Skin texture treatments, what do you need to know first? Scar types and skin booster options

Skin texture unevenness treatment is a general term for procedures that smooth out uneven skin surfaces, such as acne scars, enlarged pores, and rough skin texture. It is not a single, fixed method, but rather a combination of lasers, RF microneedling, subcision, TCA CROSS, fillers, skin boosters, and more, tailored to the type and depth of the scars, as well as skin type. The core principle is simple: first, accurately understand why your skin texture unevenness occurred.

And to let you know in advance, skin texture treatment is not a one-time procedure. Most require 3 to 6 or more sessions, repeated at intervals of 4 to 8 weeks, and the goal is 'improvement' rather than a 'complete cure'. This is because it takes time for collagen to rebuild. In this article, we will break down the types of treatments, selection criteria, and recovery management one by one.

🔍 Skin Unevenness, Let's Categorize by Cause

There are more reasons than you might think why skin looks bumpy. The most common are atrophic scars left behind by acne, and others include enlarged pores, benign skin lesions like milia, syringoma, and flat warts, as well as a decline in skin texture due to aging, which can also feel like unevenness.

If the cause is different, the approach must also be different. This is why it is said that accurate diagnosis is the first condition for treatment. In particular, acne scars are divided into the following three types, and the primary treatment option chosen varies completely depending on the type.

Conversely, keloid or hypertrophic scars are not depressions, but rather raised, elevated forms, so the treatment direction is the exact opposite of unevenness treatment. In these cases, rather than stimulating with a laser, a separate approach such as steroid injections or pressure therapy is required.

📌 Key Summary: For unevenness treatment, diagnosing the scar type (ice pick, boxcar, rolling) comes first, and raised scars must be addressed in an entirely different direction.

⚙️ What Treatments Are Used?

There are several methods used to improve skin unevenness. Let's look at the characteristics of each.

Fractional Lasers are the most widely used devices in unevenness treatment. They are divided into ablative, which vaporizes tissue minutely to induce regeneration, and non-ablative, which delivers heat only.

• Fractional CO₂ Laser (10,600nm): Ablative. An improvement of about 30–70% is reported after multiple sessions, with a long downtime of 5 to 10+ days.

• Erbium:YAG Laser (2,940nm): Causes less thermal damage than CO₂ and is advantageous for surface refinement.

• Non-Ablative Fractional (1,550nm range): Has a short recovery time of 2–5 days, but has limitations on deep scars, offering about 20–50% improvement.

RF Microneedling (Radiofrequency Microneedling) stimulates the dermis with needles while simultaneously delivering radiofrequency energy. The needle depth can be adjusted from 0.5 to 3.5mm, and it is preferred for Asian skin due to its low risk of hyperpigmentation. An improvement of about 30–60% is reported.

Subcision is a procedure that physically breaks the fibrous tethering unique to rolling scars. It is necessary for structural scars that cannot be resolved with lasers, and while it can achieve over 30–60% improvement, bruising remains for 3 to 14 days after the procedure.

TCA CROSS is a chemical reconstruction method where a high concentration (50–100%) of trichloroacetic acid is precisely placed only into ice pick scars. It is specialized for narrow, deep scars, with improvement cases of over 50% reported.

In addition, there are surgical and cosmetic approaches such as hyaluronic acid fillers (lasting 6 to 18 months) to immediately fill rolling depressions, chemical peels for shallow skin texture, and punch excision/elevation applied to deep scars.

📌 Key Summary: For improving unevenness, lasers, RF microneedling, subcision, TCA CROSS, and fillers each have different areas of strength, and they are selected to match the specific scars.

🤝 Why is 'Combination Therapy' the Standard?

Let's clear up one misconception here. There is no single, perfect treatment. In reality, ice pick, boxcar, and rolling scars are often mixed together on a face, making it difficult to resolve everything with just one device.

Therefore, the standard for unevenness treatment is combination therapy. For example, for rolling scars, you break the tethering with subcision, fill the remaining depression with a filler, and refine the overall skin texture with a fractional laser. It is a combination where each treatment covers the other's weaknesses.

