Acne scarring can be classified into atrophic icepick, boxcar, and rolling scars in addition to keloidal and hypertrophic scars. Additionally, these scars can be erythematous, hyperpigmented, and/or hypopigmented. Each scar type has a different structural cause warranting a customized approach. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices.
A Medline search was performed on combination treatments because it relates to facial acne scarring, and results are summarized. Practical applications for these combinations of procedures are also discussed.
Studies examining the efficacy and safety of ablative, nonablative, fractionated, and nonfractionated lasers, dermabrasion, chemical peels, needling, subcision, radiofrequency, stem cell therapy, fat transplantation, platelet-rich plasma, and hyaluronic acid dermal fillers for acne scars were found. The authors review their experience in combining these techniques.
Review of the literature revealed multiple single options for facial acne scarring treatment with minimal evidence in the literature found on the safety and efficacy of combining such procedures and devices. The authors' experience is that combining acne scar treatment techniques can be performed safely and synergistically with optimal patient outcomes.
*Cosmetic Laser Dermatology, San Diego, California;
†Department of Dermatology, University of California, San Diego, California;
‡Gateway Aesthetic Institute & Laser Center, Salt Lake City, Utah
Address correspondence and reprint requests to: Lisa A. Zaleski-Larsen, DO, FAAD, Cosmetic Laser Dermatology, Goldman, Butterwick, Groff, Fabi, and Wu, 9339 Genesee Avenue, Suite 300, San Diego, CA 92121, or e-mail: email@example.com
Dr. S. G. Fabi is a consultant for Merz, Ulthera, Galderma, Allergan, Lumenis, and Valeant and has received research grants from Kythera, Revance, Allergan, and Ulthera. Dr. M. Taylor has received research grants, discounted equipment, or given presentations for Endymed, Dermapen, Eclipse Medical, Solta, Palomar, Cynosure, Syneron. He also designed and owns the patent on the subcision instruments. The other authors have indicated no significant interest with commercial supporters.