American Journal of Clinical Dermatology

, Volume 19, Issue 4, pp 459–477 | Cite as

Acne Scarring Management: Systematic Review and Evaluation of the Evidence

  • Shashank Bhargava
  • Paulo R. Cunha
  • Jennifer Lee
  • George KroumpouzosEmail author
Systematic Review



Modalities for atrophic acne scarring can be classified depending upon the needs they satisfy; that is, resurfacing, lifting/volumization, tightening, or surgical removal/movement of tissue that is required for correction. A plethora of treatment options have resulted from the need to treat various acne scar types, variability of responses noted in various skin types, and increasing popularity of minimally invasive modalities. Still, there is a lack of consensus guidelines on treatment or combination therapies for various clinical scenarios.


This systematic review includes a critical evaluation of the evidence relevant to these modalities and various multimodality therapies.


We performed a systematic literature search in Medline and EMBASE databases for studies on acne scar management. Also, we checked the reference lists of included studies and review articles for further studies. A total of 89 studies were included in our quality of evidence evaluation.


The efficacy of lasers and radiofrequency in atrophic acne scarring is confirmed by many comparative and observational studies. Other modalities can be used as an adjunct, the choice of which depends on the type, severity, and number of atrophic scars. Minimally invasive procedures, such as fractional radiofrequency and needling, provide good outcomes with negligible risks in patients with dark or sensitive skin types.


There is a lack of high-quality data. Fractional lasers and radiofrequency offer significant improvement in most types of atrophic acne scars with minimal risks and can be combined with all other treatment options. Combination therapies typically provide superior outcomes than solo treatments.


Compliance with Ethical Standards


None declared.

Conflict of interest

SB, PRC, JL and GK declare that they have no conflict of interest.


  1. 1.
    Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol. 1994;19:303–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Rivera AE, Spencer JM. Clinical aspects of full-thickness wound healing. Clin Dermatol. 2007;25:39–48.PubMedCrossRefGoogle Scholar
  3. 3.
    Koo J. The psychosocial impact of acne: patients’ perceptions. J Am Acad Dermatol. 1995;32:S26–30.PubMedCrossRefGoogle Scholar
  4. 4.
    Halvorsen JA, Stern RS, Dalgard F, Thoresen M, Bjertness E, Lien L. Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J Invest Dermatol. 2011;131:363–70.PubMedCrossRefGoogle Scholar
  5. 5.
    Werschler WP, Few JW, Jacob CI, Joseph JH, Spencer JM, Taub AF. Advancing the care of post-acne scarring: expert insights into new treatment options. J Drugs Dermatol. 2016;15:518–25.PubMedGoogle Scholar
  6. 6.
    Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001;45:109–17.PubMedCrossRefGoogle Scholar
  7. 7.
    Goodman GJ, Baron JA. Postacne scarring-a qualitative global scarring grading system. J Cosmet Dermatol. 2006;5:48–52.PubMedCrossRefGoogle Scholar
  8. 8.
    Shekelle PG, Woolf SH, Eccles M, Grimshaw J. Developing clinical guidelines. West J Med. 1999;170:348–51.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Abdel Hay R, Shalaby K, Zaher H, Hafez V, Chi CC, Dimitri S, et al. Interventions for acne scars. Cochrane Database Syst Rev. 2016;4:CD011946.PubMedGoogle Scholar
  10. 10.
    Goodman GJ. Treating scars: addressing surface, volume, and movement to expedite optimal results. Part 2: more-severe grades of scarring. Dermatol Surg. 2012;38:1310–21.PubMedCrossRefGoogle Scholar
  11. 11.
    Patel L, McGrouther D, Chakrabarty K. Evaluating evidence for atrophic scarring treatment modalities. JRSM Open. 2014;5(9):2054270414540139.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Linkner RV, Jim On S, Haddican M, Singer G, Shim-Chang H. Evaluating the efficacy of photodynamic therapy with 20% aminolevulinic acid and microdermabrasion as a combination treatment regimen for acne scarring: a split-face, randomized, double-blind pilot study. J Clin Aesthet Dermatol. 2014;7:32–5.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Bhalla M, Thami GP. Microdermabrasion: reappraisal and brief review of literature. Dermatol Surg. 2006;32:809–14.PubMedGoogle Scholar
  14. 14.
    Cai GB, Li HD, Zhang Y, Liu L, Chen GY, Li TY, et al. Full face dermabrasion for acne scars [Chinese]. Zhonghua Zheng Xing Wai Ke Za Zhi. 2005;21:192–3.PubMedGoogle Scholar
  15. 15.
    Hirsch RJ, Lewis AB. Treatment of acne scarring. Semin Cutan Med Surg. 2001;20:190–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Connolly D, Vu HL, Mariwalla K, Saedi N. Acne scarring–pathogenesis, evaluation, and treatment options. J Clin Aesthet Dermatol. 2017;10:12–3.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Thiboutot D, Gollnick H, Bettoli V, Dreno B, Kang S, Leyden JJ, et al. New insights into the management of acne: an update from the global alliance to improve outcomes in acne group. J Am Acad Dermatol. 2009;60:S1–50.PubMedCrossRefGoogle Scholar
  18. 18.
