Resumen

Objectives: Investigate the currently available acne scars treatment modalities in case of patients with active acne including severe cases of acne and acne scars. Introduction: Acne scars are a widely prevalent complication that can greatly impact patient quality of life. While treatment modalities for acne scarring are now well defined including energy based devices (EBD), chemical and surgical procedures, data regarding treatment options in case of active acne are lacking. Materials / method: - 20 challenging personal cases of acne scars in active acne patients managed with single and combined treatments are dissected in order to discuss the trickiest situations practitionners may encounter when managing acne scarring including cases under active acne treatment. - Results of a case series of 18 patients with active acne presenting moderate atrophic acne scars and pigmented scars are discussed. - Preliminary results from a split face study conducted in our center using 2 sessions of 585nm to treat red acne scars in patients with active acne under isotretinoin course. Results: Results from our experience in managing acne scarring in patients with active acne consolidated with available data in the literature are discussed to provide a clearer understanding of the following issues : what are the possible options in case of active acne ? Which EBD’s are effective and safe in this subgroup ? can we combine treatments ? Which scars are best to be targeted ? What about dark skin patients ? how to combine acne treatments (topical and oral) with those different options and what possibilities in case of patients under isotretinoin ? Conclusion: Majority of patients with active acne and practitionners treating them delay acne scars treatment leading to increased risk of scarring. Early management of acne scars is an established evidence based paradigm. Patients with active acne should not be deviated from this principle.