Scar Filler (Wound and Acne Mark Filler)

Dermal filler applications can help reduce the appearance of suitable acne scars and make depressions on the skin surface less noticeable. This treatment allows us to fill the indentations formed on the skin due to various reasons and achieve a smooth, even surface. Fundamentally, the primary goal of scar filler is to improve the appearance of scars. Hyaluronic acid-based filler materials are preferred as the substance in filler applications. It is applied by injecting the filler material under the skin. These fillers fill the gaps formed beneath the skin and create a smooth, even skin surface. As a result, the appearance of acne scars is improved. The effects of scar fillers do not stop there. At the same time, it triggers the skin's collagen production and allows the scars to heal over time, enabling the skin to regenerate itself. Applied in sessions, scar fillers can maintain their effects from a few months up to several years. The longevity of the results may vary depending on the treated area, the filler material used, and personal factors. Before treating acne scars with filler procedures, the condition of the skin should be evaluated, and the opinion of a medical aesthetic physician or a dermatologist should be obtained regarding the most accurate treatment method. In addition, the individual should be informed about pre- and post-treatment skincare. In this way, the longevity of the results obtained from the treatment can be increased. Medical Aesthetic Physician Dr. Lida Çiteli answered frequently asked questions about Scar Fillers for you.

What is a Scar?

Scars are marks that form as a result of tissue damage and the repair process caused by conditions such as infections, acne, or injuries on the skin. Especially acne can cause marks, indentations, and irregularities on the skin surface of many people. It is possible to treat acne scars with scar fillers. Scar fillers lighten the appearance of these marks. Hyaluronic acid-based filler material is used in scar filling. By injecting this filler material under the skin, scar depressions are filled and the person's skin surface becomes smoother. Dermal fillers do not only fill the gaps on the skin surface. In addition, they trigger the skin's collagen production. Thanks to increased collagen production, scars show improvement over time. Scar filling is usually planned and applied in several sessions. How long the results of scar filling will last can vary depending on the quality of the filler material used, personal characteristics, and lifestyle. It generally has a duration of effect ranging from a few months to a few years. Before deciding on scar filling, a specialist dermatologist or medical aesthetic physician must be consulted to create the most suitable treatment plan for your personal needs.

What is Scar Filling (Scar and Acne Mark Filling)?

Scar filling is used to lighten the appearance of marks, indentations, and other irregularities on the skin. The filler materials used in scar filling are calcium hydroxyapatite, hyaluronic acid, and poly-L-lactic acid. The aim of this treatment, which is applied by injecting the filler material under the skin, is to fill the depressions on the skin surface and trigger the skin's collagen production. Performed using local anesthetic creams, this treatment should be carried out under clinical conditions by a specialist and experienced physician.

How is Scar Filling Applied?

Scar filling should be performed under professional clinical conditions by a specialist dermatologist or medical aesthetic physician. In scar filling, which consists of several steps, the treatment area is first evaluated and examined. Considering the individual's skin type, the type and depth of the scars, the most appropriate filler material is decided. Before the treatment, the area is numbed with local anesthetic creams to ensure the patient feels no discomfort. After the anesthesia takes effect, the filler material is injected under the patient's skin using a sterile needle or cannula. By filling the depressions on the skin surface with dermal filler material, the patient achieves a smoother skin appearance. Completed in a short timeframe of 15 to 30 minutes, this procedure can extend up to an hour if the patient has a high number of scars. Minimal swelling or redness may occur at the injection sites following treatment. However, these are natural, possible, and expected side effects. They heal spontaneously in a short time. Paying attention to skin care after treatment and following the doctor's advice can make the results of scar filling more long-lasting.

Which Scars is Scar Filling Used For?

Scar filling is used to reduce the appearance of atrophic (depressed) scars formed due to depression and tissue loss in the skin. The filler is applied under the depressed area to help raise the skin level.

Scars where it is most commonly used

• Rolling acne scars: Broad, shallow depressions with sloping edges. They generally respond well to fillers.
• Boxcar acne scars: Round or oval depressions with sharper, distinct borders. Their depth can be reduced with fillers in suitable cases.
• Trauma and injury scars: Can be used on depressed scars with volume loss resulting from cuts, falls, or impacts.
• Surgical scars: Can be preferred to correct the appearance of depressed scars formed after surgery or sutures.
• Chickenpox scars: Can be applied especially on atrophic scars of a round and depressed nature.