    Arora S. A study of efficacy of microdermabrasion in treatment of facial acne scars-Original Research. Int J Dent Med Spec. 2014;1:11–9.CrossRefGoogle Scholar
  19. 19.
    Garg VK, Sinha S, Sarkar R. Glycolic acid peels versus salicylic-mandelic acid peels in active acne vulgaris and post-acne scarring and hyperpigmentation: a comparative study. Dermatol Surg. 2009;35:59–65.PubMedGoogle Scholar
  20. 20.
    Erbağci Z, Akçali C. Biweekly serial glycolic acid peels vs. long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars. Int J Dermatol. 2000;39:789–94.PubMedCrossRefGoogle Scholar
  21. 21.
    Sharquie KE, Noaimi AA, Al-Janabi EA. Treatment of active acne vulgaris by chemical peeling using TCA 35%. JCDSA. 2013;3:32–5. Scholar
  22. 22.
    Leheta TM, Abdel Hay RM, Hegazy RA, El Garem YF. 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. J Dermatol Treat. 2014;25:137–41.CrossRefGoogle Scholar
  23. 23.
    Park JH, Choi YD, Kim SW, Kim YC, Park SW. Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients. J Dermatol. 2007;34:17–24.PubMedCrossRefGoogle Scholar
  24. 24.
    Leheta TM, Abdel Hay RM, Garem YF. Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid 20% in atrophic post-acne scars; a randomized controlled trial. J Dermatolog Treat. 2014;25:130–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Al-Waiz MM, Al-Sharqi AI. Medium-depth chemical peels in the treatment acne scars in dark-skinned individuals. Dermatol Surg. 2002;28:383–7.PubMedGoogle Scholar
  26. 26.
    Lee JB, Chung WG, Kwahck H, Lee KH. Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method. Dermatol Surg. 2002;28:1017–21.PubMedGoogle Scholar
  27. 27.
    Yug A, Lane JE, Howard MS, Kent DE. Histologic study of depressed acne scars treated with serial high-concentration (95%) trichloroacetic acid. Dermatol Surg. 2006;32:985–90.PubMedGoogle Scholar
  28. 28.
    Agrawal N, Gupta LK, Khare AK, Kuldeep CM, Mittal A. Therapeutic response of 70% trichloroacetic acid CROSS in atrophic acne scars. Dermatol Surg. 2015;41:597–604.CrossRefGoogle Scholar
  29. 29.
    Khunger N, Bhardwaj D, Khunger M. Evaluation of CROSS technique with 100% TCA in the management of ice pick acne scars in darker skin types. J Cosmet Dermatol. 2011;10:51–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Ahmed R, Mohammed G, Ismail N, Elakhras A. Randomized clinical trial of CO2 LASER pinpoint irradiation technique versus chemical reconstruction of skin scars (CROSS) in treating ice pick acne scars. J Cosmet Laser Ther. 2014;16:8–13.PubMedCrossRefGoogle Scholar
  31. 31.
    Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D. Acne scarring treatment using skin needling. Clin Exp Dermatol. 2009;34:874–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Majid I. Microneedling therapy in atrophic facial scars: an objective assessment. J Cutan Asthet Surg. 2009;2:26–30.CrossRefGoogle Scholar
  33. 33.
    Pandey A, Swain JP, Minj A. Assessment of microneedling therapy in the management of atrophic facial acne scars. J Evid Based Med Healthc. 2015;57:8911–3.CrossRefGoogle Scholar
  34. 34.
    Srivastava R, Shah YM, Garg AM, Paliwal G, Kumar A. A study of skin resurfacing for atrophic acne scars by skin needling with dermaroller. Internat Med J. 2016;3:1010–4.Google Scholar
  35. 35.
    Dogra S, Yadav S, Sarangal R. Microneedling for acne scars in Asian skin type: an effective low cost treatment modality. J Cosmet Dermatol. 2014;13:180–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Alam M, Han S, Pongprutthipan M, Disphanurat W, Kakar R, Nodzenski M, et al. Efficacy of a needling device for the treatment of acne scars: a randomized clinical trial. JAMA Dermatol. 2014;150:844–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Leheta T, El Tawdy A, Abdel Hay R, Farid S. Percutaneous collagen induction versus full-concentration trichloroacetic acid in the treatment of atrophic acne scars. Dermatol Surg. 2011;37:207–16.PubMedCrossRefGoogle Scholar
  38. 38.
    Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling versus microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016;15:434–43.PubMedCrossRefGoogle Scholar
  39. 39.
    Fabbrocini G, De Vita V, Pastore F, Panariello F, Fardella N, Sepulveres R, et al. Combined use of skin needling and platelet-rich plasma in acne scarring treatment. Cosm Dermat. 2011;24:177–83.Google Scholar
  40. 40.
