines, bruising, sun sensitivity, pain, swelling, itching, milia, lumps, bumps, large pores / orange peel, and acne. The most common treatment outcome I have heard by hundreds is they wished they would not have started with laser and tried other things first. Fat loss is a real possibility with energy devices. Many doctors use the laser on preset settings and have no idea how to use it for those with acne scarring, thus making them butchers. IF you do choose to do laser goto someone with lots of experience treating your scarring type (specialist - few the in world, not a common general derm). Aftercare is sometimes more important than the procedure. Many offices do not take care of their patients after leaving them with poor results. Walk out or never call again if a Dr says laser will solve all your problems, you are helping to pay for their very expensive and cool looking machine.



https://www.acne.org/messageboard/topic/357373-discussion-all-things-laser-new-laser-technologies-treatments-updated-laser-link-o-rama/

Q: I did all the non - energy device recommendations first with no changes in my scars. What lasers should I take a look at now (remember it is a gamble of outcomes...as acne scarred individuals, we do not heal properly)?

 
Q: What is the difference between ablative and non-ablative lasers?

Non-ablative lasers do not remove layers of skin, but instead penetrate through the skin in an attempt to stimulate collagen growth from underneath the surface of the skin. They also are not very effective. Definition of ablate from dictionary.com: "To remove by erosion, melting, evaporation, or vaporization." Ablative lasers are much more invasive than non-ablative lasers. Ablative lasers are not recommended for use on darker skin colors. Of course, with higher energy and removal of skin (in fractional cores) better outcomes are often had than non-ablative means. Also higher side effects, and in fact may make it worse. Seek an experienced professional of acne scarring. Always try non energy device solutions first. Laser is a gamble.

Examples of ablative lasers: CO2 Erbium: Yag
Grids Vs. Deep Laser Peel
Another common misconception is laser delivery. Most doctors are using grids or fractional laser now (areas of untreated skin are between where the laser treats - see above picture). They do this to avoid complications and increase healing time. Unless you have extremely thick scars and nothing can get through them (then you get Ultra Pulse to break through the tough scar tissue  this has side effects). I would instead get RF microneedling which gives better results to a scar patient. I would use Fully Ablative Erbium Resurfacing (no grids (see picture above about lasers) at the end for texture. Please note there are side effects and a deep peel is often better by a experienced Dr.
 
Q: Will ablative lasers (CO2 or Erbium) reduce the appearance of my scarring?
A: It is possible that it will reduce the appearance of your scarring but it can come with a hefty price tag, a significant amount of downtime and a risk of new scarring (see below).
 
Q: What are the "Possible" Side Effects of Ablative, Non-Ablative Laser Procedures / IPL / RF?
A: Risks from ablative procedures include: Please Note these are "possible" side effects, thousands treat well with laser, do your research, find a expert for energy devices not just someone that zaps you, and always do manual methods of scar work before laser subcision, tca cross, etc. Laser is the end of the line not the beginning, do not let the below concern you but you must be aware of "possible" side effects from aggressive laser. Swelling, scabbing, and oozing Bleeding, flaking, and redness Significant irritation that requires a longer time to heal Long-term skin discoloration and more scarring Fat Loss, Filler Loss Poor Healing by Acne Scar Sufferers (who already heal poorly) Does nothing, a waste of money with long down time and healing For ablative resurfacing with a laser, the quality of the postoperative techniques is as important as the skill of the physician during the procedure. After ablative laser treatment, the skin oozes, crusts, and needs to be cleaned and dressed for about two weeks before you look even vaguely normal. Because the top layer of skin has been stripped away, the raw, exposed skin needs to be cleaned and treated very carefully. Patients need to make sure they follow post-op care instructions precisely, because inconsistency or incomplete care can cause infection, delay healing, and increase irritation.
Non-ablative resurfacing has none of the side effects associated with ablative resurfacing. However, non-ablative resurfacing doesn't produce the same dramatic or impressive results. The advantage for non-ablative resurfacing is its minimal downtime and they work on ethnic skin without hyperpigmentation. Women can reapply makeup before leaving the doctor's office and return to work the same day.

Non-ablative lasers can cause: Swelling and potential bruising (this fade within days) Enhanced redness or a sunburn-like reaction (this is temporary) Temporary darkening of treated spots (these lighten as they heal) No improvement, a waste of money   Q: What Are Good Laser Treatments for Ethnic Skin (Black/ African, Asian, Indian, Mediterranean, Latin) ?
A:  Picosure is great, it induces collagen growth. Non Ablative so it does not harm the skin or discolor for ethnic patients. Takes away redness. Rejuvenates ethnic scars. Works on various skin types for Ethnic skin especially if you have more collagen (several treatments are needed). Also 3-7% density with the highest power on a CO2 laser for large pores, boxcars, and scars is helpful and safe in ethnic patients.  Infini RF with protected micro-needles for Ethnic Skin (various other brands have this) is a great treatment  for box cars, and rolling scars, or skin defects and pores. ** Always use nightly retin a/ tretinorin / Differin and a bleaching cream like hydroquinone, or something with Albutin and Konjac for 3 weeks prior to any treatment with a 1 week break before the treatment. This prevents discoloration in Ethnic Skin Types.

Q: What should I get instead of laser if my scars are bad?
A: RF Microneedling, subcision, and several medium TCA peels. This is done over 2 years. If you have uniform scarring that is relatively shallow (Ie. Orangepeel or Monomophic scarring), you can do Fully Ablative Erbium resurfacing (not fractional at the end of other treatments not the beginning), but I recommend TCA and Phenol Deep peels over this as they are more controllable, easier to find, and have less side effects. A deep phenol peel by a doctor is much more effective than a laser procedure if the doctor gets under your scarring once other work has been done to raise them as much as possible. Laser does not work on pits and is made for surface texture (filler and subcision does - Sculptra if you have deep pits and fat loss).
______________________________________________
13. MICRONEEDLING,  RF MICRONEEDLING, & Derminator 

   In Depth Thread on Subject: https://www.acne.org/messageboard/topic/359068-the-derminator-thread/?tab=comments


 
Q: What are other names for Microneedling? 
A: Dermaroller, Dermastamp, Microneedle, Microneedling, Needling, Single Needling, RF needling (See below question).
 
Q: What is Microneedling? 
A: This is a technique whereby an aesthetician, doctor, or tattoo artist uses either a hand tool or a tattoo machine to needle the skin without using pigment. This is said to "break up" the scar tissue thereby smoothing the appearance of the skin. This is also known as a cheap man's laser, the skin heals the tiny cores that are made.

NOTE: It is possible to needle yourself, but there are risks associated with this. Also, results are generally not as pleasing. It is best to see a specialist whenever possible.

For more information, read this thread: https://www.acne.org/messageboard/topic/359068-the-derminator-thread/?tab=comments

To buy an automated machine to do this at home: http://shop.owndoc.com/product-list.php?Derminator-pg1-cid61.html

Q: What is the "Dermaroller"? Can it improve scarring?
A: The Dermaroller is an instrument that has tiny needles embedded in it that is rolled across the surface of the skin. It is mainly used for better absorption of topical treatments and does not appear to actually break up scar tissue. 



Q: What is BETTER than microneedling? 
A: RF Microneedling is much more effective and a better treatment than at home microneedling, and it is better than laser treatments. The reason is it's much more controllable. Energy is delivered into the dermis for regeneration, using "insulated" needles which protect the top epidermis even in darker skin types unlike laser which is much more destructive. Make sure the doctor pinches your skin to feel for thickness and does not put the energy to high especially for your first treatment to see how you do. Collagen production and remodeling happens in 6 months after your treatment, you typically need 3 treatments spaced around your subcisions (see above section). The minimum amount needed between treatments is 3 months. Most doctors will push sooner treatments but this is not conductive to the bodies slow healing capabilities. Better to observe how you do. Also unlike laser the spread is much less and more controllable meaning less damage will occur if the nurse, med spa, doctor operator has done thousands of treatments. This is important to find.  Some brands are Infini, Vivance, Intracel, Intensif, Secret,etc ... As long as the needles are insulated. This is the best effective treatment as a alternative to microneedling (more effective with energy) and safer than laser. Some people still dermastamp (manual form of needling better than microneedling as there are no microtears to the skin), Derminator (automatic - does not hurt, adjustable needle length) are at home options to upkeep the skin but are very slow in action - the next step of effectiveness which is more $$$$ is RF needling. Retin A / Tretinorin / Differin Cream sold OTC at Target should be used at night when not healing from microneedling. Peels work well in conjunction with needling (they must be done at separate times allowing the body the proper months of healing time). 

 
______________________________________________
14. TCA CROSS FOR ICEPICK SCARS & ACID PEELS

** MUST READ (Link) -Everything About Acid Peels!
          How Do Do Them, What They Do, TCA Cross, Spot TCA Peels, Salicylic, Glycolic, Etc...): 
https://www.acne.org/messageboard/topic/366754-all-things-acid-peels-for-scars-tca-full-face-peel-tca-cross-paint-on-phenol-glycolic-salicylic-methods-and-techniques/


 
Q: What is the difference between TCA CROSS and a TCA peel?
A: TCA CROSS is a method whereby a doctor or skilled practitioner uses a high percentage of TCA Acid (100%) and spot treats each scar. This procedure is especially beneficial for ice pick scarring. TCA CROSS is something that should be done by a skilled practitioner because the risk of damage to your skin can be great. TCA peels (Spot Peeling) are of a much lower percentage (15-35%) than TCA CROSS. TCA peels are done by dermatologists and aestheticians and affect hyperpigmentation and more shallow scarring. Please click on the above link for a full mega-post on acid peels and their usage. 

