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Post-acne Scarring

  • Greg J. GoodmanEmail author
Chapter

Abstract

Acne is a very common inflammatory disease with superimposed opportunistic infection, which, if left untreated, will often lead to lifelong scarring. The resultant scarring is graded for the purposes of classification and communication, but the scarring is a very individual issue with even minor scarring a great issue for patients.

The treatment of scarring is usually incomplete with surface and volumetric treatments being the mainstay. Hence, grading revolves around these issues. The milder grades 1 and 2 scarring usually require multiple surface treatments with energy-based (fractionated and non-fractionated) and other surface treatments. For more severe grades where volume is a greater issue, fractionated devices appear to be the best form of energy- and nonenergy-based devices, but often, volume restoration (fillers and surgical techniques) or volume depletion (intralesional steroids and cytotoxics) is also required. The choice of the variety of fractional delivery is made on the basis of the scar and patient characteristics. Rarely, botulinum toxin may also be needed especially in hypertrophic scarring.

In all grades, it would appear that combining treatments either concurrently or sequentially is superior to employing a single modality. Combining fractionation and non-fractional therapies may be particularly efficacious (e.g. low-strength peels and needling or fractionated lasers). Otherwise combination therapy may involve fractional devices to be used to allow deeper ingress of agents by transdermal delivery (e.g. steroids, cytotoxics, bimatoprost).

Keywords

Scar Atrophic scar Keloid Hypertrophic scar Scar grade Scar treatment 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Primary PracticeMonash UniversityClaytonAustralia
  2. 2.Skin and Cancer Foundation Inc.CarltonAustralia

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