    Cachafeiro T, Escobar G, Maldonado G, Cestari T, Corleta O. Comparison of nonablative fractional Erbium laser 1,340 nm and microneedling for the treatment of atrophic acne scars: a randomized clinical trial. Dermatol Surg. 2016;42:232–41.PubMedCrossRefGoogle Scholar
  41. 41.
    Walia S, Alster TS. Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars. Dermatol Surg. 1999;25:926–30.PubMedCrossRefGoogle Scholar
  42. 42.
    Koo SH, Yoon ES, Ahn DS, Park SH. Laser punch out for acne scars. Aesthetic Plast Surg. 2001;25:46–51.PubMedCrossRefGoogle Scholar
  43. 43.
    Kye YC. Resurfacing of pitted facial scars with a pulsed Er:YAG laser. Dermatol Surg. 1997;23:685–7.Google Scholar
  44. 44.
    Hu S, Gold MH. Treatment of facial acne scars in Asian skin with the single-spot, 2940-nm Er:YAG dual-mode laser. J Drugs Dermatol. 2010;9:1341–4.PubMedGoogle Scholar
  45. 45.
    Wanitphakdeedecha R, Manuskiatti W, Siriphukpong S, Chen TM. Treatment of punched out atrophic and rolling acne scars in skin phototypes iii, iv, and v with variable square pulse Erbium:yttrium-aluminum-garnet laser resurfacing. Dermatol Surg. 2009;35:1376–83.PubMedCrossRefGoogle Scholar
  46. 46.
    Woo SH, Park JH, Kye YC. Resurfacing of different types of facial acne scar with short-pulsed, variable-pulsed, and dual-mode Er: Yag laser. Dermatol Surg. 2004;30:488–93.PubMedGoogle Scholar
  47. 47.
    Tanzi EL, Alster TS. Treatment of atrophic facial acne scars with dual-mode Er:YAG laser. Dermatol Surg. 2002;28:551–5.PubMedGoogle Scholar
  48. 48.
    Tanzi EL, Alster TS. Single-pass carbon dioxide versus multiple-pass Er:YAG laser skin resurfacing: a comparison of postoperative wound healing and side-effect rates. Dermatol Surg. 2003;29:80–4.PubMedGoogle Scholar
  49. 49.
    Jeong JT, Kye YC. Resurfacing of pitted facial acne scars with a long-pulsed Er:YAG laser. Dermatol Surg. 2001;27:107–10.PubMedGoogle Scholar
  50. 50.
    Orentreich DS, Orentreich N. Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatol Surg. 1995;21:543–9.PubMedGoogle Scholar
  51. 51.
    Nilforoushzadeh M, Lotv E, Nickkholgh E. Can subcision with the cannula be an acceptable alternative method in treatment of acne scars? Med Arch. 2015;69:384–6.PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    Alam M, Omura N, Kaminer MS. Subcision for acne scarring: technique and outcomes in 40 patients. Dermatol Surg. 2005;31:310–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Aalami HS, Balighi K, Lajevardi V, Akbari E. Subcision-suction method: a new successful combination therapy in treatment of atrophic acne scars and other depressed scars. J Eur Acad Dermatol Venereol. 2011;25:92–9.CrossRefGoogle Scholar
  54. 54.
    Kandil AH, Selim AG, Elghonemy S, Eldosoky F, Elsayed A. Evaluation of subcision-suction method in the treatment of depressed scars. Egypt J Plast Reconstr Surg. 2016;40:39–48.Google Scholar
  55. 55.
    Lee JW, Kim BJ, Kim MN. Treatment of acne scars using subdermal minimal surgery technology. Dermatol Surg. 2010;36:1281–7.PubMedCrossRefGoogle Scholar
  56. 56.
    Wang F, Garza LA, Kang S, Varani J, Orringer JS, Fisher GJ, et al. In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol. 2007;143:155–63.PubMedPubMedCentralGoogle Scholar
  57. 57.
    Goodman GJ. Management of post-acne scarring: what are the options for treatment? Am J Clin Dermatol. 2000;1:3–17.PubMedCrossRefGoogle Scholar
  58. 58.
    Goldberg DJ, Amin S, Hussain M. Acne scar correction using calcium hydroxylapatite in a carrier-based gel. J Cosmet Laser Ther. 2006;8:134–6.PubMedCrossRefGoogle Scholar
  59. 59.
    Jacovella PF. Use of calcium hydroxylapatite (Radiesse) for facial augmentation. Clin Interv Aging. 2008;3:161–74.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Sapra S, Stewart JA, Mraud K, Schupp R. A Canadian study of the use of poly-L-lactic acid dermal implant for the treatment of hill and valley acne scarring. Dermatol Surg. 2015;41:587–94.PubMedCrossRefGoogle Scholar
  61. 61.
