Atrophic acne scarring: a review of treatment options

Abstract

Background: Scarring is an unfortunate and frequent complication of acne, resulting in significant psychological distress for patients. Fortunately, numerous treatment options exist for acne scarring.

Objectives: To extensively review the literature on treatment options for atrophic acne scarring.

Materials and methods: A comprehensive literature search was conducted on the following topics: dermabrasion, subcision, punch techniques, chemical peels, tissue augmentation, and lasers.

Results: The literature supports the use of various treatment modalities; superior results may be achieved when multiple modalities are combined for a multi-step approach to scarring.

Conclusion: The safety and efficacy of various treatment devices for acne scarring is well established, but there is a paucity of split-face trials comparing modalities.

Figures

Figure 1

Atrophic acne scar types: (A) icepick, (B) boxcar, (C) icepick (black arrow) and boxcar (blue arrow), (D) rolling.

Figure 1

Atrophic acne scar types: (A) icepick, (B) boxcar, (C) icepick (black arrow) and boxcar (blue arrow), (D) rolling.

Figure 1

Atrophic acne scar types: (A) icepick, (B) boxcar, (C) icepick (black arrow) and boxcar (blue arrow), (D) rolling.

Figure 1

Atrophic acne scar types: (A) icepick, (B) boxcar, (C) icepick (black arrow) and boxcar (blue arrow), (D) rolling.

Figure 2

Schematic demonstrating subcision. A hypodermic, tribevelled, or filter needle is inserted into the subdermal plane and rotated in a fanning motion to undermine the scar, disrupting fibrous attachments.

Figure 3

Acne scars treated with skin needling: a revolving barrel equipped with multiple rows of needles is rolled across the skin.

Figure 4

The CROSS technique (A) before and (B) shortly after the procedure.

Figure 5

Diagram of the Airgent handpiece used for subdermal minimal surgery. A needleless hypodermic inoculator delivers hyaluronic acid subdermally through a high pressure jet.