From the Guidelines
Acne scars can be effectively treated through various methods including microneedling, chemical peels, laser therapy, dermal fillers, and in some cases, surgical procedures, with the goal of minimizing morbidity, mortality, and improving quality of life. When considering treatment options, it's essential to prioritize the most recent and highest quality studies, such as those published in the Journal of the American Academy of Dermatology 1. The treatment approach should be tailored to the individual's specific scar type and severity, taking into account the potential benefits and harms of each treatment modality. Some key considerations include:
- For mild scarring, starting with microneedling (3-6 sessions, 4-6 weeks apart) or chemical peels using glycolic or TCA acid at appropriate concentrations based on scar severity 1
- For moderate to severe scarring, fractional laser treatments like Fraxel or CO2 lasers typically require 3-5 sessions spaced 4-8 weeks apart for optimal results
- Dermal fillers such as hyaluronic acid can provide immediate improvement for atrophic scars but require maintenance every 6-12 months
- For deep, pitted scars, subcision (breaking up scar tissue with a needle) combined with other treatments often yields the best results It's also important to consider the potential risks and side effects of each treatment, such as hypopigmentation and persistent erythema, and to discuss these with the patient to ensure informed decision-making 1. Ultimately, the best approach often combines multiple treatment modalities tailored to the individual's specific needs, with the goal of achieving optimal outcomes and minimizing adverse effects.
From the Research
Treatment Options for Acne Scars
The treatment options for acne scars are vast and varied, including:
- Energy-based treatments, such as laser and radiofrequency 2
- Chemical-based treatments, such as peels and TCA cross 2
- Surgical-based options, such as subcision and punch excision 2
- Microneedling 2, 3
- Fillers and/or fat injections 2
- Topical agents, such as retinoids, tacrolimus, and glycolic acid 4, 3
Combination Therapies
Combination therapies, such as the use of fractional radiofrequency with other treatment options, can be effective in improving acne scarring with minimal risk to patients 2. The combination of microneedling and glycolic acid peels has also been shown to be effective in treating acne scars in dark skin 3.
Laser Treatment
Laser treatment, including ablative and non-ablative lasers, can be effective in treating atrophic acne scars 5. However, the choice of laser modality depends on various patient factors, including skin type and acne scar subtype.
Topical Management
Topical agents, such as retinoids and glycolic acid, can be used as individual therapy or in combination with other modalities to treat acne scars 4. However, there is a lack of evidence to support the widespread use of these topical agents, and further studies are needed.