    Sadove R. Injectable poly-L-lactic acid: A novel sculpting agent for the treatment of dermal fat atrophy after severe acne. Aesthetic Plast Surg. 2009;33:113–6.PubMedCrossRefGoogle Scholar
  62. 62.
    Karnik J, Baumann L, Bruce S. A double-blind, randomized, multicenter, controlled trial of suspended polymethylmethacrylate microspheres for the correction of atrophic facial acne scars. J Am Acad Dermatol. 2014;71:77–83.PubMedCrossRefGoogle Scholar
  63. 63.
    Epstein RE, Spencer JM. Correction of atrophic scars with artefill: an open-label pilot study. J Drugs Dermatol. 2010;9:1062–4.PubMedGoogle Scholar
  64. 64.
    Sage RJ, Lopiccolo MC, Liu A, Mahmoud BH, Tierney EP, Kouba DJ. Subcuticular incision versus naturally sourced porcine collagen filler for acne scars: a randomized splitface comparison. Dermatol Surg. 2011;37:426–31.PubMedCrossRefGoogle Scholar
  65. 65.
    Shilpa K, Sacchidanand S, Leelavathy B, Shilpashree P, Gorur D, Ranjitha R, et al. Outcome of dermal grafting in the management of atrophic facial scars. J Cutan Aesthet Surg. 2016;9:244–8.PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Azzam OA, Atta AT, Sobhi RM, Mostafa PI. Fractional CO2 laser treatment vs autologous fat transfer in the treatment of acne scars: a comparative study. J Drugs Dermatol. 2013;12:e7–13.PubMedGoogle Scholar
  67. 67.
    Gu Z, Li Y, Li H. Use of condensed nanofat combined with fat grafts to treat atrophic scars. JAMA Facial Plast Surg. 2018;20:128–35.PubMedCrossRefGoogle Scholar
  68. 68.
    Chawla S. Split face comparative study of microneedling with PRP versus microneedling with vitamin C in treating atrophic post acne scars. J Cutan Aesthet Surg. 2014;7:209–12.PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Tenna S, Cogliandro A, Barone M, Panasiti V, Tirindelli M, Nobile C, et al. Comparative study using autologous fat grafts plus platelet-rich plasma with or without fractional CO2 laser resurfacing in treatment of acne scars: analysis of outcomes and satisfaction with FACE-Q. Aesthetic Plast Surg. 2017;41:661–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Zhu JT, Xuan M, Zhang YN, Liu HW, Cai JH, Wu YH, et al. The efficacy of autologous platelet-rich plasma combined with erbium fractional laser therapy for facial acne scars or acne. Mol Med Rep. 2013;8:233–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Lee JW, Kim BJ, Kim MN, Mun SK. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial. Dermatol Surg. 2011;37:931–8.PubMedCrossRefGoogle Scholar
  72. 72.
    Gawdat HI, Hegazy RA, Fawzy MM, Fathy M. Autologous platelet rich plasma: topical versus intradermal after fractional ablative carbon dioxide laser treatment of atrophic acne scars. Dermatol Surg. 2014;40:152–6.PubMedCrossRefGoogle Scholar
  73. 73.
    Faghihi G, Keyvan S, Asilian A, Nouraei S, Behfar S, Nilforoushzadeh MA. Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: a split-face randomized clinical trial. Ind J Dermatol Venereol Leprol. 2016;82:162–8.CrossRefGoogle Scholar
  74. 74.
    Ibrahim MK, Ibrahim SM, Salem AM. Skin microneedling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post acne scars: a split face comparative study. J Dermatol Treat. 2017. Scholar
  75. 75.
    Manuskiatti W, Iamphonrat T, Wanitphakdeedecha R, Eimpunth S. Comparison of fractional erbium-doped yttrium aluminum garnet and carbon dioxide lasers in resurfacing of atrophic acne scars in Asians. Dermatol Surg. 2013;39:111–20.PubMedCrossRefGoogle Scholar
  76. 76.
    Walgrave SE, Ortiz AE, MacFalls HT, Elkeeb L, Truitt AK, Tournas JA, et al. Evaluation of a novel fractional resurfacing device for treatment of acne scarring. Lasers Surg Med. 2009;41:122–7.PubMedCrossRefGoogle Scholar
  77. 77.
    Cho SB, Lee SJ, Kang JM. The efficacy and safety of 10,600-nm carbon dioxide fractional laser for acne scars in Asian patients. Dermatol Surg. 2009;35:1955–61.PubMedCrossRefGoogle Scholar
  78. 78.
    Alajlan AM, Alsuwaidan SN. Acne scars in ethnic skin treated with both non-ablative fractional 1,550 nm and ablative fractional CO2 lasers: comparative retrospective analysis with recommended guidelines. Lasers Surg Med. 2011;43:787–91.PubMedCrossRefGoogle Scholar
  79. 79.
