TY - JOUR

T1 - Energy-based devices for the treatment of acne scars

T2 - 2021 international consensus recommendations

AU - Salameh, Fares

AU - Shumaker, Peter R.

AU - Goodman, Greg J.

AU - Spring, Leah K.

AU - Seago, Meghan

AU - Alam, Murad

AU - Al-Niaimi, Firas

AU - Cassuto, Daniel

AU - Chan, Henry H. L.

AU - Dierickx, Christine

AU - Donelan, Matthias

AU - Gauglitz, Gerd G.

AU - Haedersdal, Merete

AU - Krakowski, Andrew C.

AU - Manuskiatti, Woraphong

AU - Norbury, William B.

AU - Ogawa, Rei

AU - Ozog, David M.

AU - Paasch, Uwe

AU - Ross, E. Victor

AU - Clementoni, Matteo Tretti

AU - Waibel, Jill

AU - Bayat, Ardeshir

AU - Goo, Boncheol Leo

AU - Artzi, Ofir

PY - 2022

Y1 - 2022

N2 - Background and Objectives Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. Study Design/Materials and Methods An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. Results The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. Conclusion Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.

AB - Background and Objectives Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. Study Design/Materials and Methods An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. Results The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. Conclusion Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.

KW - acne scars

KW - energy based devices

KW - lasers

KW - ND-YAG LASER

KW - RANDOMIZED SPLIT-FACE

KW - ALUMINUM-GARNET LASER

KW - INTENSE PULSED-LIGHT

KW - COMBINATION THERAPY

KW - PICOSECOND LASER

KW - ERBIUM-GLASS

KW - ISOTRETINOIN

KW - VULGARIS

KW - RADIOFREQUENCY

U2 - 10.1002/lsm.23484

DO - 10.1002/lsm.23484

M3 - Review

C2 - 34719045

VL - 54

SP - 10

EP - 26

JO - Lasers in Surgery and Medicine

JF - Lasers in Surgery and Medicine

SN - 0196-8092

IS - 1

ER -