Buy TCA, Excellent Customer Service (Not Chinese Made Industrial Chemicals!): http://www.makeupartistschoice.com/
 


Q: What is TCA Cross for Icepicks
A: Please Read The Above Link for All Things Acid Peels.


 
 
  ______________________________________________
15. WHY DO ACNE SCAR TREATMENTS FAIL FOR SOME PEOPLE? Q: Why Do Acne Scar Treatments Fail on Some People?
A: Your not like anyone else who has acne scars. I cannot over-analyze every choice, health concern, and action done in your life. It all depends on how you heal. I Get your frustration.

No scar case is the same, we are not clones, one person could do a million procedures and not be you, your all different ages, ethnic backgrounds, healing capabilities, plans for treatment, outcomes, different surgeons (they treat differently as well), etc, we could go on and on. The point being is never compare yourself to someone else. Sure you can learn from their experience but do we really know every single detail about what was done and why - no.  If someone heals poorly or had a poor Dr they typically hang around here.

We are not your Drs' goto a board certified Dr for help, ... if you want get 3 opinions and choose the one you like best. Your cases have nothing to do with each other or anyone else here, everyone is a individual with a different story.

It takes time and heal (this is a marathon and not a race, many do treatments every 3 months over 3 years time),... it's slow with lots of treatments.

If is scars do not respond there are some aggressive choices that I would never suggest without seeing a few dermatologists / plastic surgeon's for a second opinion. Let's go over some reasons why treatments may fail: Auto-immune conditions, smoking, poor health and healing, poor treatment techniques by the Dr's, not doing enough treatments, expecting the skin to be glass smooth and instead having gradual % of change over a few years of treatment - many only get 50%, Doing energy work first and blasting the face thus loosing fat and collagen and complaining it got worse, re-occurring acne and scarring in different places, stress, excess sugar, dairy, processed foods, antibiotics, anti depressants, hard drugs, alcohol and the liver, poor gut health, use of bad products that strip or hurt the skin, microneedling causing more scars when they have poor healing, excessive acid peels taking away layers of the skin. A big one is patients being cheap and not doing enough mls of filler, .5ml is not going to be enough filler for excessive scar work or fat loss. If subcision was done in the past with NO filler then yes it will do nothing, If you goto a general Derm and they are clueless this is also a big one, they can make things worse. Scar treatment is often over years time with excessive time of healing, it's not quick, so mono or singular treatments will not do it for your individual scars. Some people cannot do energy devices like laser - it will literally scar them... can't do microneedling ... can't do peels, all that is left is subcision and filler or invasive face lifts. Also the order treatment is done is very important. We don't pave a road correct before the potholes are fixed. When Dr's just laser they often are not fixing the pits.

Some choices:
1) Do nothing - sometimes this really is the best solution.
2) If they are a a poor healer, anything will make their scars worse, perhaps filler w/ subcision (""many"" times) and clear and brilliant are the best options for these types. Clear and Brilliant is the most gentle laser there is, with a tiny beam, and smaller power, so it will not damage the sensitive skin, or cause fat loss, or even create other skin issues like microneedling can for poor healers. The only down side is it takes many treatments at max power to do something for small pores or slight texture (under .5mm depth). This is probably the safest energy device created for skin.  Ematrix or sublative rf is also another choice that is very gentle on the skin as it provides surface level changes not deep improvement for severe scars.
3) Often those who need subcision with pits have not had 6-8 treatments and are slow to respond to the traditional amount or needed "more" filler.  
4) Punch excision or Punch float and resurfacing (cutting and lifting, this is done for boxcars / icepicks - this does not work well for poor healers or those with many scars).
5) Had fat loss from the Dr blasting them with laser, or they were overly gentle (treatments were not strong enough), as such we have to go backwards with more treatments needed and a better Dr to move forward.
6) Get a face lift (to stretch the scars) or a very very aggressive treatment by Dr Taylor in Utah (yes there have been some with botched attempts - but it's aggressive). Do not do this unless every thing else did not work (there are risks)!
7) Sometimes a change in Dr makes the difference, ... had a patient who was not responding to subcision, turns out the Dr was not subcising their scars and just doing one spot / not being aggressive to break the bonds.

It's best if you find a therapist as I feel it's effecting you emotionally and no one deserves to suffer with scars inside and outside, that is half of the battle. ______________________________________________
16. LIST OF ACNE SCAR TREATMENT DOCTORS / RECOMMENDED DR’s LIST

** Please note we are not responsible for your treatment and care. Please be informed before you contact the physician for acne scar improvement. Further doctors can be found that are board certified on the Real Self website. 
             Some Great Places for Reviews are http://www.yelp.com and http://www.realself.com

Questions to Ask during a call screening or consultation
How to Find A Acne Scar Specialist (""Look For,"" in a DR - Does **Manual Methods): We are not a referral service, ... these are well known Drs who perform these services, your experience may vary with them or you may find someone better nearby. The more well-known they are the more costly they are, often sponsored by Pharmaceutical, and Medical Device companies to push a procedure. The biggest Drs have marketing teams, ... that is why everyone knows about them. A example is Fraxel might give them a free Laser to push this on social media and in talks they give. There are many ways to the same goal, … there is no magical machine, you “must” have done. First and foremost look for someone who does manual methods like subcision, TCA Cross ”first” depending on your scar type, NOT laser. Laser should be the end game, not the beginning. See a specialist, Derm or Plastics, (sometimes going to a Med Spa can be ok for peels or certain treatments, not for laser/surgery/ sub).  Before and After Pictures Often Mean Nothing (Paid Marketing, 1% of the best cases, we all heal differently), word of mouth by real patients is much more beneficial  If the specialist doesn't use angle lighting, beware.  If he or she does not touch your skin to feel for fibrosis, they don't know what they are doing.  If they don't ask you to animate to see if your scars are tethered they have no clue.  If they don't stretch your skin to see the amount of atrophy, beware Revision starts with a thorough examination - touch is critical, if they miss fibrosis, they have no clue.  Like every sub specialist, whoever you see should take heaps of photos People on the Scar Forum have nothing to gain by speaking about their experience, this is more reliable than review sites. Does the doctor listen to you, are the over selling something, do they answer all your many questions "why." Do they care - what is the bedside manner, ask to see their aftercare instructions for proposed procedures (this says a lot). Goto 2-3 Specialists (get their opinion), even if you have to pay for consultation (some do this by Skype and on the Phone or App). You will be spending thousands on the Dr better to be comfortable and like what they will do. Subcision is often the hardest treatment to find. Dermatology teaching colleges often offer this, ... otherwise call around and ask "do you do subcision with a cannula (Needle Type)?  How many do you do a month?. You can use our Recommended Drs below. Some travel across country only for this step of treatment, they fill locally (to them) with an expert injector (after swelling goes down). You can often see Expert Injectors (Drs and Nurses) locally to yourself, and it's easy to find Energy Drs (laser). Most treatments can be done closer to home. Do not fall for reviews (Yelp, RealSelf), they are often done by marketing teams, contact patients directly and ask questions, read reviews on Acne.org Scar Sub ... people have nothing to sell you by sharing here. RESEARCH - make a informed decision. See if the Dr has Youtube videos on Acne Scars or has done academic papers, this is a sign he specializes in it. Cheaper is not always better. You must way how experience factors into your experience. If you don't have a ton of money do the at home stuff above (See section) and get cannula subcision done first, it's a cheap procedure that can be done when you have time and money to treat.  
** Recommended Top 1% Acne Scar Specialists ** 
** Drs sorted by Country Alphabetically

Dr Davin Lim
*** Highly Recommended, Famous Specialty Acne Scars Dr, YouTube Channel : Lasers and Lifts
Australia, Brisbane 
Specialty: Subcision (W/ Cannula), TCA Cross, Laser Dermatology Specialty for Acne Scars, Vbeam, Picosure, CO2, Erbium, Fraxel, Punch Excision, Filler, PRP, Busy specialist people fly from all over the world to see for treatment. 
http://www.lasersandlifts.com.au

Dr Rullan 
*** Highly Recommended as a Top Scar Dr For the West Coast by Many Forum Members
United States, California, Chula Vista, San Diego
Specialty: Subcision, Fillers, Sedated Acid Peels for ALL SKIN TYPES (teaches Drs how to do peels for resurfacing), Uses peels as a alternative to Lasers, Even Dark Skin, TCA Cross, Vbeam, I would do my energy devices elsewhere (plenty of med spas around) 
http://www.drrullan.com/

Dr Weiner (Plastic Surgeon)
Youtube Channel: Dr Weiner
United States, Florida, Panama City
Specialty: Subcision (W/ Cannula), TCA Cross, Laser Plastic Surgery, Filler, Expert Injector, Famous trainer, pioneer Infini /Genius RF spokesman, All things Aesthetics, Friend of Dr Lim. Please Note Clinic is known to push Bellafill (filler) for acne scars ""DO NOT"" get this until you have had a HA filler a few times, to know how you like the look, we are using filler to make your own natural collagen. Get it at the end of treatment if you wish. Permanent is permanent.
http://www.theclinique.net