    Naouri M, Atlan M, Perrodeau E, Georgesco G, Khallouf R, Martin L, et al. High-resolution ultrasound imaging to demonstrate and predict efficacy of carbon dioxide fractional resurfacing laser treatment. Dermatol Surg. 2011;37:596–603.PubMedCrossRefGoogle Scholar
  80. 80.
    Qian H, Lu Z, Ding H, Yan S, Xiang L, Gold MH. Treatment of acne scarring with fractional CO2 laser. J Cosmet Laser Ther. 2012;14:162–5.PubMedCrossRefGoogle Scholar
  81. 81.
    Zhang Z, Fei Y, Chen X, Lu W, Chen J. 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. Dermatol Surg. 2013;39:559–66.PubMedCrossRefGoogle Scholar
  82. 82.
    Huang L. A new modality for fractional CO2 laser resurfacing for acne scars in Asians. Lasers Med Sci. 2013;28:627–32.PubMedCrossRefGoogle Scholar
  83. 83.
    Asilian A, Salimi E, Faghihi G. Comparison of Q-switched 1064-nm Nd: YAG laser and fractional CO2 laser efficacies on improvement of atrophic facial acne scar. J Res Med Sci. 2011;16:1189–95.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Elcin G, Yalici-Armagan B. Fractional carbon dioxide laser for the treatment of facial atrophic acne scars: prospective clinical trial with short and long-term evaluation. Lasers Med Sci. 2017;32:2047–54.PubMedCrossRefGoogle Scholar
  85. 85.
    Ortiz AE, Tremaine AM, Zachary CB. Long-term efficacy of fractional resurfacing device. Lasers Surg Med. 2010;42:168–70.PubMedCrossRefGoogle Scholar
  86. 86.
    Chapas AM, Brightman L, Sukal S. Successful treatment of acneiform scarring with CO2 ablative fractional resurfacing. Lasers Surg Med. 2008;40:381–6.PubMedCrossRefGoogle Scholar
  87. 87.
    Park GH, Rhee DY, Bak H, Chang SE, Lee MW, Choi JH, et al. Treatment of atrophic scars and fractional photothermolysis: short-term follow-up. J Dermatolog Treat. 2011;22:43–8.PubMedCrossRefGoogle Scholar
  88. 88.
    Magnani LR, Schweiger ES. Fractional CO2 lasers for the treatment of atrophic acne scars: a review of the literature. J Cosmet Laser Ther. 2014;16:48–56.PubMedCrossRefGoogle Scholar
  89. 89.
    Chan NP, Ho SG, Yeung CK, Shek SY, Chan HH. The use of non-ablative fractional resurfacing in Asian acne scar patients. Lasers Surg Med. 2010;42:710–5.PubMedGoogle Scholar
  90. 90.
    Deng H, Yuan D, Yan C, Lin X, Ding X. A 2940 nm fractional photothermolysis laser in the treatment of acne scarring: a pilot study in China. J Drugs Dermatol. 2009;8:978–80.PubMedGoogle Scholar
  91. 91.
    Nirmal B, Sripathi H, Rao R, Prabhu S, Kudur MH, et al. Efficacy and safety of erbium-doped yttrium aluminium garnet fractional resurfacing laser for treatment of facial acne scars. Indian J Dermatol Venereol Leprol. 2013;79:193–8.PubMedCrossRefGoogle Scholar
  92. 92.
    Kim S. Treatment of acne scars in Asian patients using a 2,790-nm fractional yttrium scandium gallium garnet laser. Dermatol Surg. 2011;37:1464–9.PubMedCrossRefGoogle Scholar
  93. 93.
    Gokalp H. Evaluation of nonablative fractional laser treatment in scar reduction. Lasers Med Sci. 2017;32:1629–35.PubMedCrossRefGoogle Scholar
  94. 94.
    Yang Q, Huang W, Qian H, Chen S, Ma L, Lu Z. Efficacy and safety of 1550-nm fractional laser in the treatment of acne scars in Chinese patients: a split-face comparative study. J Cosmet Laser Ther. 2016;18:312–6.PubMedCrossRefGoogle Scholar
  95. 95.
    Chrastil B, Glaich AS, Goldberg LH, Friedman PM. Second-generation 1,550-nm fractional photothermolysis for the treatment of acne scars. Dermatol Surg. 2008;34:1327–32.PubMedGoogle Scholar
  96. 96.
    Chae WS, Seong JY, Jung HN, Kong SH, Kim MH, Suh HS, et al. Comparative study on efficacy and safety of 1550 nm Er: glass fractional laser and fractional radiofrequency microneedle device for facial atrophic acne scar. J Cosm Dermatol. 2015;14:100–6.CrossRefGoogle Scholar
  97. 97.
    Rongsaard N, Rummaneethorn P. Comparison of a fractional bipolar radiofrequency device and a fractional erbium-doped glass 1,550-nm device for the treatment of atrophic acne scars: a randomized split-face clinical study. Dermatol Surg. 2014;40:14–21.PubMedCrossRefGoogle Scholar
  98. 98.
