Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Aug;4(8):50-7.

Practical evaluation and management of atrophic acne scars: tips for the general dermatologist

Douglas Fife  1
Affiliations

Practical evaluation and management of atrophic acne scars: tips for the general dermatologist

Douglas Fife. J Clin Aesthet Dermatol. 2011 Aug.

Abstract

Atrophic acne scarring is an unfortunate, permanent complication of acne vulgaris, which may be associated with significant psychological distress. General dermatologists are frequently presented with the challenge of evaluating and providing treatment recommendations to patients with acne scars. This article reviews a practical, step-by-step approach to evaluating the patient with atrophic acne scars. An algorithm for providing treatment options is presented, along with pitfalls to avoid. A few select procedures that may be incorporated into a general dermatology practice are reviewed in greater detail, including filler injections, skin needling, and the punch excision.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Subtypes of atrophic acne scars. Adapted from Jacob et al.
Figure 2
Figure 2
Photos before (A) and after (B) hyaluronic acid filler injected immediately beneath rolling acne scars of the lower face. This patient was also treated with botulinum toxin to the lower face.
Figure 2
Figure 2
Photos before (A) and after (B) hyaluronic acid filler injected immediately beneath rolling acne scars of the lower face. This patient was also treated with botulinum toxin to the lower face.
Figure 3
Figure 3
Photos before (A) and immediately after (B) injection with poly-L lactic acid demonstrating how volumetric filling of the mid-face can improve the appearance of acne scars accentuated by underlying soft tissue loss. Although this effect is temporary, it approximates what the patient will ultimately achieve with 2 to 4 sessions of treatment.
Figure 3
Figure 3
Photos before (A) and immediately after (B) injection with poly-L lactic acid demonstrating how volumetric filling of the mid-face can improve the appearance of acne scars accentuated by underlying soft tissue loss. Although this effect is temporary, it approximates what the patient will ultimately achieve with 2 to 4 sessions of treatment.
Figure 4
Figure 4
Needling device consisting of a rolling barrel studded by 2mm-long needles
Figure 5
Figure 5
Before (5A and 5C) and after (5B and 5D) photos after three sessions of skin needling. Although some of the improvement is from clearance of active acne, the patient also noticed improvement of her atrophic acne scars.
Figure 5
Figure 5
Before (5A and 5C) and after (5B and 5D) photos after three sessions of skin needling. Although some of the improvement is from clearance of active acne, the patient also noticed improvement of her atrophic acne scars.
Figure 5
Figure 5
Before (5A and 5C) and after (5B and 5D) photos after three sessions of skin needling. Although some of the improvement is from clearance of active acne, the patient also noticed improvement of her atrophic acne scars.
Figure 5
Figure 5
Before (5A and 5C) and after (5B and 5D) photos after three sessions of skin needling. Although some of the improvement is from clearance of active acne, the patient also noticed improvement of her atrophic acne scars.
Figure 6
Figure 6
Elliptical excision of a hypopigmented, sclerotic boxcar scar. Pretreatment (A), immediately postoperatively (B), one month postoperatively (C) showing improvement in color and contour
Figure 6
Figure 6
Elliptical excision of a hypopigmented, sclerotic boxcar scar. Pretreatment (A), immediately postoperatively (B), one month postoperatively (C) showing improvement in color and contour
Figure 6
Figure 6
Elliptical excision of a hypopigmented, sclerotic boxcar scar. Pretreatment (A), immediately postoperatively (B), one month postoperatively (C) showing improvement in color and contour
See this image and copyright information in PMC

References

    1. Kranning KK, Odland GF. Prevalence, morbidty and cost of dermatological diseases. J Invest Dermatol. 1979;73(Suppl):395–401. - PubMed
    1. Johnson MT, Roberts J. Skin conditions and related need for medical care among persons 1 to 74 years United States, 1971–1974. Vital Health Stat. 1978;11(212):i–v. 1–72. - PubMed
    1. Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol. 1994;19:303–308. - PubMed
    1. Cunliffe WJ, Gould DJ. Prevalence of facial acne vulgaris in late adolescence and in adults. Br Med J. 1979;1(6171):1109–1110. - PMC - PubMed
    1. Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol. 1999;41:577–580. - PubMed

LinkOut - more resources