As a skin restoration specialist in Newport Beach, California, I have dedicated my career to helping individuals understand and treat their acne scars. Acne scars can be a source of significant emotional distress, affecting self-esteem and overall quality of life. In this article, I will walk you through the various types of acne scars, the treatments available, and how to determine the best approach for your specific case.

Types of Acne Scars
Acne scars come in various forms, each requiring a tailored treatment plan. The most common types include:
Ice Pick Scars : These are narrow, deep scars that resemble small punctures.
Boxcar Scars : Characterized by sharp edges and a box-like appearance, these scars can vary in depth.
Rolling Scars : These create a wave-like texture on the skin due to underlying tissue damage.
Understanding the type of scar you have is crucial in determining the most effective treatment strategy. For instance, some scars may respond better to certain acids or lasers than others.
Evaluating Your Skin
When evaluating a patient's skin, I look at several factors, including the depth and severity of the scars, the presence of any fat loss, and the overall texture of the skin. This comprehensive assessment helps me create a personalized treatment plan.
Treatment Options
TCA Cross
One of the primary treatments I use for boxcar scars is Trichloroacetic Acid (TCA) cross. By placing a small amount of TCA directly into the scar, we can stimulate collagen production, which helps to lift and smooth the scar over time.
CO2 Laser and Dermabrasion
For more severe cases, particularly those involving thickened scar walls, I often recommend a combination of ablative CO2 laser and dermabrasion. The CO2 laser targets the deeper layers of the skin, promoting collagen remodeling, while dermabrasion mechanically sands down the thickened areas.
Subcision
Subcision is another technique I employ to break up the tethered bonds beneath the skin that contribute to the appearance of scars. This procedure involves inserting a needle under the skin to release the scar tissue, allowing the skin to rise and appear smoother.
Addressing Fat Loss
Fat loss around the scars can significantly affect the outcome of treatments. In many cases, volume replacement with fillers or fat transfer is necessary to restore the natural contours of the face. This step is crucial for achieving a balanced and youthful appearance.
Lifestyle Factors
Diet plays a vital role in skin health and collagen regeneration. I advise patients to avoid inflammatory foods such as dairy and complex sugars, which can hinder collagen production. Instead, focus on a diet rich in antioxidants and anti-inflammatory foods, similar to traditional Korean and Japanese diets, which promote healthy skin.
Hydration is also essential. I encourage patients to drink plenty of water and consider using mineral water for facial cleansing to avoid potential irritants found in tap water.
Questions Answered
- Question: Is halo not a good laser for acne scars?
- Dr. Qazi: No, the Halo laser is not ideal for treating acne scars. It is a rolling device that can potentially worsen certain types of scars, especially if not used correctly.
- Question: How do I get rid of these scars?
- Dr. Qazi: There are several approaches, including TCA cross, CO2 laser, dermabrasion, and subcision. Each method targets different aspects of scarring, so a combination of treatments may be necessary for optimal results.
- Question: Why did the Halo laser make my acne scars worse?
- Dr. Qazi: The Halo laser can cause additional scarring if used improperly. Its rolling mechanism may widen certain scars, and excessive heat can lead to further skin damage.
- Question: How to get rid of large pores on my nose that's not an ice pick scar?
- Dr. Qazi: TCA cross can be effective for large pores. It stimulates collagen production, which can help reduce pore size and improve skin texture.
- Question: When you do phenol peel do you always do dermabrasion as well?
- Dr. Qazi: Yes, for severe scars, combining phenol peels with dermabrasion is often beneficial. The phenol peel stimulates collagen, while dermabrasion removes thickened skin layers.
- Question: What are some of the less obvious things that can impact collagen regeneration and healing?
- Dr. Qazi: Diet, UV exposure, and water quality play significant roles. Avoiding inflammatory foods and protecting your skin from sun damage are crucial for collagen health.
- Question: What's the best treatments for skin of color?
- Dr. Qazi: Combination therapies work best for skin of color. Using a mix of lasers, chemical peels, and topical treatments ensures comprehensive care without exacerbating pigmentation issues.
- Question: Can we use fractional laser without subcision and TCA cross at home?
- Dr. Qazi: Fractional lasers can be used for mild texture issues but are not sufficient alone for severe scars. They should be combined with other treatments like TCA cross or subcision for best results.
- Question: Would a perfect fully ablative CO2 or dermabrasion for smoothing down rolling scar walls?
- Dr. Qazi: Both can be effective, but multiple sessions may be needed. Ablative CO2 laser and dermabrasion target different aspects of scar tissue, so combining them can yield better outcomes.
- Question: What types of food do you recommend eating lots for maximum collagen production?
- Dr. Qazi: Focus on anti-inflammatory foods rich in antioxidants. Avoid dairy and processed sugars, which can hinder collagen production.
- Question: Would you recommend Pico Laser for dark underarms? What is the estimated price for Pico laser?
- Dr. Qazi: Yes, the Pico Laser is effective for treating dark underarms. Prices vary depending on location and clinic, but it typically ranges from $100 to $300 per session.
- Question: I did fraxal two times with no results should I have done more?