    Mahmoud BH, Srivastava D, Janiga JJ, Yang JJ, Lim HW, Ozog DM. Safety and efficacy of erbium-doped yttrium aluminum garnet fractionated laser for treatment of acne scars in type IV to VI skin. Dermatol Surg. 2010;36:602–9.PubMedCrossRefGoogle Scholar
  99. 99.
    Bencini PL, Tourlaki A, Galimberti M. Nonablative fractional photothermolysis for acne scars: clinical and in vivo microscopic documentation of treatment efficacy. Dermatol Ther. 2012;25:463–7.PubMedCrossRefGoogle Scholar
  100. 100.
    Yoo KH, Ahn JY, Kim JY. The use of 1540 nm fractional photothermolysis for the treatment of acne scars in Asian skin: a pilot study. Photodermatol Photoimmunol Photomed. 2009;25:138–42.PubMedCrossRefGoogle Scholar
  101. 101.
    Lipper GM, Perez M. Nonablative acne scar reduction after a series of treatments with a short-pulsed 1,064-nm neodymium:YAG laser. Dermatol Surg. 2006;32:998–1006.PubMedGoogle Scholar
  102. 102.
    Friedman PM, Jih MH, Skover GR. Treatment of atrophic facial acne scars with the 1064-nm Q-switched Nd:YAG laser: six-month follow-up study. Arch Dermatol. 2004;140:1337–41.PubMedCrossRefGoogle Scholar
  103. 103.
    Min SU, Choi YS, Lee DH, Yoon MY, Suh DH. Comparison of a long-pulse Nd:YAG laser and a combined 585/1,064-nm laser for the treatment of acne scars: a randomized split-face clinical study. Dermatol Surg. 2009;35:1720–7.PubMedCrossRefGoogle Scholar
  104. 104.
    Chan HL, Lam LK, Wong DS, Kono T, Trendell SN. Use of 1320 nm Nd:YAG laser for wrinkle reduction and the treatment of atrophic acne scarring in Asians. Lasers Surg Med. 2004;34:98–103.PubMedCrossRefGoogle Scholar
  105. 105.
    Tanzi EL, Alster TS. Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study. Dermatol Surg. 2004;30:152–7.PubMedGoogle Scholar
  106. 106.
    Chua SH, Ang P, Khoo LS, Goh CL. Nonablative 1450 nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective study. Dermatol Surg. 2004;30:1287–91.PubMedGoogle Scholar
  107. 107.
    Badawi A, Tome MA, Atteya A, Sami N, Morsy IA. Retrospective analysis of non-ablative scar treatment in dark skin types using the sub-millisecond Nd:YAG 1064 nm laser. Lasers Surg Med. 2011;43:130–6.PubMedCrossRefGoogle Scholar
  108. 108.
    Politi Y, Levi A, Lapidoth M. Integrated cooling-vacuum-assisted non-fractional 1540 nm Erbium: glass laser is effective in treating acne scars. J Drugs Dermatol. 2016;15:1359–63.PubMedGoogle Scholar
  109. 109.
    Brauer JA, Kazlouskaya V, Alabdulrazzaq H, Bae Y, Bernstein LJ, Anolk R, et al. Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring. JAMA Dermatol. 2015;151:278–84.PubMedCrossRefGoogle Scholar
  110. 110.
    Kim JE, Lee HW, Kim JK, Moon SH, Ko JW, Lee MW, et al. Objective evaluation of the clinical efficacy of fractional radiofrequency treatment for acne scars and enlarged pores in Asian skin. Dermatol Surg. 2014;40:988–95.PubMedCrossRefGoogle Scholar
  111. 111.
    Zhang Z, Fei Y, Chen X, Lu W, Chen J. 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. Dermatol Surg. 2013;39:559–66.PubMedCrossRefGoogle Scholar
  112. 112.
    Kroepfl L, Emer JJ. Combination therapy for acne scarring: personal experience and clinical suggestions. J Drugs Dermatol. 2016;15:1413–9.PubMedGoogle Scholar
  113. 113.
    Cameli N, Mariano M, Serio M, Ardigo M. Preliminary comparison of fractional laser with fractional laser plus radiofrequency for the treatment of acne scars and photoaging. Dermatol Surg. 2014;40:553–61.PubMedCrossRefGoogle Scholar
  114. 114.
    Tenna S, Cogliandro A, Piombino L, Filoni A, Persichetti P. Combined use of fractional CO2 laser and radiofrequency waves to treat acne scars: a pilot study on 15 patients. J Cosmet Laser Ther. 2012;14:166–71.PubMedCrossRefGoogle Scholar
  115. 115.
    Simmons BJ, Griffith RD, Falto-Aizpurua LA, Nouri K. Use of radiofrequency in cosmetic dermatology: focus on nonablative treatment of acne scars. Clin Cosmet Investig Dermatol. 2014;7:335–9.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Chandrashekar BS, Sriram R, Mysore R, Bhaskar S, Shetty A. Evaluation of microneedling fractional radiofrequency device for treatment of acne scars. J Cutan Aesthet Surg. 2014;7:93–7.PubMedPubMedCentralCrossRefGoogle Scholar
  117. 117.
