Objectives: Knowing the different types of atrophic acne scars and hypertrophic scar, possible treatment options. Optimal combination protocol for best outcome.
Introduction: Acne is one of the most common skin diseases seen in dermatological practices all over the world. In colored populations, acne scars and pigmentary sequelae can affect more than 50% of the population.
Several kinds of atrophic acne scars have been noted: rolling scars, boxcar scars, and ice pick scars.
Hypertrophic scars could occurre over whole body area with different etiology such as burn, surgery, trauma etc.
Materials / method: Some deep atrophic acne scars with ice pick type or deep cox car type, or some scars with fibrotic band in deep dermis which exceeding the approachable depth of many fractional laser, would need deep penetration approach of strong precisely targeted fractional CO2 laser.
Another useful modality, the picosecond laser with focus lens can induce new collagen formation and is effective in Asian patients with acne scars, with a high safety profile even in dark skin types, and a high satisfaction rate.
Fractional Co2 laser is useful for hypertrophic scar treatment.
Results: The filler injection is one of the useful modality for atrophic scars. This approach is especially useful in volume loss due to superficial fatty layer destruction.
Subcision is one of the modality to treat atrophic acne scars, which is especially useful in treating rolling scars or deep box-car types scars.
Fractional CO2 laser in combination with laser assisted drug delivery(LAD) would have synergistic effect on the outcome and reduce the downtime.
Conclusion: In this session, I will present the combination of multiple modality , target multiple layers for comprehensive approach to atrophic acne scar treatment. And use lasers and LAD for better outcome of hypertrophic scar treatment.
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