摘要

Objectives: To report a case of papular inflammatory reaction with tram-track scarring and PIH following Micro Needling radiofrequency (MNRF)and to evaluate the effectiveness of a multimodal management strategy Introduction: MNRF is a widely used minimally invasive procedure for acne scars and skin rejuvenation with a favorable safety profile. However, rare adverse effects such as inflammatory papular reactions, patterned (tram-track) scarring, and post-inflammatory hyperpigmentation (PIH) may occur. Due to the absence of standardized management protocols, individualized, multimodal treatment approaches are often required Materials / method: A 44-year-old female developed erythematous papules, tram-track scars, and diffuse PIH after MNRF at an external center. A stepwise treatment approach was initiated, including serial chemical peels, Q-switched laser sessions, and mesotherapy with Platelet-Rich Plasma (PRP). Adjunctive topical therapy with barrier repair and depigmenting agents was prescribed. Treatment was continued over 8 months with regular follow-up Results: Progressive clinical improvement was observed over the treatment period. There was gradual resolution of inflammatory papules, softening of tram-track scars, and significant reduction in pigmentation. By the end of 8 months, near-complete resolution was achieved without recurrence or long-term sequelae. The combination therapy was well tolerated throughout the treatment course. Conclusion: Adverse effects following MNRF, though uncommon, can be distressing. Early recognition and a tailored, multimodal treatment approach can lead to excellent outcomes. This case highlights the importance of individualized management strategies and provides practical insight into treating such complications in the absence of standardized guidelines