    Kaminaka C, Uede M, Matsunaka H, Furukawa F. Clinical studies of the treatment of facial atrophic acne scars and acne with a bipolar fractional radiofrequency system. J Dermatol. 2015;42:580–7.PubMedCrossRefGoogle Scholar
  118. 118.
    Min S, Park SY, Yoon JY, Suh DH. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial. Arch Dermatol Res. 2015;307:897–904.PubMedCrossRefGoogle Scholar
  119. 119.
    Min S, Park SY, Yoon JY, Kwon HH, Suh DH. Fractional microneedling radiofrequency treatment for acne-related post-inflammatory erythema. Acta Derm Venereol. 2016;96:87–91.PubMedCrossRefGoogle Scholar
  120. 120.
    Cho SI, Chung BY, Choi MG, Baek JH, Cho HJ, Park CW, et al. Evaluation of the clinical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores. Dermatol Surg. 2012;38:1017–24.PubMedCrossRefGoogle Scholar
  121. 121.
    Vejjabhinanta V, Wanitphakdeedecha R, Limtanyakul P, Manuskiatti W. The efficacy in treatment of facial atrophic acne scars in Asians with a fractional radiofrequency microneedle system. J Eur Acad Dermatol Venereol. 2014;28:1219–25.PubMedCrossRefGoogle Scholar
  122. 122.
    Park JY, Lee EG, Yoon MS, Lee HJ. The efficacy and safety of combined microneedle fractional radiofrequency and sublative fractional radiofrequency for acne scars in Asian skin. J Cosmet Dermatol. 2016;15:102–7.PubMedCrossRefGoogle Scholar
  123. 123.
    Goel A, Gatne V. Use of nanofractional radiofrequency for the treatment of acne scars in Indian skin. J Cosmet Dermatol. 2017;16:186–92.PubMedCrossRefGoogle Scholar
  124. 124.
    Faghihi G, Nouraei S, Asilian A, Keyvan S, Abtahi-Naeini B, Rakhshanpour M, et al. Efficacy of punch elevation combined with fractional carbon dioxide laser resurfacing in facial atrophic acne scarring: a randomized split-face clinical study. Indian J Dermatol. 2015;60:473–8.PubMedPubMedCentralCrossRefGoogle Scholar
  125. 125.
    Solotoff S. Treatment of pitted acne scarring-postauricular punch grafts followed by dermabrasion. J Dermatol Surg Oncol. 1986;12:1079.PubMedCrossRefGoogle Scholar
  126. 126.
    O’Daniel TG. Multimodal management of atrophic acne scarring in the aging face. Aesth Plast Surg. 2011;35:1143–50.CrossRefGoogle Scholar
  127. 127.
    Ibrahim ZA, Eltatawy RA, Ghaly NR, Abd El-Naby NM, Abou El Fetouh HM, Abd Elateef AE, et al. Autologus bone marrow stem cells in atrophic acne scars: a pilot study. J Dermatol Treat. 2015;26:260–5.CrossRefGoogle Scholar
  128. 128.
    Munavalli GS, Smith S, Maslowski JM, Weiss RA. Successful treatment of depressed, distensible acne scars using autologous fibroblasts: a multi-site, prospective, double blind, placebo-controlled clinical trial. Dermatol Surg. 2013;39:1226–36.PubMedPubMedCentralCrossRefGoogle Scholar
  129. 129.
    Stoddard MA, Herrmann J, Moy L, Moy R. Improvement of atrophic acne scars in skin of color using topical synthetic epidermal growth factor (EGF) serum: a pilot study. J Drugs Dermatol. 2017;16:322–6.PubMedGoogle Scholar
  130. 130.
    Zaleski-Larsen LA, Fabi SG, McGraw T, Taylor M. Acne scar treatment: a multimodality approach tailored to scar type. Dermatol Surg. 2016;42:139–49.CrossRefGoogle Scholar
  131. 131.
    Taub AF, Garretson CB. Treatment of acne scars of skin types ii to v by sublative fractional bipolar radiofrequency and bipolar radiofrequency combined with diode laser. J Clin Aesthet Dermatol. 2011;4:18–27.PubMedPubMedCentralGoogle Scholar
  132. 132.
    Yeung CK, Chan NP, Shek SY, Chan HH. Evaluation of combined fractional radiofrequency and fractional laser treatment for acne scars in Asians. Lasers Surg Med. 2012;44:622–30.PubMedCrossRefGoogle Scholar
  133. 133.
    Peterson JD, Palm MD, Kiripolsky MG, Guiha IC, Goldman MP. Evaluation of the effect of fractional laser with radiofrequency and fractionated radiofrequency on the improvement of acne scars. Dermatol Surg. 2011;37:1260–7.PubMedCrossRefGoogle Scholar
  134. 134.
