Acne ScarsI recently finished pouring through the last 2 years of acne scar research and have updated the scars page. It’s an evolving field. Here’s what I found:

Lasers are becoming more and more the go-to treatment for acne scarring. Fractional lasers, which treat only a fraction of the skin at once, are also becoming more popular for their ability to reduce side effects while still producing results.

Scientists are incorporating radiofrequency devices along with lasers and data is promising, while not earthshattering, that radiofrequency could help a bit.

Scar revision specialists have treated scars with fat injections for years with lots of success. However, recently, they are trying what they call autologous fibroblasts, which are cultured connective tissue cells from the person’s own body. This is also showing lots of promise.

Despite the advances, a person embarking on scar revision should not expect miracles, but should instead expect improvement. As always, data is showing that a combination of treatments (i.e. laser combined with subcision and augmentation) produces the best outcomes especially in more severe scarring. According to an article in the journal Dermatologic Surgery, “Severe grades of scarring often require a combination of filling agents for volume deficit, injectable agents for hypertrophic disease, neurotoxins to effect movement, and fractionated and ablative resurfacing for surface changes.”

Lastly, there appears to be vast confusion amongst dermatologists in the classification of acne scars. This highlights the need to carefully select a scar revision expert who is dedicated to and experienced in this specific area of surgery. If you decide to embark upon acne scar revision, do your homework and make sure you go with someone who specializes in acne scars.

Helpful links:
Acne.org Scar Forum: join in the discussion
Acne.org Scar Gallery: share your pictures

References:

