Abstract

Objectives: To introduce a precision dermal targeting strategy for acne scar remodeling using ElaDerm, a vacuum-assisted needle radiofrequency platform with epidermal cooling, in PIH-prone Asian skin. Introduction: Acne scars are not merely surface irregularities, but three-dimensional dermal structural problems involving variable scar depth, collagen alteration, scar edge formation, and dermal tethering. In PIH-prone Asian skin, aggressive resurfacing may be limited by downtime, epidermal injury, and pigmentary concerns. Needle radiofrequency allows intradermal energy delivery with less dependence on epidermal chromophores; however, consistent tissue engagement, reproducible depth targeting, patient tolerability, and epidermal thermal burden remain important considerations in routine practice. Materials / method: This lecture reviews the technology concept and clinical application of ElaDerm for acne scars, enlarged pores, and early atrophic textural change. ElaDerm combines vacuum-assisted tissue capture, microneedle RF delivery, and simultaneous epidermal cooling. A scar-oriented treatment approach will be presented, including patient selection, scar-type positioning, facial subunit-based depth adjustment, and representative clinical cases. Clinical response and tolerability were assessed using standardized photography, physician visual assessment, patient-reported downtime, and adverse events. Results: Vacuum-assisted tissue capture supported stable skin contact and selected-depth treatment in scarred facial areas. Representative cases showed visible improvement in overall skin texture, shallow rolling or boxcar scars, and enlarged pore appearance after serial treatments. Downtime mainly consisted of transient erythema and mild edema. No serious device-related adverse events were observed in the presented cases. No unexpected pigmentary worsening was noted during routine follow-up. Conclusion: Acne scar treatment in PIH-prone Asian skin should focus on controlled dermal remodeling rather than aggressive surface injury. ElaDerm’s combination of vacuum-assisted depth targeting and epidermal cooling may help improve the reproducibility of needle RF delivery while reducing unnecessary epidermal burden. This platform can be positioned as a practical dermal remodeling option for mild-to-moderate rolling scars, shallow boxcar scars, enlarged pores, and combination scar treatment strategies.