title: Treatment of acne scarring.
abstract: BACKGROUND
  Post-acne scarring remains a common entity despite advances in the treatment of acne. This represents limitations in our quality of therapy and a failure of public education. The level of severe scarring remains as much an ongoing challenge to prevent as well as manage.
  
  
  METHODS
  This review will concentrate on the methods by which acne scarring may be improved and the available evidence for their utility. It will also rely on a grading scale of disease burden to classify patients and their ideal therapy. New therapies allowing treatment of scarring in areas other than the face will also be highlighted.
  
  
  RESULTS
  Tabulated treatment planning will present algorithms summarizing best practice in the treatment of post-acne scarring.
  
  
  CONCLUSIONS
  Post-acne scarring is being better managed. Grade 1 scars with flat red, white, or brown marks are best treated with topical therapies, fractionated and pigment or vascular-specific lasers and, occasionally, pigment transfer techniques. Grade 2 mild scarring as seen primarily in the mirror is now the territory of non-ablative fractionated and non-fractionated lasers as well as skin rolling techniques. Grade 3 scarring, visible at conversational distance but distensible, is best managed by traditional resurfacing techniques or with fractional non-ablative or ablative devices, sometimes including preparatory surgical procedures. Grade 4 scarring, where the scarring is at its most severe and non-distensible, is most in need of a combined approach.
authors.affiliation: Department of General Practice, Monash University, South Yarra, Victoria, Australia. gg@div.net.au
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Goodman
mesh_terms: D000153:Acne Keloid / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D002921:Cicatrix / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D005151:Facial Injuries / Q000628:therapy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D010817:Physician-Patient Relations; D019651:Plastic Surgery Procedures / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome