Acne scarring is not one condition, which is why two people can have the same treatment and see very different results.
Effective acne scar treatment in Bali begins with classification rather than with a device. Scar type, depth, and skin characteristics all influence what is likely to work, and no single treatment addresses every type of acne scar equally well.
Not sure what kind of scarring you have? Most people have a mix, and the mix decides the plan. A doctor-led assessment at Anaya Aesthetics, a beauty clinic Bali located in Kerobokan, maps your scar types and skin before any device is chosen. Book a scar assessment on WhatsApp.
The Three Atrophic Scar Types
Atrophic scars are the depressed type of acne scar. They are classified primarily by their shape and depth.
- Rolling scars are wide, shallow, and undulating, giving the skin a soft, uneven appearance rather than distinct pits.
- Boxcar scars are wider depressions with defined vertical edges. They can be shallow or deep and often have a more clearly outlined appearance.
- Icepick scars are narrow, deep, and sharply defined, extending vertically into the skin.
Most people have a mixture of scar types. The proportions matter, which is why rolling and boxcar scars are a useful distinction rather than simply a technical classification.
Scar Type and Treatment Match
| Scar type | Typical characteristics | Approach often considered |
| Rolling | Wide, shallow, undulating | Microneedling or Dermapen; laser in some cases |
| Boxcar | Defined edges, shallow to deep | Microneedling for shallow; laser or combination for deeper |
| Icepick | Narrow, deep, vertical | Less suited to area treatments; targeted or combination care |
This is a guide only. The right approach depends on scar depth, skin tone, pigmentation history, and how your skin responds, and is set at consultation.
Why Scar Type Determines the Treatment
Different scar morphologies respond differently to treatment. That is why classification should come before choosing a device.
Microneedling can improve the appearance of rolling and some shallow boxcar scars by creating controlled micro-injuries that stimulate collagen remodelling across the treated area. It tends to be less effective for narrow, deep icepick scars because the treatment is delivered across an area rather than directly to the deepest part of an individual scar.
A review of acne scar treatment using the acne scar classification system explains how treatment selection can be guided by scar morphology. An objective evaluation of microneedling for atrophic scars also reports improvements in atrophic acne scarring following treatment.
Microneedling and Dermapen
Dermapen is a motorised microneedling device. The underlying principle is the same as microneedling generally, with fine needles creating controlled micro-injuries that trigger the skin’s wound-healing response and stimulate collagen production.
It can:
- Create controlled micro-injuries at a selected depth.
- Stimulate collagen remodelling during the healing process.
- Treat an area rather than targeting each scar individually.
- Be useful for rolling scars and some shallow boxcar scars.
- Require a course of treatments, with the interval determined by the treatment depth and the individual’s response.
At Anaya Aesthetics, Dermapen is positioned as a collagen-stimulating microneedling treatment that can improve texture and reduce the appearance of scars, with personalised planning rather than a fixed approach for every client.
Want to know if Dermapen or laser fits your scars? Send a photo and your main concern, and a doctor will tell you honestly what is realistic. Message the medical team on WhatsApp. For a course planned over several months, ask about VIP member pricing.
Where Lasers Fit
Laser treatment for acne scars covers several different technologies, and they do not all work in the same way.
Fractional resurfacing lasers create controlled areas of thermal injury in the skin to stimulate remodelling while leaving surrounding tissue untreated. Depending on the laser and settings used, this can improve texture and the appearance of certain atrophic scars.
Laser treatment may be considered when microneedling alone does not provide enough improvement, but the appropriate technology and settings depend on the scar type, skin tone, and history of pigmentation.
Two considerations are particularly important:
- Pigmentation risk. Post-inflammatory hyperpigmentation can occur after energy-based treatments, with risk influenced by factors including skin type, treatment intensity, and sun exposure.
- Photoprotection. Sun exposure should be carefully managed around a laser course, particularly in Bali, where strong outdoor light is a regular part of daily life.
At Anaya Aesthetics, options include the Lavieen thulium fractional laser and Pico laser, which are selected according to the patient’s concerns and skin characteristics. Anaya Aesthetics’ current Pico Laser information specifically lists acne scars among its treatment indications.
The important point is that “laser” is not one treatment. The technology, settings, and treatment goal all matter.
Why Combination Treatment Can Work Better
Different scar types require different approaches, which is why combination treatment can be useful.
If you have rolling, boxcar, and icepick scars in the same area, a treatment optimised for one type may not produce the same result on the others. A review of evidence-based management of atrophic acne scarring supports the use of combination approaches for selected patients, particularly when scarring is moderate to severe.
In practice, a treatment plan may combine different modalities or sequence them over several months. The appropriate combination depends on the scar types present, their depth, the patient’s skin characteristics, and how the skin responds to treatment.
Setting Realistic Expectations
Two honest statements are worth more than a promise.
- Atrophic scarring can improve, but it rarely disappears completely. Meaningful improvement is a realistic goal; complete resolution is not.
- New acne should be controlled as much as possible before intensive scar treatment. Otherwise, new lesions can create additional scars while existing ones are being treated.
Progress is best judged through photographs taken at consistent intervals rather than by checking the skin every day in a bathroom mirror.
Our before and after gallery can also give you a more realistic sense of what a treatment course may achieve.
Sessions, Cost, and Aftercare
Scar treatment is almost always a course rather than a single session, with intervals set by the treatment and your skin’s response. At Anaya Aesthetics, Dermapen starts from IDR 3,700,000 per session, Pico laser from IDR 1,500,000 per session, and Lavieen from IDR 4,000,000, all excluding 11% tax, with multi-session packages available. The number of sessions and any combination are decided at consultation. A consultation is IDR 300,000 plus tax (IDR 333,000), waived if you proceed. Expect some redness or sensitivity after treatment and diligent sun protection throughout the course.
Make an Appointment
The most important part of acne scar treatment happens before any device is switched on.
Establishing which scar types you have, their depth and distribution, and how your skin responds to treatment helps determine what should come next.
Our medical team at Anaya Aesthetics, a beauty clinic in Bali, assesses the scarring and considers factors such as pigmentation risk, skin type, and previous treatments before recommending a course. For treatment planned across several months, available treatment offers and VIP member pricing are also worth reviewing.
To have your scarring properly assessed, make an appointment with our medical team on WhatsApp.
A device applied to the wrong scar type is not a treatment. It is a delay.
Frequently Asked Questions
Can acne scars be removed completely?
Usually not. Atrophic scarring can improve meaningfully, but complete resolution is not a realistic promise.
How many sessions will I need?
It varies with scar type, depth, and response. Scar treatment is a course, and your doctor estimates it at consultation.
Which is better, Dermapen or laser?
Neither is universally better. Dermapen suits rolling and shallow scars; laser may add more for deeper or resistant scarring. Many plans combine approaches.
Should I treat active acne first?
Yes. Controlling active breakouts first prevents new scars from forming while existing ones are treated.
Is there a pigmentation risk in Bali?
Energy-based treatments carry some risk of post-inflammatory pigmentation, managed with tailored settings and careful sun protection.