For Icepick scars, scar filling alone is usually not the ideal option. In these narrow and deep scars, different scar treatments or combination therapies can be evaluated. The appropriate filling method is determined according to the depth, width, tethering/adhesion to the base, and skin structure of the scar.

Can Fillers Be Done for Acne Scars?

Yes, fillers can be performed for acne scars. Especially in certain atrophic acne scars that cause depression and volume loss in the skin, fillers can help the skin surface look smoother.

In which acne scars is it used?

• Rolling scars: Broad, shallow depressions with indistinct edges. They generally respond well to fillers.
• Boxcar scars: Round or oval depressions with more distinct borders. Their depth can be reduced with fillers in suitable cases.

In which scars are fillers NOT suitable?

• Icepick scars: Because they are very narrow and deep, fillers alone are generally not sufficient.
• Red or brown spots: These are not depressions, but color changes; fillers do not treat these types of marks.
• Raised/keloid scars: Fillers are not preferred in scars above skin level.

Are fillers performed alone?

Not always. Especially in cases where subcutaneous adhesions pull the scar downward, it may be preferred to apply it together with subcision (releasing the tethering at the scar base). In some patients, a combined approach with lasers, microneedling, or other scar treatments may be more suitable.

In summary: Fillers can be an effective option especially in rolling and suitable boxcar-type depressed acne scars; however, the scar type must be evaluated by a dermatology or plastic surgery specialist.

How are Depressed Acne Scars Treated?

Depressed acne scars (atrophic acne scars) are marks that are difficult to eliminate completely using creams and serums alone. Treatment is planned according to whether the scar is rolling, boxcar, or icepick type and its depth.

Main treatment options:

1. Subcision

Used especially in rolling scars tethered beneath the skin that pull the surface down. This connective tissue is released with a needle, allowing the depression to lift up.

2. Scar Filler

Can be used in wide and relatively shallow depressions with volume loss. The filler is placed under the scar to help raise the skin level. In some patients, it is applied together with subcision.

3. Fractional Laser

Lasers like CO₂ or Er:YAG create controlled micro-injuries to increase collagen production and help reshape skin tissue. Preferred especially in superficial to medium-depth scars.

4. Microneedling and Radiofrequency Microneedling

Aims to stimulate collagen production. Can be an option for mild to moderate atrophic scars.

5. TCA CROSS

A method used especially in narrow and deep icepick scars. TCA is applied directly inside the scar to initiate a controlled healing process.

Which Method for Which Scar?

Most important point: A single treatment is not the best option for everyone in depressed acne scars. Especially if multiple scar types coexist, combination therapy can yield better results. Furthermore, if active acne is present, it is important to bring the acne under control before scar treatment.

Do Acne Scars Completely Disappear?

It is generally not possible for acne scars to disappear 100% completely. However, with the right treatment plan, the appearance of scars can be significantly reduced and the skin texture can be made much smoother.

The outcome depends especially on the type, depth, prevalence of the scar, skin structure, and the chosen treatment method.

Results according to scar type

• Rolling scars: Generally respond better to treatment. Significant improvement can be achieved with an appropriate combination of subcision, fillers, and skin resurfacing methods.
• Boxcar scars: Can benefit from methods like lasers, microneedling, radiofrequency, or fillers in selected cases, depending on their depth.
• Icepick scars: Because they are narrow and deep, they are harder to treat. More targeted methods like TCA CROSS or punch techniques may be required.

Is a Single Session Sufficient?

Most of the time, no. Since atrophic acne scars can have different structures, treatment usually requires multiple sessions and, when necessary, a combination of different methods. For example, a combination of subcision + scar filler + fractional laser can target different issues within the same treatment plan in suitable patients.

A realistic goal is to reduce the visibility of scars as much as possible and make the skin texture more homogeneous, rather than erasing them completely. Performing a dermatological evaluation prior to treatment to determine which scar types are present provides the most accurate approach.

What Are the Causes of Long-Lasting Acne on the Face?

There can be many reasons for acne that persists for a long time or recurs frequently on the face. Hormonal changes, products used, stress, genetic predisposition, and certain medications can play a role, especially in acne persisting into adulthood.

Most common causes

1. Hormonal changes

Recurrent, painful, and deep acne, especially around the chin, jawline, and neck, may be associated with hormonal factors. If accompanied by other symptoms such as menstrual irregularity, excessive hair growth, or hair loss, a hormonal evaluation may be required.

