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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 Kroumpouzos
Systematic Review

Abstract

Background

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.

Objective

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

Methods

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.

Results

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.

Conclusions

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.

Notes

Compliance with Ethical Standards

Funding

None declared.

Conflict of interest

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

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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

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