Bellafill or laser for acne scars?
Medically reviewed by
The Skin Med Spa medical team, led by Barbara Kowalczyk, FNP-BC and Michael Fressola, ACNP-BC
Last reviewed: September 2026
It depends on your scar type. Bellafill is FDA-approved for moderate to severe rolling acne scars on the cheeks, the soft, wavy dips that flatten when you stretch the skin. It lifts them from underneath with results you can see right away. Lasers resurface the skin to treat sharper-edged scars and overall texture over several sessions. Many people have a mix of scar types and do best with both.
First, identify your scars
| Scar type | What it looks like | Stretch test | Usually responds to |
|---|---|---|---|
| Rolling | Soft, wavy dips with sloped edges | Flattens when stretched | Bellafill, sometimes subcision |
| Boxcar | Round or oval dips with sharp edges | Stays visible | Laser resurfacing, sometimes combined with other techniques |
| Icepick | Narrow, deep pits | Stays visible | Targeted techniques, then laser |
| Texture and pores | Uneven surface without distinct pits | Varies | Laser resurfacing, microneedling |
The stretch test is simple: gently pull the skin taut with two fingers. If the dip softens or disappears, it's likely a rolling scar that can be lifted with filler.
How Bellafill works
Bellafill is collagen gel with tiny PMMA microspheres. The collagen lifts the scar right away. The microspheres stay in place as a long-term scaffold for your own tissue. It's FDA-approved for moderate to severe atrophic, distensible acne scars on the cheek in adults over 21. Because it contains bovine collagen, a skin test is required before treatment to rule out allergy.
How lasers work for scars
Resurfacing lasers like CoolPeel CO2 and ResurFX create controlled micro-injuries that trigger new collagen and smooth the surface. They're better for sharp edges and texture than for lifting soft, wavy scars. Results build over a series of sessions.
Why combining often works
Filler lifts what's sunken. Lasers refine what's on the surface. For mixed scarring, a common plan is to lift rolling scars with Bellafill, then smooth the remaining texture with laser sessions. Your provider sets the order and timing.
Honest limits
- Bellafill isn't reversible. That's why the right scar selection matters.
- Neither approach erases scars completely. Realistic goals are softer shadows and smoother texture.
- Active acne should be under control first. New breakouts create new scars.
How Skin Med Spa approaches it
Skin Med Spa offers both Bellafill and several resurfacing lasers in Downers Grove, so your plan can match each scar type instead of forcing one tool on everything. The consultation includes a close look at your scars in angled light, which is how scar types show clearly.
FAQ
Is Bellafill permanent?
It's designed as a long-term filler because the microspheres stay in place. Our Bellafill permanence guide covers the details.
Does Bellafill hurt?
It contains lidocaine. Most people describe pressure and mild stinging.
How many laser sessions for acne scars?
It varies by scar depth and device. See our guide to acne scar laser sessions.
Sources
- U.S. FDA. Bellafill premarket approval, indication for moderate to severe atrophic distensible facial acne scars. 2014.
- Suneva Medical. Bellafill instructions for use, including skin test requirement.
At Skin Med Spa, Bellafill is provided by our board-certified medical team at 960 Warren Ave. in Downers Grove, Illinois. Same-day appointments are available at 630-541-8413, and a consultation is the best way to find out what fits your skin and goals.
This is general information, not medical advice. Whether a treatment is right for you is determined by a licensed provider after an evaluation.