Acne scars are considered to be the most distressing and long-term consequences of acne vulgaris, damaging a persons physical, mental and social well-being. Depending on the clinical presentation, numerous treatment options include surgical and nonsurgical techniques. Although the last decade has witnessed considerable advances in developing new treatment technologies and applications, international treatment guidelines and reimbursement schemes still need to catch up with current knowledge and practice in many centers. 

The researchers of the present study highlighted the potential utility of energy-based devices (EBDs) for acne scarring, offered recommendations for safe and efficacious treatment, and provided consensus-based EBD treatment options based on different presentations demonstrated in a series of real-life clinical photographs.

The present study assembled an international panel of 24 dermatologists and plastic surgeons from 12 countries and a variety of practice backgrounds to develop updated consensus recommendations for treating acne scars. It comprised a two-step modified Delphi method conducted between March 2020 and February 2021, comprising two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence.

The manuscript included a comprehensive discussion and panel recommendations regarding the following topics:

• EBD role in mitigating and treating acne scars in a patient with active acne
• Use of EBDs for the treatment of different acne scar types with a particular focus on commonly used laser platforms like vascular lasers, ablative fractional lasers (AFLs), and non-AFLs (NAFLs)
• Treatment combinations
• Acne scar treatments in the skin of color.

The last part comprised 10 photos of real-life clinical cases with the panel recommendation treatment plan to gain the best esthetic outcome.

Panel members unanimously viewed that EBDs have a role in managing acne scars, with AFLs, NAFLs, vascular lasers and radiofrequency devices most commonly selected by most panel experts. EBDs are considered a first-line treatment for various acne scar types. Patients not having access to these treatments may not receive the best care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes are needed to reflect this status.

Source: Salameh F, Shumaker PR, Goodman GJ, et al. Energy-based devices for the treatment of acne scars: 2022 International consensus recommendations. Lasers Surg Med. 2022;54(1):10-26.