Designing this combination determines the results. Therefore, when choosing a clinic, instead of looking for one that emphasizes a single device, it is better to see if they create a customized plan by combining multiple treatments after a thorough diagnosis.

📌 Key Summary: Since scars are usually a mix of several types, combination therapy that blends various treatments is practically the default.

⏳ When and How Much of an Effect Will I See?

The common mechanism of unevenness treatments is collagen remodeling. The principle is that the stimulated skin slowly produces new collagen to fill in the depressions. Therefore, it is not unusual if there seems to be no major change immediately after the procedure.

The general timeline is as follows:

• Initial recovery after treatment: several days to 2 weeks

• Collagen production: about 4 to 12 weeks

• Final remodeling: 3 to 6+ months

Most require repetition of 3 to 6+ sessions at 4 to 8-week intervals, and the effects are evaluated in units of at least 2 to 3 months. This means you should not make hasty judgments.

For reference, the saying 'the more scabbing there is, the better the effect' is not true. Forcibly removing scabs only increases the risk of hyperpigmentation and secondary scarring. The correct way is to let them fall off naturally.

📌 Key Summary: Because it takes weeks to months for collagen to rebuild, the effects are slowly evaluated over 3 to 6 months.

🧴 Post-Treatment Care, Hyperpigmentation is the Key

Asian skin tends to have a higher Fitzpatrick skin type, so there is a high risk of post-inflammatory hyperpigmentation (PIH). The most common side effect experienced after unevenness treatment is indeed this hyperpigmentation.

The key to prevention is sun protection. After the treatment, you must reapply products with SPF 30–50 or higher and a high PA index every 2 to 3 hours. It does not mean you cannot undergo treatment in the summer, but rather that you should keep in mind to be more diligent with sun protection.

A few pre-check items are also important:

• If you have active acne, stabilize it first before proceeding with scar treatments.

• If you are taking or have recently taken isotretinoin (oral acne medication), you must inform the clinic. In the past, a 6 to 12-month waiting period was recommended, but recently the trend is to make flexible decisions depending on the type of procedure.

• Please also inform them in advance about any medications that affect bleeding, such as aspirin.

📌 Key Summary: Because Asian skin has a high risk of hyperpigmentation, daily sun protection after treatment is essential, and you must inform the clinic about your medications in advance.

💧 Can Depressed Scars Be Solved with Skin Boosters Alone?

This is a frequently asked question during consultations for skin unevenness. To start with the conclusion, skin boosters alone cannot fully fill deeply depressed atrophic scars. This is because skin boosters excel at improving skin texture and elasticity by replenishing moisture and nutrients within the skin, rather than being tools to fill in structurally collapsed scars.

However, that does not mean they have no role. On the contrary, they shine in the final stage of combination therapy. After refining the skin surface with a laser or RF microneedling, using skin boosters to boost the skin barrier and hydration makes the overall skin texture much smoother and helps the recovery process proceed stably.

Gangnam Onlif Clinic views this point as crucial. Rather than changing the shape of the eyes, nose, and mouth, our direction is to clear away skin concerns that hide your natural beauty. Improving unevenness also avoids pushing the skin too hard; instead, we aim for an approach that restores a natural state by refining skin texture, hydration, and elasticity together. Skin boosters play the role of organizing the texture within that flow.

Onlif chooses a method where treatments are divided and managed by specialists in each field. This operation stems from the idea that one person cannot excel at everything, so skin texture and hydration treatments like skin boosters are also handled within that perspective.

📌 Key Summary: Skin boosters are not treatments for filling deep scars, but they excel in the final step of combination therapy to refine skin texture, hydration, and elasticity.

❓ Frequently Asked Questions (FAQ)

How do I tell if my acne scar is ice pick or rolling?

