When is surgery necessary for acne scarring?

Deep crater scars: Deep atrophic or crateriform scars may need subcision (using a large bore needle or sharp instrument to release the connective tissue pulling down on the scar from underneath). Deep pitted or ice-pick scars may need punch excision or grafting.

Deep scars: Most patients develop acne "scars" which are redness or brown discoloration of the skin left behind by prior acne pimples. Fortunately, these tend to fade with time and do not require treatment. If you have deep depression in the skin from acne, you may benefit from treatments such as fraxel laser, chemical peels, acne surgery, or even fillers.

Nonsurgical options: There are many good nonsurgical options available for treating acne scars. Laser resurfacing is an effective way to reduce acne scarring with minimal down time.

When all else fails: There are several types of acne scarring. Most can be diminished with monthly regimen of creams and chemical peels. If that fails then you have fraxel laser or a more aggressive approach is co2 laser. Hope that helps.