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Evidence-based management of cutaneous scarring in dermatology part 2: atrophic acne scarring

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Abstract

Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars. Various procedures and techniques for atrophic acne scarring are discussed in detail, with stronger evidence-based support for lasers (non-fractional, fractional, ablative, and non-ablative), platelet-rich plasma as adjunctive treatment, chemical peels (glycolic acid, trichloroacetic acid, and Jessner’s solution), dermal fillers such as hyaluronic acid, and microneedling, and lesser quality evidence for microdermabrasion, subcision, and lipoaspirate grafting. Further research is needed to optimize treatment protocols, assess the efficacy of monotherapies, and establish standardized guidelines for clinicians. This paper will provide a comprehensive review of the evidence-based management of atrophic acne scars, including currently commonly utilized therapies as well as more innovative treatment options.

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Abbreviations

FASET:

Facial acne severity evaluation tool

ASRS:

Acne scar rating scale

ECCA:

Echelle D’evaluation Clinique Des Cicatrices D’acne

SCAR-S:

Global scale for acne scar severity

PIH:

Post-inflammatory hyperpigmentation

BPO:

Benzoyl peroxide

PDL:

Pulsed dye laser

ErYAG:

Erbium:yttrium–aluminum–garnet

AFR:

Ablative fractional resurfacing

NFR:

Non-ablative fractional resurfacing

MTZ:

Microthermal zones

NFP:

Non-ablative fractional photothermolysis

FCO2 :

Fractional ablative CO2 laser

PRP:

Platelet-rich plasma

TCA:

Trichloroacetic acid

TCA CROSS:

Trichloroacetic acid chemical reconstruction of skin scars

MFRF:

Microneedling fractional radiofrequency

DA:

Dermabrasion

MDA:

Microdermabrasion

kPa:

Kilopascals

PLLA:

Poly-L lactic acid

HA:

Hyaluronic acid

PMMA:

Polymethylmethacrylate

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Authors and Affiliations

  1. Georgetown University School of Medicine, Washington, DC, USA

    Emily Y. Kim & Jasmine H. Wong

  2. Galaria Plastic Surgery and Dermatology, LLC, Chantilly, VA, USA

    Aamir Hussain

  3. Department of Dermatology, Veterans Affairs Medical Center, SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA

    Amor Khachemoune

  4. Department of Dermatology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA

    Amor Khachemoune

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  1. Emily Y. Kim
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  2. Jasmine H. Wong
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  3. Aamir Hussain
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  4. Amor Khachemoune
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Contributions

EYK and JHW performed the literature search and drafted the original work. AH and AK critically revised the work. AH and AK gave final approval of the version to be published.

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Correspondence to Amor Khachemoune.

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Emily Y. Kim, Jasmine H. Wong, Aamir Hussain, and Amor Khachemoune declare that they have no conflict of interest.

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Kim, E.Y., Wong, J.H., Hussain, A. et al. Evidence-based management of cutaneous scarring in dermatology part 2: atrophic acne scarring. Arch Dermatol Res 316, 19 (2024). https://doi.org/10.1007/s00403-023-02737-9

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  • DOI: https://doi.org/10.1007/s00403-023-02737-9

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