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 .
Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring.
IMPORTANCE Fractional laser technology is routinely used in the treatment of acne scarring , with thermal injury result ing in collagen synthesis and remodeling . Use of a picosecond pulse duration with a diffractive lens array may be a new technologic advancement in the treatment of acne scarring . OBJECTIVE To investigate the safety and efficacy of a 755-nm alex and rite picosecond pulse duration laser with diffractive lens array for the treatment of facial acne scarring . DESIGN , SETTING , AND PARTICIPANTS This single-center , prospect i ve study performed in a private practice with a dedicated research department included patients with clinical ly diagnosed scarring secondary to inflammatory or cystic acne . INTERVENTIONS Patients received 6 treatments with a 755-nm picosecond laser with a spot size of 6 mm , fluence of 0.71 J/cm2 , repetition rate of 5 Hz , and pulse width of 750 picoseconds in combination with a diffractive lens array , allowing for greater surface area and pattern density per pulse . MAIN OUTCOMES AND MEASURES The pain and satisfaction scores for overall appearance and texture were recorded . Masked assessment of clinical photographs and analysis of 3-dimensional volumetric data were performed . Biopsy specimens were obtained for independent histologic evaluation by 2 investigators at baseline and at 3 months after last treatment . RESULTS Fifteen women and 5 men ( mean age , 44 years ; age range , 27 - 61 years ) with Fitzpatrick skin types I through V and facial acne scarring were enrolled . The mean pain score was 2.83 of 10 . Patients were satisfied to extremely satisfied with improvement in appearance and texture at their final treatment and follow-up visits . The masked assessment scores of 17 patients were 1.5 of 3 and 1.4 of 3 at 1 and 3 months , respectively ( a score of 0 indicates 0%-25 % improvement and a score of 3 indicates > 75 % improvement ) . A 3-dimensional analysis revealed a mean 24.3 % improvement in scar volume , maintained at 1 ( 24.0 % ) and 3 ( 27.2 % ) months after treatment . Histologic analysis revealed elongation and increased density of elastic fibers , with an increase in dermal collagen and mucin . CONCLUSIONS AND RELEVANCE Treatment of facial acne scars with a diffractive lens array and 755-nm picosecond laser produced improvement in appearance and texture at 3 months after the last treatment , with objective findings similar to those published for a series of fractional ablative laser treatments . Histologic findings suggest that improvement in scarring from this treatment goes beyond remodeling of collagen
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 .