Acne Scar Filler (Acne Scar Filler)

How does it work?

Acne scar fillers are performed using hyaluronic acid, polylactic acid, or calcium hydroxyapatite-based fillers.
• The filler is injected beneath deep depressions and lifts the skin surface.
• It also increases collagen production in the skin, gradually reducing the appearance of scars.

Its mechanism includes both physical support and, in some types, biological stimulation:

1. Mechanical Effect (Instant volume restoration)

• The filler acts like a “cushion” under the scar
• The skin surface is lifted
• The depressed appearance improves instantly, giving a smoother look

2. Optical Effect (Improved light reflection)

• Reduced depth helps light distribute more evenly
• The skin appears brighter and more even
• Scars that “don’t cover even with makeup” appear softer

3. Biological Effect (Collagen stimulation – in certain filler types)

• CaHA and PLA-based fillers stimulate collagen production beneath the skin
• Over time, tissue renewal occurs and the effect becomes longer lasting
• Skin quality improves and the area around the scar looks healthier

What to Expect?

• Scars do not completely disappear, but they become noticeably reduced
• The skin appears smoother, fuller, and healthier
• Makeup applies more evenly
• Returning to daily life is possible immediately

What are the benefits?

• Reduces the appearance of depressed acne scars
• Improves skin texture, making it more even
• Helps makeup sit better on the skin
• Adds volume and vitality
• Provides immediate visible improvement
• Return to social life in 1–2 days
• Offers a non-surgical and less aggressive alternative
• Hyaluronic acid fillers are reversible
• Some fillers support long-term collagen production
• Improves dull and tired-looking skin

Which Fillers Are Used for Acne Scar Treatment?

Fillers used for acne scars are safe, skin-compatible, and gradually absorbed. Based on scar depth, type, and skin structure, different filler materials may be selected:

1. Hyaluronic Acid-Based Fillers

• Most commonly used filler type
• Provides volume and hydration
• Lasts around 6–12 months
• Can be dissolved with hyaluronidase
• Suitable especially for rolling and boxcar scars

2. Calcium Hydroxyapatite (CaHA) Fillers

• Stimulates collagen production and supports tissue remodeling
• Suitable for deeper and fibrotic scars
• Offers long-lasting effects (12–18 months)
• Applied in subdermal layers; must be used carefully for superficial scars

3. Polycaprolactone and Polylactic Acid (PLA) Biostimulatory Fillers

• Used mainly for collagen stimulation rather than instant filling
• Triggers new tissue formation over time
• Long-lasting and near-permanent effects, but results appear gradually
• Considered for deep and firm scars

Which Filler Is Best for Whom?

• Hyaluronic acid is ideal for first-time patients
• For deep or fibrous scars, collagen-stimulating fillers may be combined
• Filler selection depends on scar depth, skin thickness, and expectations

Fillers Used in Acne Scarring and Their Properties

Filler Type Suitable Scar Types Duration Advantages

Hyaluronic Acid (HA) Rolling, Boxcar 6–12 months Natural look, hydration, reversible
Calcium Hydroxyapatite (CaHA) Deep and fibrous scars 12–18 months Stimulates collagen, lifting effect
Polycaprolactone / PLA Deep and firm scars 18+ months Long-lasting, collagen stimulation, improved tissue quality

Which acne scar types benefit from filler?

Filler treatments work best for depressed (atrophic) acne scars. However, not all depressed scars respond equally.
The following scar types benefit the most:

1. Rolling scars

Soft, wide, shallow depressions.
Filler supports these areas, smoothing the skin surface.
Example: Large wave-like depressions on the cheekbone area.

2. Boxcar scars

Sharp-edged, well-defined depressions.
Filler lifts the area, making the surface more even.
Example: A fingertip-sized sharp depression on the mid-cheek.

3. Combined scarring

When mixed types are present, fillers can be injected into suitable areas.
Example: Both rolling and boxcar scars on the cheek, with additional laser for other areas.

Scar type where filler is ineffective:

Ice pick scars:

Narrow, deep, and sharp scars.
Filler cannot reach the depth; methods like laser or TCA cross are preferred.

Conclusion:
Not every acne scar can be treated with filler. A personalized plan should be created based on scar type, structure, and depth.

Does it provide a natural look?

Yes, fillers gently lift deep scars and create a natural-looking skin texture.

Who is suitable?

• Individuals with deep atrophic acne scars, especially rolling and boxcar types
• Those wanting smoother skin texture
• Individuals seeking a more even complexion

Which areas can be treated?

Acne scar filler is applied to areas with depressed and uneven textures.
Most common treatment areas:
• Cheeks
• Temples
• Chin
• Forehead and sides of the nose (in selected cases)

Fractional laser or filler for acne scars?

Fractional laser and fillers work differently; they complement each other.

What does fractional laser do?

Fractional laser reduces surface irregularities such as texture issues, enlarged pores, and uneven skin tone.
It creates controlled micro-injuries that stimulate collagen, improving smoothness.
Most effective for superficial rolling or boxcar scars.

What does filler do?

Filler lifts areas with volume loss.
However, it does not directly treat the skin surface.
Best for deeper boxcar and rolling scars.

When to choose which?
• For both texture irregularity and volume loss: combined treatment.
• For only surface irregularity: fractional laser alone may suffice.
• For deep, well-defined depressions: filler is the priority.

Conclusion:
Fractional laser and fillers complement each other. Treatment should be personalized.

When are results visible?

Immediate improvement is seen, with more noticeable results in 3–4 weeks as collagen increases.

Do fillers remove scars completely?

Fillers significantly reduce appearance but do not eliminate scars.
Best results occur when combined with laser or microneedling.

How long do results last?

• Hyaluronic acid fillers: 6–12 months
• Collagen-stimulating fillers: 18–24 months

Is one session enough?

Most patients need multiple sessions for full improvement.
However, visible results appear after the first session.

How long does the procedure take?

Approximately 30–45 minutes.

Is the procedure painful?

A slight stinging may occur, but local anesthesia minimizes discomfort.

Is anesthesia required?

Yes, topical anesthetic cream and block anesthesia are used.

Can you return to social life immediately?

Yes, though mild swelling may occur.

Is combination treatment needed?

Often yes. Combining laser, fillers, microneedling, RF, mesotherapy, and exosome therapy enhances overall results.

Is special aftercare required?

The skin recovers quickly. Basic aftercare includes:
• Sun protection
• Gentle cleansing and moisturizing
• Avoiding heavy makeup and massage for 24–48 hours
• Applying cold compress or arnica if swelling occurs

Is regular maintenance needed?

Filler effects last 9–18 months.
Since acne scars are static, results soften over time but do not fully revert due to collagen stimulation.
Annual check-ups are recommended but not mandatory.