2. Skincare and cosmetic products

Pore-clogging products, heavy makeup, or excessive peeling and harsh cleansers that irritate the skin can worsen acne.

3. Stress

Stress can contribute to the flare-up of existing acne in some people. However, stress alone is not always the root cause of acne.

4. Diet

High-glycemic-index diets and especially high milk consumption may be associated with acne in some individuals. However, it is incorrect to state that a single food is the cause of all acne.

5. Genetic predisposition

A family history of acne can increase the likelihood of developing acne and having it persist longer.

6. Medications or other skin conditions

Certain medications can lead to acne-like breakouts. Also, not every acne-like lesion is classic acne; different skin conditions such as folliculitis, perioral dermatitis, or rosacea can look similar.

When Should You Consult a Dermatologist?

If acne persists for months, is painful and deep, leaves scars, or starts suddenly in adulthood, a dermatological examination is beneficial. A underlying cause can be investigated, especially if hormonal symptoms accompany it.

Important: Squeezing pimples can increase the risk of forming depressed acne scars. Therefore, bringing active acne under control first, followed by treating any existing depressed scars, is generally the correct approach.

Why Does Acne That Has Not Gone Away for 6 Months Occur?

Acne that does not go away for 6 months can occur due to deep cystic acne, hormonal changes, improper skin care, or a different skin problem that resembles acne.

Hard, painful acne that remains under the skin can persist for a long time. If it recurs frequently on the chin and jawline, hormonal factors should also be evaluated.

However, if a lesion in the exact same spot does not go away for months, a dermatological examination is important to understand whether it is truly acne. Squeezing or picking at it also increases the risk of permanent scarring.

Why Does Persistent Body Acne Form?

There can be several different reasons for long-lasting acne on the back, chest, shoulders, or buttocks:

• Friction and sweating: Tight clothing, backpacks, or sports gear can irritate pores and increase acne.
• Oily/unsuitable products: Body lotions, shower products, or hair care products can clog pores.
• Hormonal factors: Hormonal fluctuations can increase oil production, leading to acne, especially on the back and chest.
• Folliculitis: Small, similar-looking bumps seen especially on the buttocks, back, and chest may sometimes be hair follicle inflammation rather than acne.
• Genetic predisposition: A family history of acne can increase the risk of body acne.

If you have acne that lasts for months, is painful, or leaves scars, a dermatological examination is important. This is because treatment varies based on whether it is acne or another condition like folliculitis.

Why Do Scars Remain After Acne Clears Up?

The main reason for scars or spots remaining after acne is the damage created by inflammation in the skin tissue and the way the skin heals.

• Depressed scars: When severe inflammation damages collagen tissue, tissue loss can occur, leaving depressed scars.
• Raised scars: In some individuals, excess collagen is produced during healing, creating raised scars above the skin surface.
• Brown spots: Caused by increased melanin production after inflammation. These are not true scars, but post-inflammatory hyperpigmentation (PIH).
• Red spots: Can form due to vascular changes following inflammation and may fade over time.

Deep and cystic acne, as well as squeezing and picking at pimples, particularly increases the risk of permanent scarring.

Are Lasers or Fillers More Suitable for Acne Scars?

A single method is not the best for everyone. The type and depth of the acne scar determine whether lasers or fillers should be preferred.

• Rolling (broad and wavy depressions): Fillers can be a good option, especially in combination with subcision.
• Boxcar (box-shaped depressions): Fractional lasers may be more suitable for improving skin texture and scar borders.
• Icepick (narrow and deep depressions): Fillers are generally not suitable; more targeted methods like TCA CROSS or punch techniques can be evaluated.

Laser or Filler?

Filler: Physically elevates the depression and shows results faster. However, its longevity is limited depending on the filler used.

Laser: Stimulates collagen production to allow skin tissue to remodel over time. Results appear more slowly and multiple sessions may be required.

In summary: For depressed acne scars, combination therapies like subcision + filler + laser based on scar structure may often be more appropriate than choosing strictly "laser or filler." The most accurate choice is made through a close evaluation of the scars.

Which Treatment Method is Preferred for Acne Scars?

There is no single treatment method for acne scars. The most suitable method is determined according to the scar type and depth. In most people, a combination of different methods yields better results.

For depressed scars

• Rolling: Subcision, scar fillers, fractional lasers, or radiofrequency microneedling can be evaluated.
• Boxcar: Fractional lasers, microneedling, and fillers in suitable patients can be used.
• Icepick: More targeted methods like TCA CROSS or punch techniques can be preferred.