Dr Mark Taylor
United States, Utah, Salt Lake City
Specialty: Inventor of Full Face subcision w/ Taylor Liberator Tool (See Video Below), this is quite a harsh/ hard core treatment (4-5 things can be done at once, the body does not heal like this, it’s slooooooooooow, I always recommend to space out treatments. People often go here if nothing else works, it's quite aggressive, and there are risks. You can try to tell him you only want one procedure done if you’re not in for the surgical package which is Overpriced $$,$$$ and must be repeated, those with little time seem to take the gamble with this surgery. He says one and done surgery which I don't find true and that the subcision tool he created is better than a cannula which I also don't agree with. 
https://www.youtube.com/watch?v=NuoJMQMJ4r8

Professor and Department Head Tony Chu 
United Kingdom, London, Chiswick
Specialty: Subcision, TCA Cross, Microneedling, PRP, Economical, Set in his ways, manual methods, if you want filler or energy devices you will have to get that elsewhere in between treatments. He gives barebones manual method treatment at a affordable price, don't expect aftercare or anything special with his standard package. If you do not need aggressive subcision, consider Dr Emil below who uses cannula subcision and has the energy devices - fillers.
UPDATE: Dr Anil does the same procedures as Dr Chu (worked in the same clinic), To book an appointment call the clinic 0330-999-6833,
Consulting rooms are at: Skinmedico 215 Chiswick High Road London W4 2DW
http://www.westlondondermatology.co.uk

Dr. Emil Henningsen 
Sweden, Denmark, Nyborg
Specialty:  Subcision, TCA Cross, Laser Dermatology, Fillers.
https://emilhenningsen.dk/ 

"General" Recommended Dermatologist's and Plastic Surgeons Who Treat Acne Scars 
** Drs sorted by Country Alphabetically

Afghanistan
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here.

Dr Brunildabardhi
Albania 
Specialty: Subcision, Laser Dermatology, RF Needling, Filler
https://www.venusderm.com/

Argentina
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Argentina," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here.

Dr Manoharan (Plastic Surgeon)
Australia, Brisbane
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://drmanoharan.com.au/scars/acne-scars/

Dr Ben Chan 
Australia, Melbourne - Dandenong/ Boxhill
Specialty: Subcision, Laser Dermatology, Filler
https://www.dandenongsuperclinic.com.au/our-team/
https://www.boxhillsuperclinic.com.au/

Dr Cara
Australia, Melbourne, Sunbury
Specialty: Subcision, TCA Cross, Laser Dermatology, Punch Excision, Filler
https://completeskinspecialists.com.au/treatments/skin-conditions-treatment/scar-treatment/

Prof Greg Goodman 
Australia, Melbourne, Victoria 
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler, General Dermatology
https://www.greggoodman.com.au/

Dr Philip Bekhor
Australia, Melbourne, Box Hill  
Specialty: Subcision, TCA Cross, Laser Dermatology, Microneedle, Filler, General Derm
http://www.drphilipbekhor.com.au/

Dr Natasha Cook
Australia, Sydney, Darlinghurst
Speciality: Subcision, Laser Dermatology Specialty, Filler
https://www.darlinghurstdermatology.com/

Dr Adrian Lim
Australia, Sydney 
Dr. Davin Lim's Mentor While in Med School and Famous Derm
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler, Microneedle, General Dermatology 
http://urepublic.com.au/our-expertise/

Dr Naomi 
Australia, Sydney 
Specialty: Subcision, Laser Dermatology, Filler, All Things Filler (Expert Injector Speciality), Skin Boosters, Expensive $$,$$$, talks on several dermatology forum panels and videos and is sponsored by filler companies.
http://drnaomi.com.au/

o2Clinic (Plastic Surgeon)
Belgium, Antwerp 
Specialty: Subcision (W/ Micro Fat Injections), Laser Dermatology, Filler, Plastic Surgery
http://www.o2clinic.be/en/

Michel Bernard
Belgium, Brussels
Specialty: Laser Dermatology, Punch Excision, Filler

Brazil
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here.

Dr Frederico Fernandes Cirurgia (Plastic Surgeon) 
Brazil, Beleza
Specialty: Subcision, Laser Plastic Suergery, Filler
https://www.drfredericofernandes.com.br

Dr Ritha Capelato
Brazil 
Specialty: Subcision (W/ Over Dilute Sculptra), TCA Cross, Laser Dermatology, Filler
http://www.rithacapelato.com.br/

Dr. Rubens Pontello
Brazil
Specialty: Subcision, TCA Cross, Laser Dermatology, RF Needling, Filler, Sculptra
https://institutopontello.com.br/tratamentos/subcisao/

Dra Ana Elizabeth Rieck
Buenos Aires
Specialty: Subcision, Laser Dermatology, Filler
http://rieckklinik.com.ar/

Canada
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Canada, or Subcision Major City__________," If It Is Called Something Different in Your Language (French) Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here.

Derm CA Dermatology and Aesthetics
Canada, Calgary
Specialty: Subcision, Laser Dermatology, Filler
https://derm.ca/acne-treatments/acne-scar-therapy/

Dr Joseph Doumit
Canada, Montreal 
Specialty: Subcision, Laser Dermatology, Filler, General Dermatology Aesthetic procedures.
https://clini-derma.com/en/cosmetic-dermatology/scar-treatment/ &nbsp; Kucy Pon - Sunnybrook Dermatology (Cosmetic)
Canada, Ontario 
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
https://sunnybrook.ca/team/member.asp?t=19&page=24071&m=467  Dr Benjamin Barankin
Canada, Toronto  
Specialty: Subcision (?), TCA Cross, Laser Dermatology, Filler  Dr Motakis (Plastic Surgeon)
Canada, Ontario, Toronto 
Specialty: Subcision, Laser Plastic Surgery, Punch Excision, Dermabrasion, Chemical Peels, Micro-Needling, Filler, PRP
http://drmotakis.com/aesthetic-surgery/body/scar-revision/

Dr Payman Kosari (Plastic Suergon)
Canada, Toronto 
Specialty: Subcision, TCA Cross, Laser Plastic Surgery Specialty, Fully Ablative Erbium Resurfacing, Infini RF, Filler Dr Phillip Solomon (Plastic Surgeon)
Canada, Toronto
Specialty: Subcison, Laser Plastic Suergery, Filler, Uses Permanent Bellafill, Please do not get permanent filler until you have gotten Ha filler several times and like the results. Permanent is permanent. Remember we are using a HA filler to have your body replace it as a spacer with your own collagen.
https://www.solomonfacialplastic.com/botox-facial-fillers-lasers/bellafil-toronto/

Dr Sheldon Pollack
Canada, Toronto
Specialty: Subcision, TCA Cross, Laser Dermatology Speciality, Infini RF, Filler

Dr Shehla Ebrahim
Canada, British Columbia, North Vancouver
Specialty: Subcision, Laser Dermatology, Filler
https://www.afterglowskincare.ca/skin-conditions/acne/

Dr Ngai
Canada, BC, Vancouver, Richmond
Specialty: Subcision, TCA cross, Laser Dermatology, RF Needling, Filler
http://www.revivamd.com/skin-concerns/acne-scars/

Dr Moon Choi
Canada, Vancouver 
Specialty: Subcision, TCA Cross, Laser Dermatology, Infini RF, Filler

Dr Oconnor
Chile, Santiago
Specialty: Subcision, Laser Dermatology, RF Needling, Filler
http://www.dermatologiaestoril.cl/

Dr. Armanndo Bolaños León
Costa Rica
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://www.facebook.com/skincenter.cr

Dr Bertrand Pusel
France, Nice, La Colle Sur Loup (French Riviera) 
Specialty: Subcision, Laser Dermatology, Secret RF Microneedling, Deep Resurfacing Peel - Exoderm, Filler
https://www.villabianca.fr/tours-de-main/cicatrices.html

Yves Laudoyer
France, Nice
Specialty: Punch Excisions, Elevations, Laser Dermatology Filler

Jean Arouete
France, Paris
Specialty: Punch Elevations, Laser Dermatology, Filler

Pierre Alain Mayeux
France, Paris
Specialty: Subcision, TCA Cross, Laser Dermatology Speciality, Excisions, Filler

Dr Darrius Alamouti 
Germany, Herne
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
http://www.dariusalamouti.de/falten-subcision/

Dr Georg Popp
Germany, Augsburg
Speciaity: Subcision, Laser Dermatology, Filler
http://www.licca.de/subcision/

Dr Edwin-Josef Messer
Germany, Bad Dürkheim
Specialty: Subcision, Laser Dermatology, Filler
http://www.dr-messer.de/subzision.html

Dr Wolfgang Theiene
Germany, Munchen
Speciality: Subcision, TCA Cross, Laser Dermatology, Filler
http://www.aesthetic-antiaging.de/behandlung-muenchen/faltenkorrektur/subzision/subzision-faq/

Dr. Robert M. Grabs
Germany, Ludwigshafen
Specialty: Subcision, Laser Dermatology, Filler
https://www.plastische-chirurgie-4u.de/subzision/

Dr Jima
Greece, Athens
Speciality: Subcision, Laser Dermatology, Filler, She is a dermatologic surgeon
https://korinatzima.gr/

