title: Acne Scar Treatment: A Multimodality Approach Tailored to Scar Type.
abstract: BACKGROUND
  Acne scarring can be classified into atrophic icepick, boxcar, and rolling scars in addition to keloidal and hypertrophic scars. Additionally, these scars can be erythematous, hyperpigmented, and/or hypopigmented. Each scar type has a different structural cause warranting a customized approach. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices.
  
  
  METHODS
  A Medline search was performed on combination treatments because it relates to facial acne scarring, and results are summarized. Practical applications for these combinations of procedures are also discussed.
  
  
  RESULTS
  Studies examining the efficacy and safety of ablative, nonablative, fractionated, and nonfractionated lasers, dermabrasion, chemical peels, needling, subcision, radiofrequency, stem cell therapy, fat transplantation, platelet-rich plasma, and hyaluronic acid dermal fillers for acne scars were found. The authors review their experience in combining these techniques.
  
  
  CONCLUSIONS
  Review of the literature revealed multiple single options for facial acne scarring treatment with minimal evidence in the literature found on the safety and efficacy of combining such procedures and devices. The authors' experience is that combining acne scar treatment techniques can be performed safely and synergistically with optimal patient outcomes.
authors.affiliation: *Cosmetic Laser Dermatology, San Diego, California; †Department of Dermatology, University of California, San Diego, California; ‡Gateway Aesthetic Institute & Laser Center, Salt Lake City, Utah.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Zaleski-Larsen
authors.forename: Sabrina G
authors.initials: SG
authors.lastname: Fabi
authors.forename: Timothy
authors.initials: T
authors.lastname: McGraw
authors.forename: Mark
authors.initials: M
authors.lastname: Taylor
mesh_terms: D000152:Acne Vulgaris / Q000150:complications*; D002615:Chemexfoliation; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D017439:Cicatrix, Hypertrophic / Q000628:therapy; D003131:Combined Modality Therapy; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D062325:Intense Pulsed Light Therapy; D007627:Keloid / Q000628:therapy; D053685:Laser Therapy; D009339:Needles; D010859:Pigmentation Disorders / Q000209:etiology / Q000628:therapy