Acne Scarring Treatment: Energy Based Techniques

Acne scarring is one of the most common negative side effects of acne, caused by the uneven formation and deposition of collagen around the inflamed follicles. The scarring creates a negative impact on an individual's quality of life. It is often associated with anxiety, depression, low self-esteem, and even poor academic performance. Over recent time periods, medical interventions have evolved to successfully decrease the visibility of scars. The types of medical treatment for acne scarring have been grouped into two broad categories: energy-based and non-energy based techniques.

Energy-based techniques, such as lasers and radiofrequency devices, are discussed in further detail below.

Lasers are the most common method of energy-based techniques and can be further classified into ablative, fractional ablative, and non-ablative. In the past, the ablative laser method was widely used due to its high success rate after just one session. The procedure included the removal of the epidermis and partial dermis layers on the affected skin area, leading to remodeling and neocollagenesis. The accepted gold standard of laser resurfacing is CO2 fractional laser ablation, which has scientific evidence supporting this type of resurfacing.

In recent years, other alternatives such as radiofrequency devices have also become available.

Radiofrequency (RF) devices employ the technique of passing electrical current through the skin between electrode-pin rows, which generates deep dermal heating. As a result, a controlled injury of the skin is induced, causing a natural healing process and stimulating dermal collagen remodeling.

Microneedling radiofrequency (MRF) devices employ multiple needles that deliver RF energy directly into the dermis layer. The needles are insulated, which removes the risk of potential electrothermal damage. Additionally, this is the only technique that enables control of depth levels by needles, allowing discrete electrothermal coagulation to be performed at different levels of the dermis.