Dr Stefanos Tzovaras
Greece, Athens
Specialty: Subcision, Laser Dermatology, Phenol Deep Acid Peels, Filler, PRP
https://www.tzovarasderma.gr/
https://www.realself.com/review/greece-gr-acne-scars-treatment-subcision-dermabration-phenol-peel-decision-life?sortBy=created&offset=25&sle=0

Ceulen Huidkliniek
Holland, Netherlands, Helmond
Specialty: Punch Excisions

Dr Loek Habbema from MC 't Gooi
Holland, Netherlands
Specialty: Subcision, Laser Dermatology, Filler, Overpriced $$,$$$
http://tinyurl.com/ndtzn5m

India
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Dr Umesh Shah - Amish Hospital
India, Akota Vadodara
Specialty: Subcision. Laser Dermatology, Filler

Dr. Rajdeep Mysore Dermatologist
India, Bangalore
Specialty: Subcision, Laser Dermatology, Filler
https://www.chiraghospital.in/dr_rajdeep.html

Dr Krishna S Chaudhari (Plastic Surgeon)
India, Chaudhari
Specialty: Subcision. Laser Plastic Surgery, Filler PRP
https://www.cosmeticsurgerypune.com/contact-us/address.html

Dr Nitin Walia Swasthkibaat Skin and Hair Care Clinic
India, Dehli
Specialty: Subcision, Laser Dermatology, Filler

Venus Institute of Skin & Hair
India, Hyperabad
Specialty: Subcision, Laser Dermatology, Filler
https://www.drvenus.in/

Dr Atul Jain Skinaa Clinic
India, Jaipur
Specialty: Subcision, Laser Dermatology, Filler
https://www.skinaa.com

Dr Sonia Mangal
India, New Delhi 
Specialty: Subcision, Laser Dermatology, Filler
https://myraskinclinic.com/

Iran 
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars).

Dr Mosaferian Aesthetic Center 
Iran, Tehran
Specialty: Subcision, Laser Dermatology, Filler
https://mosaferian.com/en

Elis Fitzgerald (Plastic Surgeon) 
Ireland, Dublin  
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Excision, Filler believes in surgical (manual) methods before laser, 300 (price) Consult
https://www.fitzgeraldplasticsurgery.ie/scars-treatments/acne-scarring/

Peter Prendergast (Plastic Surgeon) 
Ireland, Dublin  
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler 
https://www.venusmedical.ie/dr-peter-prendergast/https://www.venusmedical.ie/dr-peter-prendergast/

Giovanni Salti
Italy, Firenze
Specialty: Subcision, Laser Dermatology, Filler

Dr Mario Sirito (Plastic Surgeon)
Italy, Genova
Specialty: Subcision, Laser Plastic Surgery, Filler
https://www.mariosirito.it/contatti/

Vito Abrusci
Italy, Milano
Specialty: Subcision, Laser Dermatology, Punch Excisions, Filler

Luca Siliprandi
Italy, Padova
Specialty: Punch Elevations, Laser Dermatology, Filler

Skindoctors Center
Italy, Trieste
Specialty: Subcision, Laser Dermatology, Filler

Japan
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Korea
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Renewme
Korea, Various
Specialty: Subcision, TCA Cross, Laser Dermatology, RF Needling, Fraxel, Picosure, Plastic Surgery, Filler, Micro Fat Grafting, Subcision through other methods like co2 gas, Innofill Subcision
http://rnmeskin.net/

Dr Kee Yong Seng
Kuala Lumpur
Specialty: Subcision, Laser Dermatology, Filler
https://www.premier-clinic.com

Apax Medical Clinic 
Malaysia, Singapore
Specialty: Subcision, Laser Dermatology, Filler
https://apaxmedical.com/acne-scar-removal-singapore/

Prof C.L. Goh 
Malaysia, Singapore
Specialty: Lasers for Asian Skin Types Specialist, Has Several Lasers, Written many books on the Laser Treatment, Filler
http://www.nsc.com.sg/Patient-Guide/Our-Doctors/Pages/Dermatologists.aspx

Mexico
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Dr Carmen Galera
Mexico 
Specialty: Subcision, Laser Dermatology, Microneedling, Filler 
http://www.dermaforyou.com/

Dr. María José Velázquez González
Mexico, Guanajuato
Specialty: Subcision, TCA Cross, Laser Dermatology, Chemical Peels, Microneedling, Filler
https://www.doctoralia.com.mx/medico/velazquez+gonzalez+maria+jose-15044606

Dr Amaritgen  
Mexico, Mexicali, B.C. (Baja Mexico)
1769 Nueva 21100 Mexicali, B.C. (Baja Mexico)
Speciality: Subcision, Laser Dermatology, TCA Cross, Fillers Dr Miray Al-Mustafa (Elite House or Elite Helse Medical Spa)
Norway, Oslo
Specialty: Subcision, Laser Dermatology, Filler
https://www.elitehelse.no

Pakistan
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here.

Dr Muhammad Ashraf Ganatra (Plastic Surgeon)
Pakistan, Karachi
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler, Fat Transfer
http://ganatraplasticsurgery.com/

My Skin Aesthetics & Laser Center
Pakistan, Lahore
Specialty: Subcision, Laser Dermatology, Filler
https://myskin.pk/Contact

Philippines 
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Asian Hair Restoration Center and Surgical Dermatology Center
Philippines, Pasig City, Ortigas Center
Specialty: Subcision, Laser Dermatology, Filler
https://www.hairphil.com

Dr Margaret Corcoran
Philippines, Makati
Specialty: Subcision, TCA Cross, Laser Dermatology, Infini, Picosure, Filler, Radiesse
http://www.corderm.com/services-available/acne-treatments-available

Adraneda Dermatology
Philippines, Manila
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
https://adranedadermatology.com/collections/body-treatments

Dan Lazar
Romania, Satu Mare
Specialty: Subcision, Laser Dermatology, Filler

Russia
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here.

MAK Clinic
Russia, Moscow
Speciality: Subcision by Innofill, Laser Dermatology, Filler, Prp

Dr Sherer большая каретная улица
Russia, Moscow 
Specialty: Subcision (All Types), Phenol / TCA Cross, Laser Dermatology, Filler, Expensive 100k RUB for Subcision and Filler

Saudi Arabia
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Singapore
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Dr Justin Boey 
Singapore 
Specialty: Subcision (Cannula), TCA Cross, Laser Dermatology, Filler, Specializes in Ethnic Skin 
http://sozoclinic.sg

Gangnam Laser Clinic
Singapore
Specialty: Subcision, TCA Cross, Laser Dermatology, Chemical Peels, Filler
https://www.gangnamlaser.com/subcision/

Skin Renewal 
South Africa Johannesburg, Pretoria, Cape Town
Specialty: Subcision, Laser Dermatology, Filler 
https://www.skinrenewal.co.za

Dr Nemseff
Spain, Alicante 
Specialty: Subcision (Nokor), TCA Cross, Laser Dermatology, Filler
http://goo.gl/eK2ETf

Dr Didac Barco
Spain, Barcelona
Specialty: Subcision, Laser Dermatology, Filler 
https://www.dbdermatologiabarcelona.com/subcision-de-cicatrices-de-acne

Stellakliniken
Sweden, Stockholm
Specialty: Subcision, Laser Dermatology, Punch Grafts, Excisions, Filler

Daniel Fuchs
Switzerland, Zurich
Specialty: Punch Elevations, Laser Dermatology, Filler

Thailand
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Proderma Clinic
Thailand, Bangkok
Specialty: Subcision, Laser Dermatology, Filler
https://prodermaclinics.com/en/

S-Mart Clini (Plastic Surgery)
Thailand, Bangkok
Specialty: Subcision, Laser Dermatology, Filler 
https://www.s-martclinic.com/index.html

SLC Clinic
Thailand, Bangkok
Specialty: Subcision, Laser Dermatology, Filler
https://www.slcclinic.com/en/contact.php

The Med Clinic
Thailand, Bangkok
Specialty: Subcision, Laser Dermatology, Filler
https://www.facebook.com/TheMedClinicPremier

Dr Dr. Kolawach Laochaisri Plastic Surgeon  
Thailand, Watthana
Specialty: Subcision, Laser Dermatology, Filler 
https://www.drkbeautysurgery.com/dr-kolawach-laochaisri

VR Korea International Aesthetic Clinic
Thailand, Patumthani
Specialty: Subcision, Laser Dermatology, Filler
https://www.vrclinic.com/ติดต่อเรา/

Turkey
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

UAE or United Arab Emirates
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Russia, or Subcision Major City ________ ," If It Is Called Something Different in Your Language Use That to Search, Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill) From This Country. Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Dr Asif Hussein Skin Clinics
United Kingdom, London 
Specialty: Subcision, Laser Dermatology, Filler
https://www.sknclinics.co.uk/about-skn/expert-medical-team/medical-staff/asif-hussein

Dr Ayoubi (Plastic Surgeon)
United Kingdom, London
Specialty: Subcision (W/ Sculpta For Acne Scars Expert - Trains Other Drs How To Inject It), TCA Cross, Laser Plastic Surgery, Filler
https://www.sculptrabydrayoubi.com/scar-treatment/