You can get a general sense. If it is narrow and deeply pitted under 2mm in width, it is close to an ice pick; if it is an angled depression with sharp borders, it is a boxcar; and if it is a wide and gently sloped contour, it is close to a rolling scar. However, because they are mostly mixed, receiving a direct diagnosis is the best way to get an accurate classification and treatment plan.

How many times do I need to receive skin unevenness treatment to see results?

Most require 3 to 6 or more sessions, repeated at intervals of 4 to 8 weeks. Due to the nature of collagen remodeling, results appear slowly over weeks to months rather than immediately after the procedure, so it is best to evaluate in units of at least 2 to 3 months.

Can I receive treatment if I still have active acne?

Performing stimulating procedures when active inflammatory acne is present can actually worsen it. The proper order is to stabilize the acne first before moving on to scar treatments.

Scabs have formed; can I peel them off?

No, you should not. Artificially removing scabs increases the risk of hyperpigmentation and secondary scarring. Let them fall off naturally, and focus on moisturizing and sun protection in the meantime.

Can depressed scars be improved with skin boosters alone?

Deeply depressed atrophic scars cannot be fully filled with skin boosters alone. Skin boosters are treatments that refine skin texture, hydration, and elasticity, and they work best when combined with scar treatments such as lasers or subcision.

Can I receive laser treatments while taking isotretinoin?

You must inform the clinic that you are taking it. In the past, a 6 to 12-month waiting period was recommended, but recently the trend is to make flexible decisions depending on the type of procedure. Since it varies by individual situation, it is safe to inform them accurately during your consultation.

Is there a specific treatment suitable for Asian skin?

Because Asian skin has a high risk of post-inflammatory hyperpigmentation, options like RF microneedling, which have a relatively lower pigment burden, are often preferred. The intensity of the treatment, device selection, and post-care sun protection are particularly important.

Skin Unevenness Treatment, Good Things to Check Before Choosing a Clinic

Even for the same treatment, the results and recovery process vary depending on where, by whom, and how it is performed. Asking these questions during your consultation will help you make a decision.

• Is this a clinic that performs that treatment frequently? — Different clinics specialize in different procedures. Check if it is a place that regularly conducts skin unevenness treatments.

• Can I verify the products and devices used? — Ask if you can verify the product names and authenticity (whether they are imported authorized products and if there is an unboxing verification process) during the consultation.

• Do they explain the cost breakdown? — Rather than just hearing the total amount, you can make a better judgment by listening to the explanation of which product is used, how much, and on which area.

• Do they design the treatment looking at the entire face? — Even for the same procedure, the injection points and amounts vary depending on the face shape, skin condition, and left-right asymmetry.

• Do they explain the side effects and recovery process first? — Rather than a consultation that only talks about expected positive changes, a place that also informs you of potential side effects and coping methods is better for making a decision.

• Is there a follow-up pathway after the procedure? — Check if the timing for checking progress, how to contact them if there is an issue, and the criteria for re-visiting are established.

This is How Onlif Clinic Performs Skin Unevenness Treatments

• We divide responsibilities — Based on the belief that a single doctor should not handle every single procedure, Onlif divides medical treatments among doctors responsible for each specific field.

• We verify products and devices together during the consultation — We guide you through the products used and the unboxing verification process during the consultation.

• Costs are guided along with the plan after diagnosis — Since the area, dosage, and range vary from person to person, we explain what is required and how much it costs together.

• We design looking at the overall balance of the face — We view the face through three axes: texture, balance, and signals of youth. Rather than changing shapes, we plan to refine areas that obscure your natural impression.

• We inform you about side effects and the recovery process first — Along with the changes you can expect, we guide you through individual differences, potential side effects, and coping methods before the procedure.

• We look at the progress after the procedure together — If verification is needed during the recovery period, we guide you on re-visiting and contact pathways.

If you are considering skin unevenness treatment, it is best to first check what is possible and what is difficult in your current state. An accurate diagnosis and treatment plan can only be determined through an in-person consultation. Come and check through a consultation at Gangnam Onlif Clinic.