- Dr. Qazi: Fraxel may not be sufficient for severe scars. Consider combining it with other treatments like TCA cross or subcision for better results.
- Question: Which laser can I use for scarring from a rock?
- Dr. Qazi: The appropriate laser depends on the type of scar. Consult with a specialist to determine the best option for your specific case.
- Question: If someone gets pimples after finishing isotretinoin when should they start a second course is low dose enough and how long should it be?
- Dr. Qazi: Start with topical retinoids before considering a second course of isotretinoin. Low-dose isotretinoin can be effective, but consult with a dermatologist for personalized advice.
- Question: These look exactly like mine. Does this have the ability to shift your facial fat if you have a naturally full face and want to preserve it?
- Dr. Qazi: Yes, severe scarring can affect facial fat distribution. Treatments like subcision and volume replacement can help restore balance without compromising your natural features.
- Question: Do you think there needs to be more transparency about what real human skin and texture looks like in the digital space?
- Dr. Qazi: Absolutely. With the rise of AI and filters, it's important to promote realistic expectations and celebrate diverse skin textures.
- Question: Why do you use acure and not aviclear?
- Dr. Qazi: Acure offers real-time feedback and has shown promising results in normalizing oil production without systemic side effects. Aviclear may be suitable for some, but individual responses vary.
- Question: Do you think you're close to done with your own scar and acne journey?
- Dr. Qazi: Not entirely. While I've made significant progress, I continue to explore new treatments to further improve my skin's appearance.
- Question: Do you think over time there's more you want to do on your skin?
- Dr. Qazi: Yes, there's always room for improvement. I plan to document my journey to share insights and experiences with others.
- Question: What fellowships allow locum tenens, did you do a fellowship for your specialty?
- Dr. Qazi: Locum tenens opportunities vary by specialty and institution. I did not pursue a formal fellowship but gained extensive experience through clinical practice.
- Question: How do you feel about Winlevi about treating acne before fixing scarring?
- Dr. Qazi: Winlevi is okay but not the best option for everyone. Spironolactone is often more effective and cost-efficient for managing hormonal acne.
- Question: Can rejuran be beneficial for any kind of scars?
- Dr. Qazi: Rejuran has mixed reviews for scar treatment. While some patients report benefits, others find it ineffective. Individual results may vary.
- Question: What if you can't take spironolactone?
- Dr. Qazi: Alternative options include isotretinoin or Acure laser treatments. Discuss with a dermatologist to find the best solution for your needs.
- Question: Do you have any office in New York City if not any doctors you recommend?
- Dr. Qazi: I am based in Newport Beach, California, but I can provide guidance for finding reputable specialists in New York City.
- Question: Does that mean that a facelift and fat transfer would be need to be done at an earlier age?
- Dr. Qazi: Early intervention with scar treatments can help prevent the need for more invasive procedures later. Breaking up scar tissue and restoring volume can delay the need for facelifts.
- Question: After residency you worked at work as an attending. If you do fellowship can you do attending and fellowship?
- Dr. Qazi: Typically, fellows remain within their hospital system. Moonlighting as an attending during fellowship is possible but varies by institution and state regulations.
- Question: I booked my consultation with you but I can I book an acure before separately?
- Dr. Qazi: Yes, you can book an Acure session separately. It's a smart move to address acne before focusing on scar treatments.
- Question: Is it safe to perform subcision on the temples I know we have veins there?
- Dr. Qazi: Subcision on the temples can be performed safely using blunt cannulas. It's generally easier than people assume, but caution is necessary due to the presence of veins.
- Question: How often do you get patients around my age 20 years old?
- Dr. Qazi: I see many patients in their early 20s, especially during summer breaks. Acne can significantly impact young adults, and timely treatment is crucial.
- Question: With attending salary is it allowed to do both or can you only do fellowship?
- Dr. Qazi: Fellows can moonlight within their hospital system, often earning higher salaries for additional shifts. Rules vary by state and institution.
- Question: What steps to clear these scars on dark skin?
- Dr. Qazi: A combination of TCA cross, CO2 laser, subcision, and volume replacement is effective for clearing scars on dark skin. Tailored approaches ensure optimal results.
- Question: Do you guys give any student discounts?
- Dr. Qazi: We offer discounts for students on certain treatments. Check our website or contact us directly for more information.
- Question: Do you think in effect similar to micro swelling could happen with treatments?
- Dr. Qazi: Volume replacement through treatments can create a temporary plumping effect, but it should be done gradually to ensure natural-looking results.
- Question: I'm 30 right now is it too late to start treatment?
- Dr. Qazi: Absolutely not! There's no age limit for scar treatments. Patients in their 80s have seen improvements, so it's never too late to start.
- Question: Is Picos Pro a good laser?
- Dr. Qazi: Yes, the Picos Pro is an excellent laser for treating pigmentation and other skin concerns. It's versatile and effective for various conditions.
Final Thoughts
In conclusion, understanding your acne scars and the available treatments is the first step toward achieving clearer, healthier skin. By combining medical expertise with personalized care, we can work together to address your unique needs and help you regain confidence in your appearance. Remember, you're not alone in this journey, and effective solutions are within reach.
To learn more or book your consultation, visit DoctorQazi.com.