Management of post-acne scars in Asians - need for a paradigm shift? 

Facial acne scars can cause physical, emotional distress and affects quality of life. The treatment of acne scars depend on the types of scars present. Very often a combination of treatments modalities are used to achieve optimal outcome. Currently, fractional laser (non-ablative and ablative) resurfacing is the gold standard for acne scar treatment. It is considered fairly effective and has few side effects. However it requires multiple treatments to achieve acceptable outcomes. Recently fractionated radiofrequency ‘sublative’ rejuvenation’ has been introduced and reported to improve acne scars, mild rhytids, skin texture and skin tightening with minimal downtime.
We share our experience in a retrospective study of 107 patients who were treated with an ablative CO2 fractional laser for their post-acne scars. Two hundred and ten fractional CO2 laser treatments for facial acne scars were performed on 107 patients (65 males and 42 females, Fitzpatrick skin types II- V). Post-inflammatory hyperpigmentation was the most common adverse effect observed in 6.4% of patients. 70.0% of patients expressed >25% satisfaction in treatment outcome. Mean clinical improvement score, based on the clinical photography assessment, was 1.3 (quartile grading scale). Overall the improved of scars appears limited.
There is a need for a paradigm shift for more aggressive treatment and prevention of scar formation in the management of patients with active vulgaris. This will probably the best way to prevent acne scar from developing.

Cl. Prof. Chee-Leok Goh

National Skin Centre, Singapore