  • Leheta TM, Abdel Hay RM, El Garem YF. “Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid 20% in atrophic post-acne scars; a randomized controlled trial.” The Journal of Dermatologic Treatment. 2014; 25(2): 130-6.
  • Nirmal B, et al. “Efficacy and safety of Erbium-doped Yttrium Aluminium Garnet fractional resurfacing laser for treatment of facial acne scars.” Indian Journal of Dermatology. 2013; 79(2): 193-8.
  • Al-Dhalimi MA, Arnoos AA. “Subcision for treatment of rolling acne scars in Iraqi patients: a clinical study.” Journal of Cosmetic Dermatology. 2012; 11(2): 144-50.
  • Manuskiatti W, et al. “Comparison of fractional erbium-doped yttrium aluminum garnet and carbon dioxide lasers in resurfacing of atrophic acne scars in Asians.” Dermatologic Surgery. 2013; 39(1 Pt 1): 111-20.
  • Sardana K, et al. “Histological validity and clinical evidence for use of fractional lasers for acne scars.” Journal of Cutaneous and Aesthetic Surgery. 2012; 5(2): 75-90.
  • Bencini PL, et al. “Nonablative fractional photothermolysis for acne scars: clinical and in vivo microscopic documentation of treatment efficacy.” Dermatologic Therapy. 2012; 25(5): 463-7.
  • Maluki AH, Mohammad FH. “Treatment of atrophic facial scars of acne vulgaris by Q-Switched Nd:YAG (Neodymium: Yttrium-Aluminum-Garnet) laser 1064 nm wavelength.” Journal of Cosmetic and Laser Therapy. 2012; 14(5): 224-33.
  • Hedelund L, et al. “Fractional CO2 laser resurfacing for atrophic acne scars: a randomized controlled trial with blinded response evaluation.” Lasers in Surgery and Medicine. 2012; 44(6): 447-52.
  • Qian H, et al. “Treatment of acne scarring with fractional CO2 laser.” Journal of Cosmetic and Laser Therapy. 2012; 14(4): 162-5.
  • Huang L. “A new modality for fractional CO2 laser resurfacing for acne scars in Asians.” Lasers in Medical Science. 2013; 28(2): 627-32.
  • Kimura U, et al. “Biophysical evaluation of fractional laser skin resurfacing with an Er: YSGG laser device in Japanese skin.” The Journal of Drugs in Dermatology. 2012; 11(5): 637-42.
  • Cho SI, et al. “Evaluation of the clnical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores.” Dermatologic Surgery. 2012; 38(7 Pt 1): 1017-24.
  • Ong MW, Bashir SJ. “Fractional laser resurfacing for acne scars: a review.” British Journal of Dermatology. 2012; 166(6): 1160-9.
  • Wada T, et al. “Efficacy and safety of a low-energy double-pass 1450-nm diode laser for the treatment of acne scars.” Photomedicine and Laser Surgery. 2012: 30(2): 107-11.
  • Azzam OA, et al. “Fractional CO(2) laser treatment vs autologous fat transfer in the treatment of acne scars: a comparative study.” The Journal of Drugs in Dermatology. 2013; 12(1): e7-e13.
  • Lorenc ZP. “Techniques for the optimization of facial and non-facial volumization with injectable poly-l-lactic acid.” Aesthetic Plastic Surgery. 2012; 36(5): 1222-9.
  • Halachmi S, Amitai DB, Lapidoth M. “Treatment of acne scars with hyaluronic Acid: an improved approach.” The Journal of Drugs in Dermatology. 2013; 12(7): 3121-3.
  • Goodman GJ. “Treating scars: addressing surface, volume, and movement to expedite optimal results. Part 2: more-severe grades of scarring.” Dermatologic Surgery. 2012; 38(8): 1310-21.
  • Tenna S, et al. “Combined use of fractional CO2 laser and radiofrequency waves to treat acne scars: a pilot study on 15 patients.” Journal of Cosmetic and Laser Therapy. 2012; 14(4): 166-71.
  • Zhang Z, et al. “Comparison of a fractional microplasma radio frequency technology and carbon dioxide fractional laser for the treatment of atrophic acne scars: a randomized split-face clinical study.” Dermatologic Surgery. 2013; 39(4): 559-66.
  • Leheta TM, et al. “Do combined alternating sessions of 1540 nm nonablative fractional laser and percutaneous collagen induction with trichloroacetic acid 20% show better results than each individual modality in the treatment of atrophic acne scars? A randomized controlled trial.” The Journal of Dermatologic Treatment. 2014; 25(2): 137-41.
  • Lee SJ, et al. “Ablative non-fractional lasers for atrophic facial acne scars: a new modality of erbium:YAG laser resurfacing in Asians.” Lasers in Medical Science. 2014; 29(2): 615-9.
  • Shah S, Alam M. “Laser resurfacing pearls.” Seminars in Plastic Surgery. 2012; 26(3): 131-6.
  • Preissig J, Hamilton K, Markus R. “Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface.” Seminars in Plastic Surgery. 2012; 26(3): 109-16.
  • Mohammed G. “Randomized clinical trial of CO2 laser pinpoint irradiation technique with/without needling for ice pick acne scars.” Journal of Cosmetic and Laser Therapy. 2013; 15(3): 177-82.
  • Finlay AT, et al. “Classification of acne scars is difficult even for acne experts.” Journal of the European Academy of Dermatology and Venereology. 2013; 27(3): 391-93.
  • Kwok T, Rao J. “Laser management of acne scarring.” Skin Therapy Letter. 2012; 17(2): 4-6.
  • Sobanko JF, Alster TS. “Management of acne scarring, part I: a comparative review of laser surgical approaches.” American Journal of Clinical Dermatology. 2012; 13(5): 319-30.
  • Levy LL, Zeichner JA. “Management of acne scarring, part II: a comparative review of non-laser-based, nominally invasive approaches.” American Journal of Clinical Dermatology. 2012; 13(5): 331-40.
  • Munavalli GS, et al. “Successful treatment of depressed, distensible acne scars using autologous fibroblasts: a multi-site, prospective, double blind, placebo-controlled clinical trial.” Dermatologic Surgery. 2013; 39(8): 1226-36.

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