Concern · Acne scars
Why do acne scars require different treatments?
What you may be noticing
Textural change left behind after acne has cleared — indentation, tethering, or an uneven surface that doesn't resolve on its own. Sometimes alongside redness or pigment from the same breakouts. Scarring can look similar from a distance while behaving very differently under treatment.
One concern, several scar types at once
Acne scars don't all have the same shape, depth or tissue behavior.
A patient can have several scar types at the same time, as well as pigmentary or vascular changes left over from the acne that caused them. A single device is unlikely to be the correct answer for every scar type present in one face.
What Dr. Lancho assesses
- Scar morphology
- Depth
- Tethering/contour
- Overall texture
- Pigmentation/redness
- Skin characteristics
- Active acne status
- Previous scar procedures
Clinical reasoning
These components often coexist — they aren't ruled out one by one.
Morphology & depth
Different scars sit at different depths and hold their shape differently. This changes which approach can actually reach and remodel them.
Tethering & contour
Some scarring pulls the surface down at a fixed point; other textural change is shallower and more diffuse. The two don't respond the same way.
Pigment & redness
Marks left by the acne itself — not the scar tissue — are frequently present alongside it, and are assessed as their own component.
Active acne status
Scar-focused treatment while acne is still active is generally reconsidered until the active disease is controlled.
Treatment approaches
Scar treatment is often staged, not single-session.
Depending on which components the assessment finds, an approach may draw on RF microneedling or medical microneedling — treatments capable of reaching different depths and tissue behaviors, sequenced according to what each scar actually needs.
When combination treatment makes sense
Where morphology, tethering and pigment are all genuinely present, Dr. Lancho may consider a staged plan — each treatment given a defined role for a defined component — rather than one procedure asked to resolve every scar type at once.
What treatment can — and cannot — change
Results depend on scar depth and type, the treatment selected and individual biology. Deeper or more tethered scarring can improve without fully resolving — the objective set during consultation is what's realistic for the scarring actually present, not a uniform outcome.
Related treatments
RF microneedling for skin remodeling — Addresses textural and structural scar components at a depth chosen for the finding.
Sylfirm X
Medical microneedling — A controlled-injury approach considered where texture and shallower scarring are the primary target.
Microneedling
Where confirmed appropriate for the scar type present, fractional light-based treatment may also be considered.
If acne is still active
Scarring is generally assessed once active disease is controlled — treating scar-focused technology while acne is still active can work against the plan rather than for it.
Before your consultation
Bring what the acne left behind — and whether it's still active.
You don't need to arrive knowing the scar type. That's what the assessment is for.