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 .
High versus moderate energy use of bipolar fractional radiofrequency in the treatment of acne scars: a split-face double-blinded randomized control trial pilot study
Bipolar fractional radiofrequency ( FRF ) device was firstly FDA -approved for treating atrophic acne scar in 2008 through the process of dermal coagulation and minimal epidermal ablation . The average energy at 60 mJ/pin was widely used to treat atrophic acne scars . However , the higher energy was delivered , the deeper ablation and coagulation were found . At present , the new generation of a device with bipolar FRF technology with electrode-pin tip was developed to maximize ability to deliver energy up to 100 mJ/pin . The objective of the study was to explore and compare the efficacy of utilizing high energy ( 100 mJ/pin ) and moderate energy ( 60 mJ/pin ) of bipolar fractional radiofrequency in treatment of atrophic acne scar in Asians . This is a split-face , double-blinded , r and omized control trial , pilot study by using parallel group design technique . Thirty healthy subjects with Fitzpatrick skin phototype III-IV diagnosed as atrophic acne scares were enrolled . All subjects received four monthly sessions of bipolar FRF treatment . Left and right facial sides of individual patients were r and omly assigned for different energy ( high energy at 100 mJ/pin versus moderate energy at 60 mJ/pin ) . Acne scars improvement was blinded grade d by dermatologist using global acne scarring score ( GASS ) which was subjectively evaluated at baseline , 1- , 3- , and 6-month follow-up . Objective scar analysis was also done using UVA-light video camera to measure scar volume , skin smoothness , and wrinkle at baseline , 3- , and 6-month follow-up after the last treatment . Side effects including pain , erythema , swelling , and crusting were also recorded . Thirty subjects completed the study with full 4-treatment course . The mean GASS of high energy side and moderate energy side was significantly reduced at 1- , 3- , and 6-month follow-up visits . At 1 month follow-visit , high energy side demonstrated significant improvement compared with moderate energy side ( p = 0.03 ) . Postinflammatory hyperpigmentation ( PIH ) developed in 21/120 sessions in high energy side ( 17.5 % ) and 16/120 sessions in moderate energy side ( 13.3 % ) . Pain score and the duration of erythema after treatments were significant higher on the side that was treated with high energy . Bipolar FRF device was safe and effective in the treatment of atrophic acne scars in Asians .  High energy setting demonstrated significant higher efficacy at 1 month follow-visit . However , the efficacy of both energy setting s was comparable at 3- and 6-month follow-up . In addition , side effects were significantly more intense on the side treated with high energy
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 .