Dr Firas Al-Niaimi 
United Kingdom, London
Specialty: Subcision (Aggressive, Tumescent, Anesthesia), TCA Cross, Laser Dermatology, Filler
https://drfirasalniaimi.co.uk/condition/acne-scarring-london/

Dr H
United Kingdom, London
Specialty: Subcision (Taylor Liberator Subcision Developed by Dr Taylor Utah - Only One In Europe, Most Aggressive Subcision, Tumescent), TCA Cross, Laser Dermatology Speciality, Several Lasers, RF Needling, Erbium, CO2, Fraxel, Fully Ablative Laser Resurfacing, Filler
https://www.drhconsult.co.uk/treatments/acne-scarring/subcision/
https://www.youtube.com/watch?time_continue=274&v=0QTWRRTH__M

Dr Nick Lowe
United Kingdom, London, Portsmouth
Specialty: Subcision (?), Main Focus - Laser Dermatology, wrote many articles on Laser Treatments, All the Energy Devices, Filler, $$,$$$ Overpriced
https://www.drnicklowe.com/

Perfect Skin Solutions Dr Patel
United Kingdom, London, Portsmouth
Specialty: Subcision, Laser, Filler
https://perfectskinsolutions.co.uk/contact/

United States
Note: Search especially Instagram or Whatever Popular Social Media (Twitter, Facebook, Etc,...) The Aesthetics Clinics Use to Advertise "Subcision," "Acne Scar," or "Subcision Your State ________," Several Dr's Post Videos Doing the actual Procedure (so you can checkout their skill). Call The Local Dermatology or Plastic Surgery College (That Teaches Dermatologists / Plastic Surgeons And Ask If They Know Any Dr's Who Does Subcision For Scars). Plastic Surgeon's Tend to Have More Education and Surgical Skill Than General Clinics Here. 

Skin Wellness Center of Alabama
United States, Alabama, Birmingham and Chelsea 
Specialty: Subcision (W/ Over Dilute Sculptra), Laser Dermatology, Chemical Peels, Hydro Facials, Filler
https://www.skinwellness.com/our-services/medical-dermatology/#acne-scar-surgery

Dr Farhan Taghizadeh (Plastic Surgeon)
United States, Arizona, Phoenix
Specialty: Subcision, Laser Plastic Surgery, Filler, Chemical Peels
https://www.arizonafacialplastics.com/

Phoenix Dermatology
United States, Arizona, Phoenix 
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
https://phoenixvillevalleyforgedermatology.com

Pinnacle Dermatology
United States, Arkansas, Little Rock
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://www.pinnacledermar.com/contact-1

Dr Cynthia Lopez
United States, California, Fresno 
Specialty: Subcision, TCA Cross, Laser Dermatology, J Plasma Resurfacing, Fully Ablative Laser Resurfacing, Filler, Specializes in Ethnic Skintype
http://www.rejuvimed.com/new/ACNE-ACNEScars.php

Dr Hazany
United States, California,  Los Angeles, Beverly Hills, Agora Hills, Palmdale, Los Alamitos, Long Beach
Specialty: Subcision, (Taylor Liberator Subcision Developed by Dr Taylor Utah, Most Aggressive Subcision, Tumescent), TCA Cross, Laser Dermatology, Punch Excision, Filler, Specializes in Ethnic Skintypes, See his Youtube Channel.
https://www.hazanyderm.com/acne-scaring

BH Dermatology and Cosmetic Center
United States, California, Los Angles, Beverly Hills, Encino, Glendale
Specialty: Subcision, Laser Dermatology, Filler
https://bhskin.com/education/subcision/

Dr Liu (Plastic Suergon)
United States, California, Los Angeles, Beverly Hills, Arcadia
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://www.perryliumd.com/contact/

Premiere Dermatology
United States, California, Los Angles, Brea
Specialty: Subcision, Laser Dermatology , Filler
http://www.premierederm.com/skin-problems-fullerton/acne-scarring/

Dr John Vartanian
United States, California, Los Angeles, Glendale
Specialty: Subcision, Laser Plastic Surgery, Chemical Peels, Excision, Scar Revision, Dermabrasion, Filler
https://www.facial-plastic.com/scar-revision-los-angeles-ca/

Dr Rahmani 
United States, California, Los Angeles, Hollywood
Specialty: Not recommended. Mainly a laser dermatologist, pushing his "package" or he will not treat.  Big into Mixto laser. 

Dr Jason Emer
United States, California, Los Angeles, Hollywood
Specialty: Not recommended. Laser Dermatology, Bellafill, Overpriced $$,$$$, markets, Stacks 5 Treatments at Once (this causes bad results - we don't heal like this). He uses Hollywood glits and glamor to do the hard sale. Many reports that he does not seem like he cares for his patients. Charging a few patients with severe scars $60,000 (crazy I know) for treatments and telling them they had to treat with him for life, those who have contacted me are worse off then when they first started treating with him. Sponsored by energy device manufactures.

Dr Pien
United States, California, Los Angeles, Irvine & Beverly Hills
Specialty: Laser Dermatology, Laser Jedi, USA Version of Dr Lim, Laser Expert who wrote several books on the Subject, Over 30 lasers to use, Fully Ablative Resurfacing, Stem Cell, Hyperbaric Chamber, Filler, Specializes in Ethnic Skin, Overpriced $$,$$$,
https://www.amaskincare.com/services/acne-scarring/

Laser Skin Care Dermatology Associates 
United States, California, Los Angles, Long Beach
Specialty: Subcision, Laser Dermatology, Filler
https://www.lasercarespecialists.com/cosmetic/skin-rejuvenation/subcision-for-acne-scar-treatment/ 

Orange County Horizon Dermatology and Laser Institute 
United States, California, Los Angles, Orange County
Specialty: Subcision, Laser Dermatology, Filler
http://www.horizonderm.com/acne-scar-therapy-orange-county-california/

Contour Dermatology
United States, California, Los Angles, Palm Springs
Specialty: Subcision, TCA Cross, Laser Dermatology, RF Microneedling, Filler Fat Grafting, All Aesthetics treatments, checkout his Youtube channel to see the Dr in action.
https://contourderm.com/

Annie Chiu The Derm Institute
United States, California, Los Angles, Redondo Beach
Specialty: Subcision, Laser Dermatology 
https://www.thederminstitute.com/contact-us/

Dermatology and Hair Restoration
United States, California, Los Angles, Santa Monica
Specialty: Subcision, Laser Dermatology, Filler
https://santamonicaskin.com/acne-scars/subcision/

Dr Bryan K. Chen
United States, California, Los Angeles, San Diego
Specialty: Subcision (Subcision W/ Saline), TCA Cross, Laser Dermatology, Filler
https://insightderm.com/services/san-diego-subcision-acne-scar-treatment/

Dr Goldman
United States, Los Angeles, San Diego
Specialty:  Subcision (?), Practice Has Several Top Laser Dermatologists, Experts in lasers, Written Several Books and White Papers on the Subject, Laser Jedi, Filler 
https://clderm.com/meet-the-team/

Dr Kim (Plastic Surgeon)
United States, California, Los Angles, Hollywood 
Dream Clinic - Plastic Surgeon in LA Also Has Clinic in Korea 
Specialty: Subcision, Laser Plastic Surgery, Filler, Fat Grafting, Korean Face Lifts, Specializes in Ethnic Skin
http://www.drkennethkim.com/meet-dr-kim/dream-medical-group/ 

Professor and Department Head UC Irvine Dr Chris Zachary 
United States, California, Los Angles, Irvine
Dr. Davin Lim's Mentor While in Med School
Specialty: Subcision, Filler,  General Dermatology, Laser Dermatology, Laser Jedi, Wrote several books on Laser Treatment, he is Hesitant to treat patients we are told especially if they are ethnic and need laser done because of possible complications. Overpriced $$,$$$, talks on several dermatology forum panels and videos and is sponsored by laser device companies. 
http://www.drzachary.net/

Dr Sandra Lee AKA Dr Pimple Popper YouTube Channel
United States, California, Los Angles, Upland 
Specialty: Subcision (?), TCA Cross (?), Laser Dermatology, Popping Pimples/Cysts and dealing with other complex body issues (removal),General Derm, Extractions, Pushes Permanent Bellafill for scar filler so ask for HA Filler,  Electrosurgery to remove aesthetic issues, Rhinophyma treatment,  Famous for being on the Doctors TV Show, Specializes in Ethnic Skin. 
http://www.skinps.com/

Dr Suzanne Kilmer 
United States, California, Sacramento
Specialty: Laser Dermatology, Laser Jedi, "USA Version of Dr Lim For Energy Devices." Lecturer and Trains Drs on anything about Lasers, pushes Fraxel exclusively - sponsored, Overpriced $$,$$$, talks on several dermatology forum panels and videos and is sponsored by laser device companies.  Told she will not do subcision and other manual methods, you would have to do that elsewhere or goto UC Davis Dermatology Dept and ask for subcision).
http://www.skinlasers.com/

Dr Charles Perry (Plastic Surgeon)
United States, California, Sacramento
Specialty: Subcision, Laser Plastic Surgery, Chemical Peels, Filler, Over Dilute Sculptra, Fat Grafting
http://www.916cosmeticsurgery.com/ Dr Heath
United States, California, Sacramento, Roseville
Specialty: Subcision, Laser Dermatology, Excision, Chemical Peels, Filler
http://www.granitebaydermatologyandlaser.com/cosmetic-dermatology/scarring.php

