New options for managing acne scars

Consider scar type, skin category, patient treatment tolerance when selecting therapies

There are new options for managing acne scars in patients of all skin types, according to Roy G. Geronemus, M.D., director of Laser & Skin Surgery of New York and clinical professor of dermatology, New York University Medical Center.

When treating acne scars, dermatologists should first take into consideration that acne scars are heterogeneous and occur in patients of all phototypes, says Dr. Geronemus who presented during the 36th Annual Conference of the American Society for Laser Medicine & Surgery, Boston, Mass.

“It is important to choose the appropriate technology based upon the type of scars that the patient has, as well as consideration of the skin type,” Dr. Geronemus says. “Patients’ tolerance for ablative or non-ablative resurfacing also factors into the decision.”

One of the most important advances in acne scar treatment has been the development of technology for patients with darker skin phototypes, where previously many of these patients could not be treated, according to Dr. Geronemus. The dermatologist cites a study published March 2015 in JAMA Dermatology on the use of a picosecond pulse duration laser with diffractive lens array for facial acne scar treatment.

Dr. Geronemus and colleagues studied patients with Fitzpatrick skin types I through V with scarring secondary to inflammatory or cystic acne. Patients received six 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, according to the study’s abstract.

The researchers conclude the treatment resulted in improved appearance and texture at three months after the last treatment, and histologic findings suggest the treatment goes beyond collagen remodeling to improve scars.

As for the future, Dr. Geronemus says that there is new evidence that fractional radiofrequency might also be helpful for acne scars in patients of all skin types.

Disclosure: Dr. Geronemus is on the medical advisory board of Cynosure and Solta.


Brauer JA, Kazlouskaya V, Alabdulrazzaq H, Bae YS, Bernstein LJ, Anolik R, Heller PA, Geronemus RG. Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring. JAMA Dermatol. 2015 Mar;151(3):278-84.

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