Tretinoin hasn't improved my acne scars - what next?
Tretinoin can help with textural change, pigmentation and very shallow scars, but it will not fill deeper scars. Dipped scars are defects within the dermis, sometimes tethered to deeper tissue, and they need treatments that change the structure of the scar.
What tretinoin can and cannot do
Over months of use, tretinoin can stimulate collagen within the skin and improve surface texture, pigmentation and skin quality. The response is variable, with some patients noticing an improvement and others not noticing a difference. It is also an effective acne treatment, and controlling acne is the most effective way to prevent new scars.
Treatments that change the scar
- Subcision: for tethered, rolling scars - broad dips that make the skin look wavy.
- TCA CROSS: for narrow, deep ice pick scars and deep boxcar scars.
- Punch excision: for a small number of very deep scars.
- Fractional laser: ResurFX or CO2 laser for shallower scarring and texture, once the deeper scars have been treated.
Most people have more than one type of scar and need a combination of these, in the right order.
Keep using tretinoin?
Yes, if it suits your skin - for acne control, pigmentation and skin quality - but not in the expectation that it will fill your scars.
Scars not improving?
I can assess which types of scar you have and plan the treatments that will change them. An acne scar consultation is in person.
Related Articles
- Can tretinoin fill in pitted acne scars?
- What order should acne scar treatments be done in?
- Is it acne scarring or just texture?
- How I treat acne scars