Granite Bay Dermatology and Laser Center
United States, California, Sacramento, Roseville
Specialty: Subcision, Laser Dermatology , Filler
http://www.granitebaydermatologyandlaser.com/cosmetic-dermatology/scarring.php

California Dermatology Institute & Berman (Long List of Offices - Price Fix Bay Area Dermatologists)
United States, California, Various Offices in Northern California - Bay Area
Specialty: Subcision, TCA Cross, Laser Dermatology, Chemical Peels, Filler, Various Cosmetic Procedures, Overpriced $$,$$$, Not Rated Highly - Call Center Takes Booking and Contact For Specific Procedures You Are Looking For.
https://www.skinmds.com/skin/acne-scars/subcision.htm
https://californiaskininstitute.com/treatments/subcision-for-scars/

Dr Lopez
United States, California, Oakland
Specialty: Subcision (call to check), TCA Cross, Laser Plastic Surgery, Microneedling, J Plasma Full Face Ablative Resurfacing, Excision, Filler
https://aestheticlasercenter.com/j-plasmar/Filler

Dr Seven Swengel
United States, California, Los Gatos
Specialty: TCA Cross, Infini RF, Subcision, Fillers, General Derm
http://www.RefinedMD.com

Dr Morganroth (California Dermatology Institute - Price Fix Bay Area Dermatologists)
United States, California, Mountain View
Specialty: Subcision, TCA Cross, Laser Dermatology, Excision, Filler, Permanent Bellafill, Overpriced $$,$$$, It's a factory, General Dermatologist
http://www.morganroth.com

Dr Pratrica Wong
United States, California, Palo Alto
Specialty: Subcision, TCA Cross, Laser Dermatology, Excision, Filler, Overpriced $$,$$$, It's a factory, General Dermatologist
http://www.patriciawongmd.com/

Dr Evan Ransom (Plastic  Surgeon)
United States, California, San Francisco 
Specialty: Subcision, Laser Plastic Surgery, Infini RF, Lasers, Aesthetics, Dermabrasion, Filler
http://www.sanfranciscofacialplasticsurgery.com

Dr Rajagopal (Plastic Surgeon)
United States, California, San Francisco
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Scar Revision, Microdermabrasion, Chemical Peels, Filler, Answers Questions RealSelf.com
https://www.sfcosmeticsurgery.com

UCSF Department of Dermatology & Surgery
United States, California, San Francisco
Specialty: Subcision, TCA Cross, Laser Dermatology, Fully Ablative Laser Resurfacing, Chemical Peels, Filler, Reviews For General Dermatology Clinic and Not Cosmetic Services. 
https://www.dermatology.ucsf.edu/dermatologic-surgery-services-provided

Dr Hayes Gladstone (California Dermatology Institute - Price Fix Bay Area Dermatologists)
United States, California, San Ramon
Specialty: Subcision, Laser Dermatology, Fraxel 1927nm, Clear and Brilliant, Terrible RF Machine Profound (RF Needling is Better), Filler, Permanent Bellafill, Overpriced $$,$$$
http://www.gladstoneclinic.com

Dr William Ting (California Dermatology Institute - Price Fix Bay Area Dermatologists)
United States, California, San Ramon
Specialty: Subcision, TCA Cross, Laser Dermatology, Picosure, RF Microneedling, Excision, Filler, Permanent Bellafill, Overpriced $$,$$$, It's a factory
http://www.DrWilliamTing.com

Dr Riopelle (Plastic Surgeon)
United States, California, San Ramon
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://www.riopellecosmetic.com/conditions.html#acne-scars

Dr Tang
United States, California, Saratoga
Specialty: Subcision, TCA Cross, Laser Dermatology, Excision, Filler, Permanent Bellafill, Overpriced $$,$$$, General Dermatologist
http://www.rejuvemedical.com/

Dr Richard Ort
United States, Colorado, Lone Tree
Specialty: Subcision, TCA Cross, Laser Dermatology Specialty, Chemical Peels, Filler, General Dermatology
http://www.myskincaredoctor.com/cosmetic-acne-scarring.php

Omar Ibrahimi
United States,  Connecticut 
Specialty: Laser Dermatology Specialty, Latest and greatest laser and energy device treatments (rf needling), told he will not do subcision or manual methods, do those elsewhere. 2 offices one not far from Long Island - NYC.
https://ctskindoc.com/lasercosmetic-treatments/acne-scar-reduction/

Dr Adrian 
United States, Disctrict of Columbia, Washington DC
Specialty: Subcision, TCA Cross, Laser Dermatology Specialty, Filler, PRP
https://lasersurgery.com

Dr. Burgess
United States, District of Columbia, Washington DC
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler, Specializes in Ethnic Skin
https://www.ctr4dermatology.com/blog/acne-scars-treatment-washington-dc/

MetroDerm DC
United States, District of Columbia, Washington DC
Specialty: Subcision, TCA Cross, Laser Dermatology, Don't Get Venus Viva (Terrible Device - Infini is better), Chemical Peels, Filler, PRP
https://www.metrodermdc.com/acne-scar-treatment.html

Dr Noelle S. Sherber
United States, District of Columbia, Washington DC 
Specialty: Subcision (?), TCA Cross, Laser Dermatology, Microneedle, Filler, General Derm,
http://sherberandrad.com/

Dr Richard Sadove (Plastic Surgeon)
United States, Florida, Gainesville
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Excision, Filler, Fat Grafting For Acne Scars Specialist, Over Dilute Sculptra, Permanent Bellafill, Face Lifts, he is a expert in fat grafting for acne scars, but this procedure is outdated. You can get several years of lasting filler for the cost of fat grafting. It's often only lasts a few years and is absorbed, and it can be lumpy, this is why you need 3 procedures which are invasive surgeries. His website does says he performs over dilute (saline) sculptra for widespread scarring and fat loss, I suggest this over fat grafting.  If you want things permanent after liking temporary fillers, get Bellafill 
http://acnescarflorida.com/about-dr-sadove/

Dr Jeremy Green
United States, Florida, Miami
Specialty: Subcision, Laser Dermatology Specialty, All of The Latest and Greatest Lasers, Filler.
https://www.skinassociatesfl.com/jeremy-b-green-md/

Dr Jill Waibel Laser Burn and Traumatic Scar Specialist
United States, Florida, Miami
Specialty: Laser Dermatology, Specializes in major burn and body scars with lasers and steroid drip, grafting, surgeries, General Derm, Overpriced $$,$$$, talks on several dermatology forum panels and videos and is sponsored by laser device companies. Not open to manual methods of acne scar work.
http://www.miamidermlaser.com/jill-waibel/

Dr Ben Brown (Plastic Surgeon)
United States, Florida, Pensacola
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://www.drbenbrown.com/services/non-surgical/

Dr Tomas Pane (Plastic Surgeon) 
United States, Florida, Palm Beach
Specialty: Youtube Video of Dr Doing Subcision, Laser 
https:// acplasticsurg.com/ask-dr-pane-can-subcision-with-co2-fractional-improve-my-acne-scars/

Dermatology Associates
United States, Georgia, Atlanta
Specialty: Subcision, Laser Dermatology, Excision, Punch Excision, Chemical Peels, Filler, Fat Grafting
https://www.dermatlanta.com/cosmetic-dermatology/acne-scarring/

Dr. Castillo (Plastic Surgeon)
United States, Georgia, Atlanta 
Specialty: Subcision, Laser Plastic Surgery, Chemical Peels, Scar Revision, Filler, Real Self Reviews
http://nelsoncntr.com/2015/10/26/what-can-i-do-to-improve-scarring/

Dr Edmond Griffin
United States, Georgia, Atlanta 
Specialty: Subcision, TCA Cross, Laser Dermatology, Excision, Filler
https://www.dermatlanta.com/cosmetic-dermatology/acne-scarring/

Dr Ron Moy
United States, Hawaii
Specialty: Subcision, Laser Dermatology, Filler, Specializes in Ethnic Skin, General Cosmetic Dermatologist

Chicago Lake View Dermatology
United States, Illinois, Chicago
Specialty: Subcision, Laser Dermatology, Filler
https://www.lakeviewderm.com/chicago-dermatologist/cosmetic-dermatology-treatments-chicago/subcision-chicago/37

Dr Murad Alam 
United States, Illinois, Chicago
Specialty: Subcision, Laser Dermatology, Filler

Dr Steven Mandrea
United States, Illinois, Chicago 
Specialty: Subcision (W/ Sculptra), Laser Dermatology, Filler 

Illinois Dermatology Institute (Medical Group Plastics and Dermatology) 
United States, Illinois, Chicago 
Specialty: Subcision, Laser Dermatology is Specialty, Filler
https://www.illinoisderm.com/subcision

Dr Tina B. West
United States, Maryland, Chevy Chase
Specialty: Subcision, TCA Cross, Laser Dermatology, Microneedle, Filler, General Derm
http://www.westskinlaser.com

Dr Cynthia Abban
United States, Illinois, Gurnee
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler, Specializes in Treating Ethnic Skin/ Skin of Color
https://www.aurorahealthcare.org/doctors/cynthia-y-abban-md-phd

