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Severe acne scars are categorized as grade 4 acne scarring on the GoodmanBaron scale. This means they are nondistensible scars that cannot be concealed with makeup or normal beard growth in male patients. These scars are visible at conversational distances of at least 50 centimeters.

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How to treat acne scarring costeffectively?

To achieve effective scar revision while minimizing costs, a single major session is usually sufficient for most patients. The recommended approach involves subcising in multiple levels to release as much tissue as possible. This session includes laser resurfacing, TCA excisions, and RFM (Radiofrequency Microneedling). In some cases, additional sessions may be necessary if:

Extensive scarring is present, such as scars on the temples, forehead, and cheeks.
Scars need to be reattached due to persistent inflammation caused by acne.
Active acne is present, even if it's mild, as it can hinder collagen production.
Minimal downtime is desired by the patient.

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What are other treatments used for scar revision?

Following one to two sessions of the aforementioned treatments, patients are typically transitioned to senior nurses for costeffective and effective treatments, which include:

Cannula and saline subcision: A lowrisk procedure with minimal downtime to address mild scars.
Biostimulatory injections of "fillers": These hybrid hyaluronic acid molecules stimulate the production of collagen.
TCA Paint: Specifically used for deep ice pick and boxcar acne scars.
CO2 lasers: Utilized with one of three devices, these lasers are effective for boxcar and rolling scars.
NA Hybrid 1570 or 1550 lasers: Recommended for mild scars and offer minimal downtime.
Manual microneedling: Primarily used for scars on the forehead and temples.
RF microneedling: Suitable for deeper rolling acne scars that require collagen remodeling, particularly on the cheeks and jawline.
It is important to note that while these treatments are widely accepted in the medical literature, they do not qualify for a Medicare rebate.