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Acne scars are a persistent problem
Acne heals. Scars, not always. And even if fifteen or twenty years have passed since the last breakout, atrophic scars — those small depressions in the skin — continue to appear in every photo with side lighting, in every magnifying mirror, every morning when the skin doesn't quite look even.
Serious acne scar treatment requires a combination of techniques: fractional laser, microneedling, medical peel, subcision and, in very specific cases, filling with hyaluronic acid. In this article, we focus on the role of hyaluronic acid within this arsenal: which scars respond well, how we do it at Santé Clinics, and what results to expect.
Which scars can we treat with hyaluronic acid
Atrophic scars (i.e., those that are “indented”) are usually classified into three types:
- Rolling scars. Gentle, wide depressions with rounded edges. Good response to hyaluronic acid, especially when combined with subcision.
- Boxcar scars. Vertical edges, flat base, deep. Variable response, depending on depth. More superficial ones may improve with filler; deeper ones require combination with fractional laser or microneedling.
- Ice-pick scars. Narrow, deep, “V”-shaped. Do not usually respond well to hyaluronic acid. They are better treated with techniques like TCA cross or fractional laser.
That's why diagnosis is crucial. Not all scars can be filled, and selling a single treatment for all is a technical error.
Why hyaluronic acid works
Hyaluronic acid acts in two different ways depending on how it is applied:
- As a volumizer. It restores volume to the base of the scar, raising it to the level of the surrounding healthy skin. The effect is immediate and mechanical.
- As a biostimulator. There are non-crosslinked or low-crosslinked hyaluronic acids that stimulate endogenous collagen production and deeply hydrate. The effect is gradual and improves the quality of the surrounding skin.
In practice, the doctor combines both strategies in the same patient.
How we do it at Santé
1. Scar diagnosis
Each scar is evaluated individually: type, depth, base, edges, width, presence or absence of fibrous bands underneath. This evaluation determines whether it is a candidate for filling, subcision + filling, or if it should be combined with laser, microneedling, or peeling.
2. Subcision when necessary
Many atrophic scars have fibrous bands that pull the tissue downwards. Before filling, we release them with a microcannula or specific needle (subcision technique). Without this step, the filler does not work well: the tissue continues to pull downwards.
3. Hyaluronic acid application
We work with hyaluronic acids selected according to the area: low-crosslinked products to improve skin quality and denser fillers to volumize the base of deeper scars. The application is done with a microcannula or very fine needle, in small, precisely distributed amounts under each scar.
4. Session
The session lasts 30–60 minutes depending on the number of scars. We apply topical anesthesia beforehand. You will leave with slight local inflammation that subsides within 24–72 hours.
5. Combined plan
Filling alone is rarely the complete answer. In most patients, we design a plan that combines:
- Subcision + hyaluronic acid for rolling scars.
- Fractional laser or microneedling to improve overall texture.
- Mesotherapy with vitamins or skinboosters to improve skin quality.
- Controlled medical peeling in some cases.
- Professional dermocosmetics at home.
The plan is created during the consultation, and results are evaluated at 3 and 6 months.
What results to expect
- Immediate: treated rolling scars appear elevated, and the skin looks more even. Side lighting, the best scar test, improves significantly.
- 2–4 weeks: the product settles. The real result is assessed here.
- Duration: between 6 and 12 months depending on the product type, area, metabolism, and combination with other techniques. When the plan combines filler + subcision + laser, part of the improvement is structural and permanent.
What we cannot promise (and no one should)
- Scars are not “erased.” They improve, in some cases very significantly, but the skin does not return to its pre-acne state.
- Ice-pick scars are not a good indication for filling.
- Very fibrous scars may require several combined sessions.
- Results are operator-dependent: the difference between a well-filled scar and a poorly filled one is enormous.
Therefore, a serious clinic manages expectations during consultation. The promise is not perfection: it is noticeably better skin.
Why Santé Clinics is a good option
- Medical team with specific experience in scars and advanced harmonization.
- Combinable catalog: laser, microneedling, peeling, mesotherapy, and fillers available under the same roof.
- Objective skin analysis beforehand (Observ 520x).
- Traceable, registered products with hyaluronidase availability for any complication.
- 10,000+ patients and 4.9 on Google.
- Avenida Diagonal 384, Barcelona. Service in Spanish, English, Portuguese, and Russian. Hours Monday to Friday 9:00–21:00, Saturdays and Sundays 10:00–20:00.
FAQ
Is it painful? It's uncomfortable, not painful. We apply topical anesthesia and work with fine cannulas or small needles.
How many sessions do I need? Between 1 and 3 initial sessions depending on the number of scars, spaced 4–6 weeks apart. Afterwards, maintenance if appropriate.
How much does it cost? It depends on the number of vials, combined technique, and scars to be treated. It is evaluated and quoted during the initial free consultation.
Is it reversible? Yes. Hyaluronic acid is reversible with hyaluronidase. For scars, reversibility is rarely needed, but it is an important clinical guarantee.
Is it combined with fractional laser? Yes, in many cases. The combination is usually the most effective option.
Are scars “erased”? Not completely. They improve significantly, especially rolling and superficial boxcar scars. Ice-pick scars require other techniques.
Is there an age limit for treatment? It's best when acne is completely controlled and the skin has finished scarring (minimum 6–12 months post-breakout).
Book your free consultation
If acne scars have been appearing in every photo for too long, the first step is a good diagnosis. Request your free consultation at Santé Clinics, Avenida Diagonal 384, Barcelona, via WhatsApp or phone at +34 699 14 58 87.
