Acne and Acne Scar Treatment

Ann Arbor Acne Treatment

There is now hope for those who suffer from unsightly acne facial scars! Bellafill is the only FDA approved filler for treatment of distensible acne scars.

How Common is Acne?

Acne is the most common skin disorder in the United States  (estimated to affect up to 90% of teenagers in the western world).   It is not just a disease affecting teenagers. Almost 50%  of men and women in their twenties and thirties continue to have acne.  For some, difficulties continue into later adult life.  A growing number of women have acne in their 30s, 40s, 50s, and beyond.

What Parts of My Skin May be Affected by Acne?

Acne  affects skin with the most oil producing glands  (face, upper chest, back).  Bacteria (normally present on the skin) overgrow, multiplying in numbers, infecting and degrading the skin.

PostInflannatory Hyperpigmentation (POI)

Without treatment, dark spots (post inflammatory hyperpigmentation- PIH) and permanent scars appear on the skin , even as acne clears. Patients have told us that this PIH is an unsightly reminder that they had acne.  (fortunately we have multiple treatments available that will help make this less noticeable).


Acne scars affect the majority of people with acne vulgaris (95%). These scars are caused by  abnormal  healing following dermal inflammation from active acne. Although scarring may occur with any form of acne vulgaris, it is most likely to occur with certain varieties including the severe nodulocystic variety.

Types of Acne Scars

Atrophic acne scars are the most common type of acne scar and have lost collagen from this healing response. Three types of atropic scars occur: ice-pick ; boxcar ; and rolling. Ice pick scars are  narrow  and  deep scars that extend into the dermis. Rolling scars are wider (4–5 mm across) with  a wave-like pattern. Boxcar scars are round or ovoid, indented with sharp borders (size varies from 1.5–4 mm).

Dr.Burke has developed a method of digital computer imaging to diagnose exactly where the problem areas and help direct more exact treatment.

This  photo below is of a patient with severe acne scarring of her cheeks.  She has had one Bellafill treatment.


Optimal Treatment through Microsubincision

Optimal correction requires a second treatment (and sometimes a third) in the future.  Dr.Burke uses a special technique to treat distensible boxcar scars like these.  This involves release of underlying scarred skin through microsubincision followed by careful injection of tiny amounts of Bellafill to gently lift the scar toward the surrounding tissue level.

Keloid and hypertropic scars also occur, but are less common. The following video illustrates Dr.Burke and his patient discussing treatment of distensible acne scars with Bellafill .

This next video illustrates Dr.Burke treating distensible facial acne scars with Bellafill.

This is Sharon 15 months after her Bellafill Treatment:

Fat Atrophy and Facial Volume Loss add to Acne Scar Prominence

Adding Underlying volume and supporting facial tissues through minimally invasive options such as the Silhouette Instalift also improves scar appearance



Postinflammatory hyperpigmentation (PIH) is the result of nodular or cystic acne which leaves an inflamed red discoloration on the skin surface after the original acne lesion has resolved. PIH occurs more often in darker skin colors. Untreated scars can last for years and remain  permanent. For many, this is the major cosmetic complaint.

Dr.Burke offers laser treatments for active acne which convert a biologic byproduct of bacterial metabolism into an antibiotic like compound acting to suppress the bacteria producing it.acnedrrobertburkepatient2015



Dr.Burke also offers noninvasive and minimally invasive treatments to treat the side effects of acne – unsightly facial scars.

The actual treatment selected depends on individual findings and your history.

Dr.Burke is the first physician in Ann Arbor to offer Bellafill, Bellafill_Logo_CURRENT

the first and only FDA approved filler for the treatment of unsightly acne scars.  The mechanism of action is illustrated in the following video:

Use of Computer Digital Imaging in Treatment Planning for Correction of Acne Scars

Dr.Burke uses digital computer imaging to help plan the actual treatment of acne scars. Digital photography starts with computer aided capture of the actual scars and surrounding skin.  This helps with discussion and actual localization of the specific scars to be treated. Distensible scars are the best responders while ice pick scars do not respond (other treatments are available for these).

Treatment includes microsubincision and careful microdeposition of small aliquots of Bellafill under the actual scars, elevating them to more closely match that of the surrounding skin.