Atrophic Acne Scars Management: A Systematic Review | ||||
| Benha Medical Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 16 August 2025 PDF (710.53 K) | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/bmfj.2025.397409.2493 | ||||
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| Authors | ||||
Eman M. K. Sanad1; Nader N. Nazmy2; Dina H Mohammed  2
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| 1Dermatology Department, Faculty of Medicine, Benha University, Benha, Egypt. | ||||
| 2Dermatology, Venereology and Andrology Department, Faculty of Medicine, Benha University, Benha, Egypt. | ||||
| Abstract | ||||
| Atrophic acne scars, including ice-pick, boxcar, and rolling types, are long-term consequences of inflammatory acne and can lead to substantial psychological distress. This systematic review aimed to assess the efficacy and safety of current therapeutic modalities for treating atrophic acne scars. A comprehensive literature search was conducted in PubMed, Scopus, and Cochrane databases from January 2000 to April 2025, adhering to PRISMA guidelines. Randomized controlled trials and comparative studies were included, with two reviewers independently screening articles and extracting data on interventions, outcomes, and adverse effects. Risk of bias was assessed using Cochrane methodology. Of the 554 records screened, 42 studies met inclusion criteria. Microneedling, particularly when combined with platelet-rich plasma (PRP), demonstrated consistent improvement in scar appearance with minimal adverse effects. Fractional CO₂ laser, especially when used alongside PRP or subcision, was effective for rolling and boxcar scars. Other modalities such as radiofrequency microneedling, chemical peels (e.g., TCA-CROSS), subcision, and dermal fillers also showed benefit, especially when applied in combination. Most reported side effects were mild and transient. Overall, multimodal, individualized treatment approaches based on scar type and severity appear to offer the most favorable outcomes. Treatments like microneedling, PRP, and fractional CO₂ laser have the strongest supporting evidence, but future high-quality RCTs with standardized endpoints and longer follow-up periods are needed. | ||||
| Keywords | ||||
| Acne Scars; Microneedling; Platelet-Rich Plasma; Fractional CO₂ Laser; Subcision | ||||
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