If there are only spots/stains

• Brown spots: Pigmentation treatments and appropriate skin care are prioritized.
• Red spots: Vascular-targeted lasers or light therapies can be evaluated.

In summary: The best method for acne scars is selected according to the scar type. Especially if multiple scar types are present, combined treatment can be more effective.

What is the Difference Between Scar Filling and Other Acne Scar Treatments?

The main difference between scar filling and methods like lasers, microneedling, and subcision lies in how they work and when the results appear.

• Scar filling: Raises the skin level by placing filler material under the depression. Therefore, results are visible immediately. Depending on the filler used, its effect may be temporary.
• Laser: Provides controlled skin renewal to increase collagen production. Results appear over time and multiple sessions may be required.
• Microneedling / Radiofrequency: Aims to improve skin tissue over time by stimulating collagen production.
• Subcision: Releases the subcutaneous bands pulling the depression down. It is an important option, especially in rolling scars.

In short: While fillers directly elevate the depression, most other methods aim for skin remodeling and collagen production. Therefore, in suitable patients, these methods can be used together rather than as alternatives to each other.

Who is Suitable for Scar Filling (Scar and Acne Mark Filling)?

Scar filling is used to reduce the appearance of depressions caused by acne scars, trauma, or surgical wounds on the skin. In other words, if you complain of scars and depressions on your skin, you can apply for scar filling. Although scar filling is generally a safe treatment method, the individual's skin type, scar type, depth, and general health status should still be evaluated. However, it should be noted that scar filling is the most attractive treatment method for individuals with deep and prominent acne scars or depressions. Whether you are a suitable candidate for scar filling is determined by the physician after evaluating your skin structure, the type and depth of scars, your general health status, and the filler material to be used. Doctors only advise against filler applications for pregnant or breastfeeding mothers, or individuals with active skin infections. Therefore, it is essential to schedule a doctor's appointment prior to treatment.

How Many Types of Scars Are There? What Are the Scar Types?

Tissue changes that occur during the skin's healing process following conditions like injury, inflammation, or trauma are called scars. Acne scars are generally classified into three main types. These are keloid scars, atrophic scars, and hypertrophic scars.

Atrophic Scars

Being the most common type of scar following acne, atrophic scars leave depression-like marks on the skin. Resulting from tissue loss beneath the skin, this type of scar manifests as gaps beneath the skin surface. Subtypes like icepick scars, rolling scars, and boxcar scars are available.

Hypertrophic Scars

Occurring as a result of excess tissue formed after skin wounds heal, hypertrophic scars generally have a red and raised appearance. However, it should be noted that these scars tend to flatten over time. Collagen deposits remaining in the wound area are the primary cause of hypertrophic scars.

Keloid Scar

Considered a subtype of hypertrophic scars, keloids are scars that tend to grow beyond the original wound boundary on the skin and expand over time. Keloids have indistinct borders and are darker in color than normal skin tone. They are harder to treat compared to others.

What Are Acne Scar Treatments?

Acne scars are marks that remain on our skin after acne heals. These marks are a source of discomfort and anxiety for many people. However, with scar filling, it is possible to lighten the appearance of these marks and make the skin smooth. Treatment methods used in eliminating acne scars are as follows:

What is Scar Treatment with Chemical Peeling?

In the treatment of acne scars, dermatologists primarily consider chemical peeling applications. In chemical peeling, damaged and dead cells on the skin surface are exfoliated. Subsequently, new and healthy skin cells replace the peeled skin. As a result, the appearance of acne scars is lightened.

What is Laser Scar Treatment?

Another treatment method used in acne scar treatment is laser applications. Laser beams trigger collagen production in the lower layer of the skin and accelerate the skin's self-renewal process. This contributes to the healing of scars. Options like micro-ablation or fractional lasers are available in laser scar treatment. This procedure helps reshape the scar tissue on the skin surface and aims to achieve a smooth skin appearance for the individual.

What is Scar Treatment with Dermaroller?

Another popular application used in treating acne scars is the dermaroller. In dermaroller treatment, a roller equipped with fine needles is rolled over the skin. Creating mild trauma on the skin surface, this application initiates the skin's self-renewal and healing process. It triggers collagen production in the skin. This significantly reduces the appearance of acne scars.

