When you’ve spent years managing your acne, at times feeling as though your skin has it in for you, the resulting scarring can feel like a cruel joke. Not to be confused with hyperpigmentation or dark spots, which can be treated over time, acne scarring permanently alters the texture of your skin, leaving "dents" where there were once breakouts.
According to Dr. Anjali Mahto, consultant dermatologist and author of The Skincare Bible: Your No-Nonsense Guide To Great Skin, inflammatory acne can damage the collagen fibers within the deeper layers of our skin. "New collagen is formed as a repair response but may not be as even as before, resulting in atrophic scarring," Dr. Mahto says. "However, scarring is also more likely to occur if you squeeze or pick at your spots, too." This is a habit I have been guilty of over the years.
Most of my acne scarring resides in the center of my face, resembling oversized pores, and although I’m passionate about skin positivity, these scars have chipped away at my confidence. On down days, scrolling through social media makes me feel even worse. It’s hard not to take those "perfect skin" pictures you see on Instagram at face value, and feel as though everyone except you has baby's-bottom skin.
I get filler injected to plump out a few of the expression lines around my mouth (the ones my foundation would always collect in) and, during a recent appointment at the clinic, I had a lightbulb moment: Could filler be injected into my scars to plump them up in the same way it does my lines?
According to Dr. Mahto, the answer is yes. "Dermal fillers can be used for indented scars and the treatment can be offered by a good cosmetic dermatologist," she told me. "However, depending on the type of filler used, the treatment will need to be repeated at regular intervals, typically every six months, to maintain the outward results. Indented scars often require multiple modalities of treatment to get the best result, and fillers can be combined with other treatments such as microneedling or laser."
Aesthetic doctor and plastic surgeon Dr. Maryam Zamani seconded this, touting hyaluronic acid-based fillers as a good option for treating pitted skin. "They are especially useful if scarring is isolated rather than widespread. Injecting underneath an atrophic scar plumps and lifts the area resulting in a more even finish, semi-permanently reversing the damage caused by inflammatory acne," she explained. "Plus, natural collagen development often occurs as a healing response post-injection, which can further improve the appearance of the skin." It pays to take the shape and size of the scar into consideration, too: "Broad, rolling scars are round in shape and respond best, while boxcar scars, which are more square-looking, and deep triangular 'ice pick' scars can be trickier to treat."
I couldn’t wait to try the filler, and as someone who is no longer squeamish when it comes to needles, I looked to Dr. Zamani for my procedure. Dr Zamani strongly recommends booking in for a consultation (this should be common practice) and scheduling the procedure for a later date, especially if you aren't au fait with injectables. This gives you time to consider all your options and make an informed decision rather than a spontaneous one.
The filler was injected underneath my scars; however, some were too small to treat, and an acid-based peel was suggested for a later date. Around 0.5 ml of filler was injected into the viable scarring in my cheeks, and it was all over in a matter of minutes with virtually no pain. All I felt was a slight prick as the needle entered my skin, and then a pressure as the filler was pushed underneath my scars.
Prices for non-permanent hyaluronic acid-based fillers such as Juvederm and Restylane range from £150 to £850 (roughly $270 CAD to $1,500 CAD) for 1 ml. The cost of my treatment was £750 (roughly $1,300 CAD) and I opted to use the other 0.5 ml on my lines. I wondered why most aestheticians only use non-permanent filler for this procedure, as I imagined that this type of treatment would benefit from permanent fillers — and, frankly I wanted a long-term fix.
"I personally don’t advocate permanent filler for any treatment," Dr. Zamani explained. "The results will gradually wear off after around 6-18 months and need repeating. However, in my experience, scars rarely return to their previous state. As we age, the positioning of our skin and bones changes, too, and permanent fillers don’t accommodate these changes which can result in an unnatural look."
To me, the change was pretty much instant, and improved even more around two weeks later. Friends and family couldn’t tell the difference and thought I was a little crazy, but I was incredibly happy with the results. Sure, the transformation was subtler than I would have liked, but Dr. Zamani had forewarned me that I would not have baby-smooth skin, so my expectations were far more realistic by the time she began injecting me. What I have noticed is that my foundation hugs my skin better, as does my blush, and I’ve even started wearing cream blush, something I never did before.
To see better results for my type of scarring, I was sent home with a skin-refining team of vitamin C and retinol. I’m also carrying on with my monthly microneedling sessions and will try a peel during the winter when my skin is less exposed to the sun.