Want acne scar treatment matched to your scar type, not a one-size protocol?

Four scar types matched to four modality combinations

✦Scar-type protocol matrix

Ice pick scars

Narrow, deep, V-shaped. Microneedling RF is non-negotiable here. Standard stack: Pico Laser fractional + microneedling RF + Rejuran S layered across the course.

Rolling scars

Wide, undulating wave-pattern. Subcision releases fibrous bands first, then bioremodeller fills the released space, then microneedling RF stimulates collagen. Rejuran S layers in for dermal repair.

Boxcar scars

Wide, sharp-edged craters. Pico Laser fractional + microneedling RF combined session every 4-6 weeks. Resurfaces edges + stimulates dermal fill. Rejuran S supports repair.

Hypertrophic scars

Raised, firm, often pink. Different problem (too much scar tissue). Steroid + 5-FU injection monthly + laser flattening protocol over months.

Pico fractional resurfacing

Standard Pico session at fractional spot-size pattern. Reaches both ice-pick depth and boxcar edges. Dr Samantha's preferred foundation modality.

Microneedling RF + PN Healer combo

Anti-matte RF microneedling delivers RF heat through 24 insulated needles into the deep dermis, followed by PN Healer infusion for dermal repair signalling.

Why acne scars need to be classified before treatment

Acne scars are not one thing. They fall into four anatomical categories that respond to different modalities. Treating an ice-pick scar with the same protocol you'd use for a rolling scar gives partial results at best, no result at worst. Dr Samantha's protocol starts with a magnified scar-type assessment.

• Ice pick scars: narrow, deep, V-shaped. Deeper than wide. Microneedling RF is non-negotiable for this scar type. Pico fractional alone won't reach the depth. Standard stack: Pico + microneedling RF + Rejuran S, layered across the course.
• Rolling scars: wide, shallow, undulating wave-pattern surface. Caused by tethered dermal fibrous bands. Need subcision (release the bands) + bioremodeller (fill the space) + resurfacing.
• Boxcar scars: wide, sharp-edged, flat-bottomed. Look like small craters. Respond to Pico Laser fractional resurfacing + microneedling RF dermal stimulation.
• Hypertrophic / keloid scars: raised, firm, often pink. The opposite problem, too much scar tissue, not too little. Injection (steroid + 5-FU) + laser flattening protocol.

At Nexus, Pico Laser is the foundation modality for ice-pick and boxcar scar removal because it reaches the depth those scar types require. Microneedling RF layers in for additional dermal stimulation. Polynucleotide booster (PN Healer) signals dermal repair across all scar types.

How Dr Samantha sequences acne-scar modalities at Nexus

Pico Laser is Dr Samantha's foundation modality for ice-pick and boxcar scars because it reaches the depth those scar types require. Microneedling RF layers in for additional dermal stimulation and collagen response. PN Healer (polynucleotide booster) signals dermal repair across all scar types. Subcision releases fibrous bands for rolling scars specifically. Bioremodeller (Profhilo or SkinViv) layers in as a dermal-quality canvas under any other modality. Per-modality pricing lives in the menu above.

Two modalities are deliberately NOT on the Nexus menu. Surgical scar excision is referred to plastic surgery for severe cases, outside the scope of medical aesthetics. Chemical TCA Cross was removed from the Nexus menu per Dr Samantha's clinical assessment in May 2026. Hypertrophic raised scars are managed with intralesional steroid + 5-FU injection, priced per case.

Dr Samantha's protocol layers Pico Laser + microneedling RF + PN Healer as the foundation for most patient cases, with Rejuran S as a must-do additional layer for depressed scars (ice pick, rolling, boxcar). Bioremodeller (Profhilo or SkinViv) layers in for the dermal-quality canvas. Subcision adds in for rolling scars specifically.

Not every acne scar is atrophic. Some 'scars' are actually post-inflammatory hyperpigmentation (PIH), dark spots or brown spots left by acne that has already healed. For PIH cases, the protocol is laser + microneedling + Rejuran Healer alone. Microneedling RF and Rejuran S are not needed for pigment-only cases.

Dr Samantha's scar-type to modality matching

Each scar type has a primary modality + secondary supports. The classification at consultation determines the combination.

• Ice pick → Primary: Pico fractional. Secondary: microneedling RF, PN Healer. Need depth to reach the V-shape.
• Rolling → Primary: subcision. Secondary: bioremodeller (fill released space), microneedling RF. Bands have to be released first.
• Boxcar → Primary: Pico fractional + microneedling RF together. Resurface the sharp edges + stimulate dermal fill.
• Hypertrophic → Primary: steroid + 5-FU injection. Secondary: laser flattening. Different problem (too much scar tissue), different protocol.

What a scar-type assessment + first session looks like

Sessions and course structure

Side effects and recovery from acne scar protocols

Common, in most patients:

• Mild redness 30-60 minutes post-session, settles to baseline within 2-4 hours.
• Pinpoint marks at injection or microneedling points for 24-48 hours.
• Mild peeling 3-5 days post-Pico session as resurfacing response.
• Redness, red spots, or small bumps from Rejuran S typically resolve in 1-5 days.
• Bruising may occur with injectables (subcision, Rejuran S) and usually settles within a week.

Sun protection (SPF 50) is non-negotiable for the duration of the protocol course. PIH is the most common avoidable complication on Asian skin, so conservative fluence + strict sun avoidance for 4 weeks post-Pico is part of the protocol.

Aftercare across acne scar protocols

Why a matched acne scar protocol earns its place at Nexus

• Scar-type classification first: prevents treating ice-pick scars with surface microneedling (the most common acne-scar protocol failure).
• Layered modality approach: Pico + RF + PN Healer reaches surface, deep dermis, and dermal-repair signalling layers across the protocol.
• Realistic framing: acne scar removal is a 5-10 session course over months, not a one-and-done protocol. Dr Samantha gives honest improvement language at consultation, not a percentage promise.
• PIH prevention protocol: conservative fluence + strict sun protection across the course. Most common avoidable complication on Asian skin.
• Photo documentation: grid-overlay before/during/after photos track response across the 4-6 session course.