Scar Filling

One of the most effective methods used in treating acne scars is scar filling. Filling the gaps beneath the scars with hyaluronic acid-based filler material provides a much smoother and even appearance to the skin. This method is an extremely effective treatment, especially in eliminating pitted acne scars.

How is Scar Treatment Done?

Acne scars are a major skin health issue experienced by many people. However, it is important to know that scars are a treatable skin condition. There are numerous methods applied in acne scar treatment to heal the skin and give it a smooth appearance. Methods applied in the treatment of acne scars are as follows:

Microdermabrasion

This method uses tiny crystals to reduce dead skin cells and scar marks on the top layer of the skin. A mild exfoliation is applied to the skin surface in this procedure. Microdermabrasion encourages skin renewal, resulting in healthier and younger-looking skin.

Chemical Peeling

Special chemical components used in chemical peeling peel the upper layer of the skin, thereby reducing scar marks. In addition to scar marks, chemical peeling can also address skin tone inequalities and improve the overall appearance of the skin.

Laser Treatment

Laser treatment reduces the appearance of scar marks by triggering collagen production in the lower layer of the skin. The intensity and type of laser beams are determined according to the depth of the scars and the patient's skin type. Laser treatment is frequently preferred as it delivers effective results.

Scar Filler Effect

By injecting dermal filler materials, scar marks on the skin are filled and the skin is made smoother. The hyaluronic acid-based filler material used in scar filling contains collagen-stimulating properties. This lightens the appearance of scars while adding radiance to the skin.

Dermabrasion

Dermabrasion treatment subjects the upper layer of the skin to controlled trauma, helping eliminate scar marks. The dermabrasion procedure ensures skin surface renewal and achieves a smoother skin texture.

Is Scar Filling Permanent?

No, scar filling is not a permanent application. Hyaluronic acid-based filler materials are absorbed by the body over time and lose their effect. Although this duration varies depending on the person's age, metabolism, environmental conditions, and lifestyle, it generally shows efficacy between 6 to 24 months.

How Soon Does Scar Filling Show Its Effect?

Scar filling begins to show its effects immediately after the injection. However, time is needed to see the final results. Ultimate results can extend over a period of 4 to 12 weeks along with increased collagen synthesis.

How Many Sessions is Scar Filling Performed?

How many sessions of scar filling will be applied is determined according to the expectations and needs of the individual. While a single session of scar filling may be sufficient for many patients, additional sessions can be planned if deep and widespread acne scars are involved. A three-session treatment plan can be made for advanced scars. Leaving a timeframe of 4-6 weeks between scar filling sessions is beneficial for skin renewal and collagen production.

What is the Recovery Process After Scar Filling?

Scar filling is a minimally invasive treatment procedure. Therefore, a fast and comfortable recovery process is experienced. Although side effects like mild redness, tenderness, bruising, or edema due to injection may occur, these heal in a short time without requiring any treatment. These complications, which decrease within the first two to three days, disappear within three to seven days. You can continue your daily life from where you left off immediately after treatment.

What Should Be Considered After Scar Filling?

To ensure successful and long-lasting results after treatment, the following points should be considered:

• Avoid direct exposure to sunlight, and use sunscreens
• Do not use any cosmetic products on the first day
• Avoid heavy exercises and physical activities
• Avoid hot and steamy environments like Turkish baths and saunas
• Stay away from chemical ingredients that could irritate the skin.

All these precautions reduce the risk of complications and ensure longer-lasting results.

What Are the Differences Between Scar Filling and Laser Treatment?

Differences between scar filling and laser acne scar treatment:

Scar filling physically fills the depressed areas in the skin, shows its effect immediately, and is mostly preferred for atrophic scars. In contrast, laser scar treatment provides skin surface renewal and triggers the skin's collagen production. It generally yields successful results on superficial and medium-depth scars. When deemed necessary, the doctor can apply these two treatments in combination to achieve maximum benefit.

What Are Scar Treatment Prices?

The prices and costs of scar treatment are shaped by the treatment method to be used, the size of the treatment area, the quality of materials used, and the expertise of the specialist performing the treatment. You can contact a medical aesthetic clinic to get up-to-date and clear information regarding the prices of scar fillers and other scar treatments.

Which Cities Do We Provide Scar Filling (Scar and Acne Mark Filling) Services To?

Medical Aesthetic Specialist Dr. Lida Çiteli provides Scar Filling (Scar and Acne Mark filling) services to patients coming from different cities of Turkey and from different parts of the world within the scope of health tourism at her clinic based in Istanbul.