Abstract :
Objectives: Acne scarring is a frequent sequela of acne vulgaris with considerable cosmetic and psychosocial impact. This review critically evaluates current treatment modalities, emphasizing efficacy, limitations, and emerging concepts. Material and Methods: A structured literature search was conducted in PubMed, Scopus, and Google Scholar for studies published from January 2010 to June 2025. Keywords included “acne scars,” “atrophic scars,” “microneedling,” “laser,” “radiofrequency,” “chemical peel,” “subcision,” “fibroblast transfer,” and “regenerative therapy.” Eligible studies were English-language human trials, randomized controlled trials (RCTs), systematic reviews, and relevant narrative reviews. Exclusion criteria were non-facial scars, animal or in vitro studies, and case series with fewer than five patients. Data were extracted on interventions, outcomes, and safety. Results: Acne scar management strategies are categorized into energy-based (ablative and non-ablative lasers, fractional photothermolysis, microneedling [MN], radiofrequency, and Tixel) and non-energy-based modalities (chemical peels, MN, subcision, dermabrasion, punch techniques, fillers, and grafting). Ablative lasers show strong efficacy but carry downtime and pigmentary risks. Non-energy approaches, such as MN and trichloroacetic acid chemical reconstruction of skin scars, are safer with modest improvement. Combination regimens, including MN with platelet-rich plasma or subcision with fillers, consistently outperform monotherapy. Emerging regenerative options, such as autologous fibroblast transfer, demonstrate encouraging long-term results. Conclusion: Optimal acne scar management requires individualized, multimodal strategies tailored to the scar type and patient profile. Combination therapy offers the most consistent benefit, while regenerative techniques represent a promising frontier for future care.
Keyword :
Acne scars, Chemical peel, Fibroblast transfer, Laser, Microneedling, Regenerative therapy, Subcision