Edit - sorry I'll update this but yes, I do believe acne scars can improve. Maybe not 100 percent, but enough to find happiness.

...

I know they won't improve by themselves, so I'm definitely going to do lots of treatments to improve them. I'm just scared they won't get better at all no matter what I do  

My advice to you. Try small spots at a time.because scars will not disappear fast anyway. So see your reaction one by one. Then do the treatment for your whole face. These treatments can improve scarring but also have risks. And we should think of the risks as well and not just consider everything to be 100% safe.

You have done a lot of research, that treatment looks solid, I have worse scars than yours and I am 4 months post Accutane, currently getting PRP combined with microneedling, just had 1 session till now, lets see how much improvement I get after 3 months.

Hey Petsme,

I know how you feel. I come from scars much worse than yours. They were the result of accutanegone terribly wrong, leaving me with scars so much worse than the acne I initially tried to treat.

From my now 2+ years of conducting scar treatments, I can tell you this: scars can improve but the process is incredibly slow. It will most likely take longer than you think, even after reading other people's journeys and thinking you have realistic expectations. We just naturally hang on to what we so desperately want to hear and the rest goes in one ear and out the other.

You are very right to start slow and see what your skin can handle. What is also important is to make sure you are in optimal health to create the perfect environmentfor wound healing. Exercising (running) made a big difference for me, so did switching to a whole food plant-based diet. It just speeds up the process. One thing I would advise you to look deeper into is your low carb high protein diet. Animal protein (not plant protein) and dairy is very inflammatory for the body. When the body is busy fighting off that inflammation, it has fewer resources for less important tasks, like scar remodeling and wound healing. Also, you need way less protein than you think. For an average woman, 45 grams is more than enough and recommendations are getting lower each year. That is very easily obtainable through plant sources. Furthermore, if low carb means low fruit, I would look deeper into that as well. Fruit is essential for wound healing and scar remodeling (vitamin C!). And the available evidence points towards supplements just not doing the trick.

I would highly recommend anyone treating their scars to check out www.nutritionfacts.org or https://www.youtube.com/channel/UCddn8dUxYdgJz3Qr5mjADtA as a source of evidence-based nutritional information.

Good luck. It will get better. Slowly.

@arte90 I do eat a lot of fruits and veggies, they are mostly my only carbs besides like sweet potatoes.  sorry for the confusion!!  I should have put something like no pasta, bread, grains/ added or refined sugars / low starch. And as for proteins I eat a lot of nuts and chicken, rarely red meats. 

As far as a college student (soon to be med student!!!) I think I eat pretty healthy hehe  I know I could do better so I will try to refine it once my treatments begin!! 

Honestly I see so many great pictures, even in scientific journals and see the actual evidence, but somehow I have noooo hope at all. I don't even know what grade I'd classify my scars as or anything 

Cut down any sugar / processed, I am sure you already do this, you can eat raw fruits and veggies.
Some Carbs are ok if they come from veggies.

Rolling the biggest improvement I have seen is subcision and filler. I know your a student. Keep that in the back of your mind, if by the 3rd sub you need lifting I would save up for this. Filler can be affordable at a med spa, etc. Health savings accounts or CC. Just a option if you need more lift.
You can start with the saline injections (during your sub - cheap, and Chinese cupping - Amazon for several weeks after sub and see how you do).

Plan looks good, don't get caught up on dates, ... you might not have down time certain months for treatment or you might want to hold out for more healing, ... that is ok, your body is in no rush to heal. It will look worse "sometimes" before better.

BA

In overhead lighting they just look ghastly, it makes me sick  like chunks of my face are missing. Will I really get improvement? 

Then in your average lighting up close: 

Yes. I firmly believe you will see improvement. You still have plenty of facial fat, and your scars look very shallow.

edit - Though, I'm surprised BA is alright with your treatment plan. He usually advocates for four weeks between TCA and microneedling

I am actually going off a study he posted on his scar treatment guide that showed promising results  After I finish those 6 sessions, I am going to continue doing TCA (at higher percentages though) and microneedling, but with 1-2 months in between each. I think he is okay with it because 1) the study had these parameters, and 2) the peel is only 15-18%, and he usually advocates for 25-30% 

Well while I personally do not like the shorter healing periods, collagen takes 3 months (min) to peak and build, I find higher level TCA peels (single layer) more beneficial once your skin is ready for them, but some can never reach that as their skin does not like any higher (or can get damage), also note in the study they had Dark ethnic skin so their levels must be low or they would PIH. We start low and build up to see, so we don't burn or cause damage (with test spots).

... I fully support your plan if that is what you are set on doing. Few people can treat every 2 weeks, let alone every month. It's a slow process. The down time is hard to find sometimes. It's really how you react to that percentage of acid. You just don't want to stress the skin out to much with constant procedures and not allow healing time. Also be aware in studies they sometimes push the max of what is done. I believe it had Indian participants, they have much thicker skin than someone who is sensitive. Even it is know that men's skin is thicker than a woman's (because men historically hunter / gather worked outdoors). Just test it out and see what works. I have people often mistake what they can handle ... aka it's not frosting, or it's not doing the peel quickly in a week, ... they expect a magical process. As you see from Quad's post it's a very slow process with a little bit of skin at a time. 12% several times a month can screw up your skin big time, as you wear away the moisture barrier and peel quicker than the body produces new layers. So just be aware ;-P I am sure you will do fine. Less is more, only treat the areas of concern is often best.

@Petsme
Go searching a therapist. Your problem are not the scars, you have BDD like I. Don't spend so much time on this forum. Your scars are nothing compared to other people. A therapist will help more than every treatment and the small percentage you will get over years (my own experience). Good luck.

You actually have pretty good skin considering the circumstances. If that's as bad as your scars look directly under light, then i'd say you're actually quite fortunate. They don't look that deep at all and could be drastically improved with the right chemical peels.

Hey guys- thank you for your support.

This is is an old post hehe and my scars have gotten less red in the past few months. Also, I finished university and just started medschool this month so keeping busy has definitely helped me focus less on my scarring.

Unfortunately I've had to extend my accutane course, and my acne seems to just get worse over time. Been on for almost 7 months now. Still looking forward to improving my scars, especially the large rolling areas

Your scars similar to mine except I think I might have more than you. Not that I can afford it, but is Infini Rf a good treatment for rolling and boxscars? 'Cause the thought of subcision alone gives me hella anxiety and makes me wanna barf my brains out.

@star-foxHey there! Yes, Infini is great for both of those, but of course subcision would be best for any scars that are tethered. Infini won't give you perfection because it doesn't treat the skins surface, but it will definitely help fill in pitting or depressions