摘要

Objectives: A lot of modalities can be used while treating acne scars. It is important to choose a single mono treatment or a combination and to determine its sequence according to the type, severity and location of acne scar. In my presentation I describe methods of diagnosing, followed by constituting a treatment plan utilizing a combination of different types of subcision and energy based devices (lasers and RF) Introduction: Atrophic acne scars are a very common condition which leads to insecurity and difficulties in communication. The distribution and types of acne scars are unique in each face. Their visualization is different under various sources of light. During the consultation it is important to simulate the worst possible light to mark the areas of skin depression of rolling scars and to consider the treatment plan and modalities to achieve the best possible result. Depending on the severity and predominant acne type the decision to use one modality or combination is made. Materials / method: After taking the patient’s history I mark the areas of depression using either polarized light source or phone’s flash positioned above patient’s face. Once the areas of depression are marked the decision on what type of subcision is preferable is made. I use both cannula (with or without filler) and also pneumatic jet remodeling with HA. Cannula with calcium hydroxyapatite is preferable for larger volume loss on the cheek area. While jet remodeling is the best solution for temples. My next step is energy based devices. I use full field, fractional erbium laser or RF. Results: It is extremely important to take photos and use other diagnostic devices on each step of the acne treatment road (before, after the first step, final). The percentage of overall improvement depends on the severity of acne scars and the modality used. The first result is evident on the 2 months mark after the subcision- the time it takes for skin remodeling. The final result takes from 2 to 6 months depending on the used modality. Every patient notes the improvement from 30 up to 70% . All patients have better quality of life and higher self esteem. Conclusion: It is known that acne scarring can cause depression, lower quality of life, make patients feel embarrassed and less self confident. Treating acne patients with multi modal approach is very gratifying. They no longer need to hide or cover their faces. Are more confident under different sources of light, can make selfies in the elevators.