Dr Greg Chernoff (Plastic Surgeon)
United States, Indiana, Indianapolis
Specialty: Subcision, Laser Plastic Surgery, Photo Facial, Dot Laser, Punch Excisions, Micro Needling, Hydra Facials, Chemical Peels, Filler, PRP
https://drchernoff.com/acne-treatment-and-prevention-center/

Jazzi Cosmetic Surgery (Plastic Surgery)
United States, Kentucky, Lexington
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://www.jazzi.co/contactus

Dr Duplechain (Plastic Surgeon)
United States, Louisiana, Lafayette
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://www.drduplechain.com/

Laser Skin & Vein
Hunt Valley, Maryland, Hunt Valley 
Specialty: Subcision, Laser Dermatology, Excision, Punch Excision, Chemical Peels, Filler
https://mdlsv.com/Conditions-We-Treat/Scars

Boston Medical Cosmetic & Laser Center
United States, Massachusetts, Boston 
Specialty: Subcision, TCA Cross, Laser Dermatology, Chemical Peels, Filler, Specializes in Ethnic Skin
https://www.bmc.org/cosmetic-and-laser-center/team

Dr Ishoo
United States, Massachusetts, Boston
Specialty: Subcision, Laser Dermatology, Clear and Brilliant, Fraxel 1927nm, Excision, Punch Excision, Chemical Peels, Filler, Sculptra, Fat Grafting
https://www.bostonacnespecialists.com/subcision

Dr Shivananjappa
United States, Massachusetts, Boston
Specialty: Subcision, Laser Med Spa, RF Microneedling, Filler, PRP, Bellafill, pushes patients to buy the package and will not just agree to subicsion, more of a Med Spa, likes to stack treatments all at one time, without time between treatments to heal. 
https://shanthalamd.com/

Dr Rox Anderson
United States, Massachusetts, Boston
Specialty: Laser Dermatologist, Invented many laser technologies used today, teaches dermatologists, Subcision (?)
https://www.massgeneral.org/children/doctors/doctor.aspx?id=16786

Skincare Physicians
United States, Massachusetts, Chestnut Hill
Specialty: Subcision, TCA Cross, Laser Dermatology, Excision, Chemical Peels, Filler
https://www.skincarephysicians.net/services/cosmetic-dermatology/acne-scarring/

Department of Dermatology & Surgery
United States, Michigan, Ann Arbor
Specialty: Subcision, Laser Dermatology, Fully Ablative Laser Resurfacing, Chemical Peels, TCA Cross, Filler, Most Reviews For General Dermatology Clinic and Not Cosmetic Services. 
https://medicine.umich.edu/dept/cosmeticderm/treated-conditions/scars-acne-scarring

Dr Jeffrey Orringer 
United States, Michigan, Ann Arbor
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler

Dr. Mark A. McCune
United States, Missouri, Kansas City, Overland Park 
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
http://www.kcderm.com/medical-dermatology/#acne

Laser Dermatologic Surgery Center
United States, Missouri, St. Louis
Specialty: Subcision, Laser Dermatology, Fully Ablative Laser Resurfacing, Scar Revision, Chemical Peels, Filler
https://lasersurgeryusa.com/acne-scarring/

Dr Reken
United States, Nevada, Reno
Specialty: Subcision, TCA Cross, Laser Dermatology, Chemical Peels, Filler
http://renosparksmedspa.com/acne

Dr Rapaport 
United States, New Jersey
Specialty: Not recommended. Laser Dermatologist, CO2-Infini, Pushes Package, General Derm, Head Strong in his "Methods," only does Subcision As Part of the Package.Reports of Mixed Results. 

Dr Boakye
United States, New Jersey, Englewood Cliffs
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
http://www.bergenderm.com/services

Dr Andrew Miller (Plastic Surgeon)
United States, New Jersey, Edison
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Punch Excision, Filler
http://www.associatesinplasticsurgery.com/

Dr Sprarano (Plastic Surgeon)
United States, New Jersey, Manasquan 
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Punch Excision, Filler
http://www.drsparano.com/scar-revision

Dr Berry Dibernardo
United States, New Jersey, Montclair 
Specialty: Subcision, TCA Cross, Laser Dermatology, Microneedle, Filler, General Derm, Overpriced $$,$$$, he talks on several dermatology forum panels and videos and is sponsored by laser device companies. 
http://www.newjerseyplasticsurgery.com

Dr Kapila Paghdal
United States, New Jersey, Ridgewood, Oakland
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler, PRP
http://www.millburnlaser.com/kapila-paghdal-md/
https://www.northernbergenderm.com/ourphysicians

Dr. Alizadeh (Plastic Surgeon)
United States, New York, Long Island
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Laser Resurfacing, Punch Excision, Dermabrasion Chemical Peels, Filler, Over Dilute Sculptra, Fat Grafting, Specializes in Ethnic Skin. 
https://www.doctoralizadeh.com/cosmoplastic-surgery/skin/acne-scar-reduction.html

Allure Plastic Surgery Dr Miller (Plastic Surgeon) 
United States, New York 
Specialty: Subcision, Laser Plastic Surgery, Dermabrasion, Excision, Filler
https://www.newyorkplasticsurgeryallure.com/acne-scar-treatment

Dr Tatiana Khrom
United States, New York 
Specialty: Subcision, TCA Cross, Laser Dermatology, CO2, RF Needling, Filler, Over Dilute Sculptra, Specializes in Ethnic Skin, From a Happy Forum Member: "Cannula subcision with sculptra + prp done. Cost was $1000 and includes TCA cross if required, which I thought was reasonable."   
https://www.khromdermatology.com/acne-scar-treatment-brooklyn-ny/

Metro Dermatology 
United States, New York 
Specialty: Subcision, TCA Cross, Laser Dermatology, Punch Excision, Filler, Specializes in Ethnic Skin 
https://metrodermatology.net/acne-scarring/

Dr Michelle Green 
United States, New York 
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
http://www.michelegreen.com

Dr Nelson Lee Novick
United States, New York City, & Israel - Prices 1/2 Off, perfect for Europeans / Middle Eastern Region
Specialty:  Subcision (Nokor) W/ Filler, TCA Cross, Expensive Famous Dr Known For Using Only Manual Methods, Filler Master Injector, General Derm, Will not do any energy device, we are told he is quite expensive as he has exclusive NYC patients with Overpriced $$,$$$, see Dr. Khrom or Dr Weiner for a better deal. If you want Energy Devices You Will Have To Go Elsewhere In Between Treatments. 
http://www.doctornovick.com

Dr Prasad (Plastic Surgeon) 
United States, New York, Manhattan & Long Island 
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Fully Ablative Laser Resurfacing, Excision, Filler, PRP, Specializes in Ethnic Skin, Overpriced $$,$$$
https://prasadcosmeticsurgery.com/acne-scars-treatment/

Dr Ron Shelton
United States, New York
Specialty: Subcision, TCA Cross, Laser Dermatology is his specialty, Infini RF, Filler, General Derm
http://www.thenyac.com

Dr Roy Gerononus 
United States,  New York 
Specialty: Subcision, TCA Cross, Laser Dermatology is his Specialty, Fillers, General Derm, Overpriced $$,$$$, he talks on several dermatology forum panels and videos and is sponsored by laser device companies. If you want lasers and your in NYC this is the guy to goto, he has all of them in his office (including rf needling), but again often not doing manual methods instead preferring lasers and other energy devices.  Not great for manual methods of acne scar work.
http://www.laserskinsurgery.com/Dermatologists/Roy-G-Geronemus-MD

Dr Julia Tzu 
United States, New York 
Specialty: Subcision, TCA cross, Laser Dermatology, Filler, Specializes in Ethnic Skin 
http://www.wallstreetdermatology.com

Washington Square Dermatology
United States, New York, Washington Square
Specialty: Subcision, Laser Dermatology, Clear and Brilliant, Chemical Peels, Filler, PRP, Most Reviews For General Dermatology Clinic and Not Cosmetic Services. 
http://www.washingtonsqderm.com/cosmetic-dermatology/

Dr Yang
United States, New York
Specialty: Subcision, TCA Cross, Laser Dermatology, Infini RF, Filler, General Derm
http://www.GeorgeYangMD.com

Dermatology, Laser & Vein
Uninted States,  North Carolina, Charlotte
Specialties: Subcision, TCA Cross, Laser, Infini
http://www.carolinaskin.com/dlvsc_services/acne-scars/

Dr Payman Kosari & Dr Gilly Manuvale (Plastic Surgeon)
United States, North Carolina, Charlotte, Monroe, Pineville
Specialty: Subcision (Aggressive), Laser Plastic Surgery, Fully Ablative Erbium Laser Resurfacing, Infini + PRP,  Ematrix Subaltive RF, Ultrapulse CO2, Punch Excision, Chemical Peels, Dermabrasion and Micro-Needling, Filler - Bellafill, PRP, Specializes in Ethnic Skin
https://www.carolinaskin.com/dlvsc_services/acne-scars/

Dr Patricia Dickerson
United States, Ohio, Centerville
Specialty: Subcision, Laser Dermatology, Chemical peels, Filler
https://caringderms.com/acne-acne-scarring/

Dr Tyler Angelos (Plastic Surgeon)
United States, Ohio, Columbus 
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Punch Excision, Filler
https://lasercenteratcaps.com/

