Discussion : Ablative lasers seem to achieve the highest degree of efficacy , albeit this is associated with significant pain and downtime , and the risk for long-term pigmentary changes .
Non-ablative fractional photothermolysis ( FP ) has a much safer profile but can not achieve as good cosmetic results .
The efficacies of fractional radiofrequency microneedling and radiofrequency are slightly inferior to that of FP but offer an even safer adverse profile .
Conclusion : Multiple devices have been used with varying levels of efficacy and very different safety profiles .
There is an overall lack of high- quality evidence about the effects of different interventions .
Introduction : Acne scarring is a very common problem , which can be extensive , and may lead to significant psychosocial morbidity .
Multiple types of treatments are used to ameliorate atrophic scars with varying degrees of success .
This paper provides an overview of the various energy-based modalities that are commonly employed against acne scarring .
Objectives and methods : A comprehensive literature search of papers published since 2008 was performed in order to determine the efficacy and adverse reactions of commonly used energy-based treatments against post-acne scarring .
Safety and Efficacy of Erbium‐Doped Yttrium Aluminum Garnet Fractionated Laser for Treatment of Acne Scars in Type IV to VI Skin
BACKGROUND Ablative resurfacing lasers are effective for treatment of  acne scars , but they have a high risk of complications . Fractional lasers have less severe side effects but more moderate efficacy than ablative devices . Studies were performed in individuals with Fitzpatrick skin type I to VI . OBJECTIVE To determine the efficacy and safety of an erbium 1,550‐nm fractional laser in the treatment of facial acne scars in Fitzpatrick skin types IV to VI . METHODS We conducted a prospect i ve , single‐blind , r and omized trial in patients with acne scars ( n=15 ) , skin type IV to VI , with a 1,550‐nm erbium fractionated laser .  Patients were divided into two groups ; one was treated with 10 mJ and the other with 40 mJ. Five monthly laser sessions were performed . A patient question naire was distributed . RESULTS There was a significant improvement in the acne scarring and overall appearance ( p<.001 ) . No significant difference was found between 10 and 40 mJ. Patients were highly satisfied with their results . Significant postinflammatory hyperpigmentation was seen ; pain was significantly higher in darker skin . CONCLUSIONS Fractional photothermolysis is effective for the treatment of acne scars , but practition‐ers should be aware of the higher incidence of pain and postinflammatory hyperpigmentation in individuals with skin types IV to VI . The study was funded by Reliant Technologies , Inc. , which participated in the study design . Galderma ( Ft . Worth , TX ) provided Tri‐luma cream and GlaxoSmithKline ( Research Triangle Park , NC ) provided valacyclovir ( Valtrex )
Discussion : Ablative lasers seem to achieve the highest degree of efficacy , albeit this is associated with significant pain and downtime , and the risk for long-term pigmentary changes .
Non-ablative fractional photothermolysis ( FP ) has a much safer profile but can not achieve as good cosmetic results .
The efficacies of fractional radiofrequency microneedling and radiofrequency are slightly inferior to that of FP but offer an even safer adverse profile .
Conclusion : Multiple devices have been used with varying levels of efficacy and very different safety profiles .
There is an overall lack of high- quality evidence about the effects of different interventions .
Introduction : Acne scarring is a very common problem , which can be extensive , and may lead to significant psychosocial morbidity .
Multiple types of treatments are used to ameliorate atrophic scars with varying degrees of success .
This paper provides an overview of the various energy-based modalities that are commonly employed against acne scarring .
Objectives and methods : A comprehensive literature search of papers published since 2008 was performed in order to determine the efficacy and adverse reactions of commonly used energy-based treatments against post-acne scarring .