Postacne scars: keloids & atrophy. How to manage?

Objetivos: To evaluate the clinical characteristics, pathophysiology, and current management strategies for post-acne scarring, with a focus on atrophic and keloid scar types. Introducción: Post-acne scarring is a common sequela of inflammatory acne and can result in significant cosmetic and psychological burden. Scars are broadly classified into atrophic and hypertrophic/keloid types, reflecting different underlying mechanisms of wound healing. Atrophic scars, including ice-pick, boxcar, and rolling scars, result from collagen loss, whereas keloids arise from excessive collagen deposition and aberrant fibroblast activity. The diversity of scar types necessitates individualized treatment approaches. Materiales / método: 35 patients Laser resurfacing Ipl Filler injections Separations Steroid intralesion injections Resultados: Atrophic scars were effectively managed with modalities aimed at stimulating collagen production and dermal remodeling, including microneedling, chemical peels, laser resurfacing, and dermal fillers. Keloid scars responded best to treatments targeting fibroblast proliferation and collagen synthesis, such as intralesional corticosteroids, Botulinum Toxin A (BoNT-A), silicone-based therapies, and energy-based devices. Combination therapies demonstrated superior outcomes compared to monotherapy in both scar types. Treatment response varied depending on scar severity, duration, and patient-specifi Conclusión: Post-acne scars present a therapeutic challenge due to their heterogeneity. A tailored, multimodal approach based on scar type—atrophic or keloid—yields the most effective outcomes. Early intervention and individualized treatment planning are critical to improving both aesthetic results and patient quality of life. Further research is warranted to optimize treatment protocols and long-term outcomes.