    Taylor MB, Zaleski-Larsen L, McGraw TA. Single session treatment of rolling acne scars using tumescent anesthesia, 20% trichloroacetic acid, extensive subcision, and fractional CO2 laser. Dermatol Surg. 2017;43:S70–4.PubMedCrossRefGoogle Scholar
  135. 135.
    Anupama YG, Wahab AJ. Effectiveness of CO2 laser with subcision in patients with acne scars. J Cosmet Laser Ther. 2016;18:367–71.PubMedCrossRefGoogle Scholar
  136. 136.
    Nilforoushzadeh MA, Faghihi G, Jaffary F, Haftbaradaran E, Hoseini SM, Mazaheri N. Fractional carbon dioxide laser and its combination with subcision in improving atrophic acne scars. Adv Biomed Res. 2017;6:20.PubMedPubMedCentralCrossRefGoogle Scholar
  137. 137.
    Garg S, Baveja S. Combination therapy in the management of atrophic acne scars. J Cutan Aesthet Surg. 2014;7:18–23.PubMedPubMedCentralCrossRefGoogle Scholar
  138. 138.
    Faghihi G, Poostiyan N, Asilian A, Abtahi-Naeini B, Shahbazi M, Iraji F, et al. Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: a randomized split-face clinical study. J Cosmet Dermatol. 2017;16:223–9.PubMedCrossRefGoogle Scholar
  139. 139.
    Sobanko JF, Alster TS. Management of acne scarring, part I: a comparative review of laser surgical approaches. Am J Clin Dermatol. 2012;13:319–30.PubMedCrossRefGoogle Scholar
  140. 140.
    Fitzpatrick RE. Treatment of inflamed hypertrophic scars using intralesional 5-FU. Dermatol Surg. 1999;25:224–32.PubMedCrossRefGoogle Scholar
  141. 141.
    Alster TS, Handrick C. Laser treatment of hypertrophic scars, keloids, and striae. Semin Cutan Med Surg. 2000;19:287–92.PubMedCrossRefGoogle Scholar
  142. 142.
    Shih PY, Chen HH, Chen CH, Hong HS. Rapid recurrence of keloid after pulse dye laser treatment. Dermatol Surg. 2008;34:1124–7.PubMedGoogle Scholar
  143. 143.
    Goodman GJ. Treatment of acne scarring. Int J Dermatol. 2011;50:1179–94.PubMedCrossRefGoogle Scholar
  144. 144.
    Kearney C, Brew D. Single-session combination treatment with intense pulsed light and nonablative fractional photothermolysis: a split-face study. Dermatol Surg. 2012;38:1002–9.PubMedCrossRefGoogle Scholar
  145. 145.
    Alster TS, Mcmeekin TO. Improvement of facial acne scars by the 585 nm flashlamp-pumped pulsed dye laser. J Am Acad Dermatol. 1996;35:79–81.PubMedCrossRefGoogle Scholar
  146. 146.
    Park KY, Ko EJ, Seo SJ, Hong CK. Comparison of fractional, nonablative, 1550-nm laser and 595-nm pulsed dye laser for the treatment of facial erythema resulting from acne: a split-face, evaluator-blinded, randomized pilot study. J Cosmet Laser Ther. 2014;16:120–3.PubMedCrossRefGoogle Scholar
  147. 147.
    Rao J. Treatment of acne scarring. Facial Plast Surg Clin North Am. 2011;19:275–91.PubMedCrossRefGoogle Scholar
  148. 148.
    Alexis AF, Coley MK, Nijhawan RI, Luke JD, Shah SK, Argobi YA, et al. Nonablative fractional laser resurfacing for acne scarring in patients with Fitzpatrick skin phototypes IV–VI. Dermatol Surg. 2016;42:392–402.PubMedCrossRefGoogle Scholar
  149. 149.
    Cohen BE, Elbuluk N. Microneedling in skin of color: a review of uses and efficacy. J Am Acad Dermatol. 2016;74:348–55.PubMedCrossRefGoogle Scholar
  150. 150.
    Saluja SS, Walker ML, Summers EM, Tristani-Firouzi P, Smart DR. Safety of non-ablative fractional laser for acne scars within 1 month after treatment with oral isotretinoin: a randomized split-face controlled trial. Lasers Surg Med. 2017;49:886–90.PubMedCrossRefGoogle Scholar
  151. 151.
    Spring LK, Krakowski AC, Alam M, Bhatia A, Brauer J, Cohen J, et al. Isotretinoin and timing of procedural interventions: a systematic review with consensus recommendations. JAMA Dermatol. 2017;153:802–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of DermatologyR.D. Gardi Medical College and C.R. Gardi HospitalUjjainIndia
  2. 2.Department of DermatologyMedical School of JundiaíSão PauloBrazil
  3. 3.Department of DermatologyAlpert Medical School of Brown UniversityProvidenceUSA
  4. 4.Department of DermatologyRhode Island HospitalProvidenceUSA

Personalised recommendations