The correct route, in one sentence
Active acne is a disease. Acne scarring is a surgical and energy problem. They are two different things, with two different routes, and doing them in the wrong order will cost you time and money.
If you have spots, pustules, cysts or active flares, your route is the dermatology consultation and medical acne treatment.
If the acne is already controlled and what remains are pits, marks and uneven texture, then yes: it is time for acne scar treatment, and that is where the surgeon comes in.
Why treating scars during active acne makes no sense
This is why a serious professional will tell you to wait, however impatient you are.
First: active acne keeps producing new scars. Treating the old ones while others form is chasing the problem. The money invested is consumed by the disease nobody switched off.
Second: inflamed skin responds worse to energy and carries more risk of pigmenting — post-inflammatory hyperpigmentation — very especially in phototypes IV to VI, which is most of Mexico.
And third, the point almost nobody says aloud: the best treatment for acne scars is not having acne scars. Treating acne early and properly is, by a distance, the most cost-effective intervention in this whole story.
Where laser does help in active acne
With caveats, and always as an adjunct — never replacing medical treatment:
- Intense pulsed light (IPL) can help with the residual redness left by healed spots — those flat red marks that take months to fade.
- Certain light protocols have an effect on the inflammatory component, but they do not replace medical therapy and are not the answer to moderate or severe acne.
- Superficial peels can accompany treatment in selected cases, always prescribed in consultation.
- What no laser does: cure acne. If someone offers to “clear your acne with laser” and does not mention medical treatment, they are selling sessions.
And once the scars are there, laser alone is not enough either
Here is the second half of the honesty, and it is what separates a machine clinic from a surgeon.
Acne scars are not all the same, and those that are tethered to the floor — rolling scars — or narrow and deep — ice-pick scars — do not respond well to a surface laser, however powerful. They need subcision (releasing the scar from beneath), punch excision or other surgical techniques before the energy.
A clinic with only a laser will laser them, because it is all it can do. The result: partial improvement, disappointment, and several sessions paid for. The correct sequence is surgery first, energy afterwards. See acne scars.
Summary: which one is you
Active acne (spots, cysts, flares) → dermatology consultation. Medical treatment. The sooner, the fewer scars.
Flat red or brown marks, no texture change → these usually fade on their own with photoprotection and time. No laser is needed for that, and whoever sells it to you knows it.
Pits, depressions, uneven texture, with the acne already controlled → acne scars. This is where the plastic surgeon comes in, and it is his ground.
Frequently asked questions
Can I have laser while I still have spots?
As a rule, it is not advisable: active acne keeps generating new scars, inflamed skin responds worse, and there is more risk of pigmenting, especially on darker skin. First the disease is switched off; then what it left behind is treated.
Do the red marks left behind need laser?
Almost never. The flat red or brown marks a spot leaves usually fade on their own with time and strict photoprotection. What does need treatment is a scar with elevation or a pit, which is a structural change.
How long must I wait after controlling the acne?
Until the disease is stable and inflammation has settled, and that interval is set by each patient’s course, not a fixed calendar. Treating scars over still-active acne is throwing money away.
Does laser cure acne?
No. Acne is a disease and it is treated medically. Certain light protocols can help as adjuncts, but they do not replace medical treatment and are not the answer in moderate or severe acne.
Why am I told I need surgery and not just laser for the scars?
Because tethered or very deep scars do not respond well to a surface laser: they must be released or excised first. A clinic that only owns a laser will laser them anyway, and the result will be partial.
Every case is different. Get your questions answered in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.