Dr Centeno (Plastic Surgeon)
United States, Ohio, Columbus
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Laser Resurfacing, Punch Excision, Dermabrasion, Filler, Fat Grafting, Over Dilute Sculptra 
https://www.instituteplasticsurgery.com/home-male/active-acne-scar/
https://www.youtube.com/watch?v=xegyqGBdjPg

Dr Banker
United States, Ohio, Maumee
Specialty: Subcision, TCA cross, Laser Dermatology, Chemical peels, Filler, Bellafill
https://luxe-laser.com/

Dr Ringpfeil
United States, Pennsylvania, Philadelphia 
Specialty: Subcision, Laser Dermatology, Infini Rf, Punch Grafting, Chemical Peels, Filler, Sculptra
https://philadelphiadermatology.com/scar-treatment.php
https://www.ringpfeildermatology.com/cosmetic-dermatology/acne-scars.php

Jefferson University Cosmetic Dermatology
United States, Pennsylvania, Philadelphia
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://hospitals.jefferson.edu/diseases-and-conditions/acne-scarring.html

Pennsylvania Center For Dermatology
United States, Pennsylvania, Philadelphia
Specialty: Subcision, TCA Cross, Laser Dermatology, Punch Excision, Dermabrasion, Chemical Peels, Filler, PRP
http://pennsyderm.com/aesthetic-services/acne-scarring/

University of Pennsylvania Dermatology Department - Cosmetic Surgery and Skin Health Center
United States, Pennsylvania, Pittsburgh & Sewickley
Specialty: Subcision, TCA Cross, Laser Plastic Surgery / Dermatology, Chemical Peels, Filler  
https://www.upmc.com/Services/dermatology/cosmetic-skin

Dr Enzer (Plastic Surgeon)
United States, Road Island, Providence
Specialty: Subcision, Laser Plastic Surgery, Excision, Filler, Fat Grafting For Scars 
https://www.doctorenzer.com/fasula-scar-removal/

Dr Levy
United States, Tennessee, Memphis
Specialty: Subcision, Laser Dermatology, Vivance RF Needling, Excision Chemical Peels, Filler 
https://www.levydermatology.com/

Dr Brian Biesman (Plastic Surgeon)
United States, Tennessee, Nashville
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://drbiesman.com/services/scar-treatment/acne/

Dr Michael Gold
United States, Tennessee, Nashville
Specialty: Subcision, TCA Cross, Laser Dermatology, Fillers, General Derm, Overpriced $$,$$$,  talks on several dermatology forum panels and videos and is sponsored by laser device companies. 
http://www.goldskincare.com

Dr Berlin 
United States, Texas, Arlington, Southlake 
Specialty: Subcision, TCA Cross, Laser Dermatology, Scar Excision, Punch Excision, Filler
http://www.dfwskinsurgery.com/Acne-Scarring.html

Dr Adam Mamelak and Dr Hansen
United States, Texas, Austin, and Dripping Springs
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://www.sanovadermatology.com/services/conditions-treatments/acne-scarring/
https://www.sanovadermatology.com/dermatologist/dr-mamelak/

Dr Bassichis (Plastic Surgeon)
United States, Texas, Dallas
Specialty: Subcision, Laser Plastic Surgery, Excision, Broken Line Closure, Dermabrasion, Filler
http://www.advancedfacialplastic.com/procedures/surgical-procedures/scar-revision/

Kassir Dermatology
United States, Texas, Dallas
Specialty: Subcision, Laser Dermatology, Filler
http://www.kassirdermatology.com/cosmetic-procedures/cosmetic-dermatologist/

Dr John Burns (Plastic Surgeon)
United States, Texas, Dallas 
Specialty: Subcision (Aggressive), TCA Cross, Laser Plastic Surgery, Deep Full Laser resurfacing (Erbium).
http://drjohnburns.com/

James F. Boynton (Plastic Surgeon)
United States, Texas, Huston
Specialty: Subcision, TCA Cross, Laser Plastic Surgery, Filler
https://www.boyntonplasticsurgery.com/non-surgical/scar-revision/

Dr Audra Clos
United States, Texas, Huston
Specialty: Subcision, TCA Cross, Laser Dermatology 
https://houstonskin.com/about-us/audra-clos,-md

Dr Paul Driedman
United States, Texas, Huston
Specialty: Laser Dermatologist, Laser Jedi, ""USA Version of Dr Lim"" (Main Focus is Lasers - Written Several Books On Subject, Teaches to Dermatology Students), Genius Rf Needling Replaces Infini, Picosure, Clear and Brilliant, 1927nm Full Density Fraxel for Pores, Spectra or Hollywood Carbon Laser Peel for Pores, Fully ablative Laser Resurfacing Deep Peel, Rhinophyma Laser Treatment, Filler, Scultra, Bellafill
https://www.dermlasersurgery.com/
https://www.dermlasersurgery.com/procedures/laser-skin-resurfacing-houston-tx/

Dr. Brad Bader (Plastic Surgeon)
United States, Texas, Plano
Specialty: Subcision, Laser Plastic Surgery, Laser Resurfacing, Excision, Geometric Closure of Scar, Scar Revision, Filler
https://www.baderfacialplastics.com

Dr Sam Lam (Plastic Surgeon) 
United States, Texas, Plano
Specialty: Subcision, Laser Plastic Surgery, Filler, Fat Grafting, Plastic Surgery, Overpriced $$,$$$, talks on several dermatology forum panels and videos and is sponsored by laser device companies. 
http://www.lamfacialplastics.com/

Dr Peter Raphael 
United States, Texas, Plano
Specialty: Subcision, TCA Cross, Laser Dermatology, Filler
https://www.ai4ps.com/

Dr Alan Kenneth
United States, Texas, San Antonio
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://www.dermsa.com/content/staff/alan-kenneth-silverman-m-d/

Dr Ghohestani
United States, Texas, San Antonio
Specialty: Subcision, Laser Dermatology, Dermabrasion, Punch Excision, Chemical Peels, Filler 
http://www.texasacneclinic.com/laseracnescar

Texas Institute of Dermatology
United States, Texas, San Antonio 
Specialty: Subcision, TCA Cross, Laser Dermatology, Punch Grafting, Excision, Chemical Peels, Filler, PRP 
https://www.sanantoniodermatology.org/acne-scar-treatment

Plastic Surgery and Dermatology Associates
United States, Virginia, Fairfax
Specialty: Subcision, Laser Dermatology, Excision, Punch Excision, Chemical Peels, Filler
https://www.psda-va.com/scar-treatment-fairfax/

McLean Dermatology and Skincare Center
United States, Virginia, McLean
Specialty: Subcision, Laser Dermatology, Filler 
https://mcleandermatologycenter.com

Dr Joe Niamtu (Plastic Surgeon)
YouTube Channel: Joe Niamtu
United States, Virginia, Midlothian 
Specialty: Subcision (Taylor Liberator Aggressive Subcison w/ Truminescent Anesthesia), TCA Cross, Laser Plastic Surgery, Excision, Punch Float Excision, Scar Revision with Geometric Closure, Electrosurgery of Moles and Other Cosmetic Issues, Dermabrasion, Chemical Peels. He trains other Dermatologists and Plastic Surgeons how to do complex procedures.
http://www.lovethatface.com/
https://www.youtube.com/watch?v=sqoy5D6ilss

Dr Travis Shaw (Plastic Surgeon)
United States, Virginia, Richmond
Specialty: Subcision, Laser Plastic Surgery, Filler
https://travisshawmd.com

Dr Brecht (Plastic Surgeon)
United States, Washington, Burien
Specialty: Subcision, Laser Plastic Surgery, Punch Elevation, Excision, Scar Revision, Chemical Peels, Filler
https://www.arspabydrbrecht.com/scar-revision/

Dr Philip Young
United States, Washington, Seattle
Specialty: Not recommended. Ear Nose and Throat Dr, who calls Himself a Plastic Surgeon. He has a package for acne scar patients and actively markets his services. Reports of bad treatments. Disciplinary Action Found - Unprofessional Conduct (10/1/2015) https://www.healthgrades.com/media/english/pdf/sanctions/HGPY2F741CD1C5E54BB2A10012015.pdf
Board Action (6/25/2015) https://www.healthgrades.com/media/english/pdf/sanctions/HGPY2F741CD1C5E54BB2A06252015.pdf

Dr Brandith Irwin
United States, Washington, Seattle
Specialty: Subcision, Laser Dermatology, Chemical Peels, Punch Grafting, Filler, Sculptra
https://www.madisonskin.com/subscision-for-treatment-of-acne-scarring/

Dr Reinertson
United States, Washington, Seattle 
Specialty: Subcision, Laser Dermatology, Chemical Peels, Filler
https://www.seattlecosmedicskincare.com/treatments/skin/scar-revision/

Dr James Ridgeway (Plastic Surgeon) 
United States, Washington, Seattle 
Specialty: Subcision, Laser Plastic Surgery, Dermabraison, Scar Revision , Filler
https://www.drjamesridgway.com/surgical/reconstructive/scar-treatment/


Reported By Several Forum Members: Treated Poorly & Treatment Mistakes Made: Dr. Luc Louis Huysmans - Belgium Dr. Claus Jung - Munchen, Germany Dr Kkveg - Amsterdam
  ______________________________________________
17. ANATOMY (FAT / MUSCLE) PICTURES
 

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18. SOURCES
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