Laser and Energy Treatments for Acne Scarring: A Review of Clinical Trials

December 2024 | Volume 23 | Issue 12 | 1058 | Copyright © December 2024


Published online November 30, 2024

doi:10.36849/JDD.8195

Rachel L. Ziebart BSNa, Luis A. Antezana MDb, Olivia M. Crum MDc, Magnus Lynch MDd, Saranya P. Wyles MD PhDc

aMayo Clinic Alix School of Medicine, Rochester, MN
bMayo Clinic Division of Plastic and Reconstructive Surgery, Rochester, MN
cMayo Clinic Department of Dermatology, Rochester, MN
dKings College Department of Dermatology, London, England

Abstract
Background: Acne scarring can have a detrimental impact on quality of life, making early and effective treatment essential. Lasers and energy-based treatment are the preferred treatment modality, yet a clear consensus on the ideal laser selection is lacking in the literature.
Aims: This review article aims to describe the therapeutic potential of lasers for acne scarring with a focus on clinical trials involving atrophic facial acne scars.
Methods: A search was conducted in PubMed with keywords such as "acne scars", "laser resurfacing", "fractional laser", "nonfractional laser", "ablative laser", "nonablative laser", with attention to clinical trials completed between 2018 to 2022; results were summarized in narrative format.
Results: Improvement in acne scarring is seen from a variety of lasers, with ablative lasers offering the most significant improvement combined with a longer downtime as compared to nonablative lasers. Laser treatment can be combined with a variety of other therapies, including platelet-rich plasma, to increase efficacy. The choice of laser is highly individualized and relies on shared decision-making between the patient and physician.
Conclusion: This study presents an overview of clinical trials in laser treatment for acne scarring between 2018 through 2022. Overall, ablative lasers offered the most significant improvement in acne scars. Laser selection is a patient-centered process that requires attention to the type of scarring present, the patient's goals, and the advantages and disadvantages unique to each laser.

J Drugs Dermatol. 2024;23(12):1058-1062. doi:10.36849/JDD.8195

INTRODUCTION

Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit that can lead to permanent scarring, leaving the face disfigured and negatively impacting one’s quality of life.1 Acne-related scarring has been associated with higher rates of mental distress and suicidal ideation,2 making the treatment of acne scars a priority for clinicians.

Traditional classification of atrophic acne scars includes 3 main types: (1) ice pick, (2) boxcar, and (3) rolling,1 as illustrated in Figure 1. Treatment options for acne scarring vary based on depth and extent of involvement and can include laser resurfacing, microneedling, chemical peel, dermal fillers, subcision, and punch excision, among others.1 Research is lacking on the selection of the best laser or energy-based device for the treatment of atrophic acne scars.3 This study aims to synthesize the results of clinical trials from 2018 to 2022 into an up-to-date narrative review of laser and energy-based devices for atrophic acne scars.

MATERIALS AND METHODS

A search of clinical trials published between the years 2018 to 2022 was conducted in PubMed with the following keywords, "atrophic acne scars", "acne scars", "ablative laser", "nonablative
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