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At least 19 recordsLinked to original sources
PubMed1999

Tretinoin-iontophoresis in atrophic acne scars.

BACKGROUND: Atrophic acne scars are a frequent problem after acne. Hitherto, mainly invasive treatment measures were possible. In a recent paper, we demonstrated the positive effects of iontophoresis with 0.025% tretinoin gel vs. estriol 0.03%. OBJECTIVE: In this further study, the recording of the clinical effects of iontophoresis with 0.025% tretinoin gel in atrophic acne scars was supplemented by immunohistochemistry investigations of collagen I and III, proliferation markers, and the estimation of epidermal thickness. METHODS: The treatment was performed twice weekly in 32 volunteer patients for a period of 3 months by application of the substance under a constant direct current of 3 mA for 20 min. Skin biopsies prior to and at the end of treatment were performed in 32 voluntary patients in order to investigate collagen I/III and proliferation markers by immunohistochemistry methods. RESULTS: Clinically, at the end of treatment, in 94% of patients a significant decrease in the scar depth was observed. Neither epidermal thickness nor proliferation markers revealed a significant increase at the end of treatment. Furthermore, collagen I and collagen III showed no common trend, as expressed statistically by a lack of significance. In some cases, increases in collagen III became evident at the end of treatment. CONCLUSIONS: Tretinoin-iontophoresis is an effective, noninvasive treatment of atrophic acne scars without causing disturbing side-effects.

Acne Vulgaris↗
PubMed2000

Biweekly serial glycolic acid peels vs. long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars.

BACKGROUND AND OBJECTIVE: Treatment of atrophic acne scars is difficult and generally unsatisfactory. Although many clinical studies have been performed to investigate the efficacy of glycolic acid in the treatment of acne vulgaris, to the best of our knowledge no placebo-controlled study has been carried out to ascertain the effect of glycolic acid on atrophic postacne scars. DESIGN: A single, blind, placebo-controlled, randomized comparative clinical study was conducted in 58 women with atrophic acne scars. The subjects were randomly divided into three study groups. Glycolic acid peels with 20%, 35%, 50%, and 70% concentrations were applied serially at 2-week intervals to 23 patients in Group A. Twenty patients in Group B used a 15% glycolic acid cream once or twice daily for a period of 24 weeks. The remaining 15 patients in Group C applied a placebo cream twice daily during the same period. RESULTS: The differences between the results in the different groups were statistically significant at week 24 (P<0.001). Home application of low-strength glycolic acid was better tolerated and had less side-effects than glycolic acid peels; however, repeated short-contact 70% glycolic acid peels provided superior results compared with the maintenance regimen (P<0.05), and apparently good responses were observed only in the peel group (P<0.01). CONCLUSIONS: Glycolic acid peeling is an effective modality for the treatment of atrophic acne scars, but repetitive peels (at least six times) with 70% concentration are necessary to obtain evident improvement. Long-term daily use of low-strength products may also have some useful effects on scars and may be recommended for patients who cannot tolerate the peeling procedure.

Acne Vulgaris↗
PubMed2004

Flattening of atrophic acne scars by using tretinoin by iontophoresis.

Atrophic scars are a frequent consequence of acne, with a negative esthetic and psychological influence. Treatment of atrophic acne scars includes different invasive methods. In our study, we used a noninvasive method with local application of 0.05% tretinoin gel by iontophoresis. In patients with a tendency towards exacerbation, we performed mild peeling with 5% trichloroacetic acid (TCA) solution 3-4 times during the treatment. Twenty-minute treatments were applied on 38 patients, 29 women and 9 men, during 3.5 months on average. Median age of patients was 21 years (range, 16-29). Clinical assessment included an assessment of scars, pore size, skin moisture, vascularization, and skin firmness and elasticity. As confirmed by photographs taken before and after therapy, the treatment proved to be clinically effective in decreasing acne scars and persistence of effects. Flattening of acne scars was observed in 79% of the patients. The results depended on duration of scars persistence as well as on a the type of scars. The best results were achieved with younger scars as well as with superficial and ice pick scars. Side effects involved a very mild retinoid dermatitis and more often acne exacerbation. The therapy was clinically effective and the patients accepted the treatment very easily. Local therapy of acne scars with tretinoin by iontophoresis can in some cases successfully replace invasive techniques, and could also be combined with those techniques.

Acne Vulgaris↗
PubMed1995

New treatment of atrophic acne scars by iontophoresis with estriol and tretinoin.

BACKGROUND: Common treatment of atrophic acne scars consists of invasive methods such as dermabrasion, chemopeeling, or implantation of bovine collagen. In our study a new noninvasive treatment method consisting of local iontophoresis is demonstrated. Local iontophoresis was performed with either estriol--a mainly topically active estrogen--or with tretinoin. PATIENTS AND METHODS: Eighteen women were treated with estriol iontophoresis twice weekly for a period of 3 months. In addition to photographic and clinical documentation of the skin, venous blood for determination of serum levels of prolactin and estradiol according to standard radioimmunoassay methods was obtained monthly. Tretinoin iontophoresis was performed according to the same time schedule in 28 patients (19 women and 9 men) with atrophic acne scars. RESULTS: Improvement of acne scars was observed in 93% of patients treated with tretinoin iontophoresis and in 100% of the group treated with estriol iontophoresis. No hormonal changes were noted in the estrogen group. Side effects involving the skin appeared in the tretinoin group in 4 cases and consisted of increased dryness and of retinoid dermatitis. CONCLUSION: Both treatments were shown to be clinically effective in decreasing acne scars and persistence of effects. This promising new therapeutic approach may thus replace invasive treatment methods in many patients.

Acne Vulgaris↗
PubMed2026

Comparison of a 755-nm picosecond laser and a 1565-nm nonablative fractional laser for the treatment of atrophic acne scars: a 20-week prospective, randomized, split-face clinical study.

To compare the efficacy and safety of a 755-nm picosecond laser with a diffractive lens array (P-DLA) and a 1565-nm nonablative fractional laser (NAFL) for the treatment of atrophic acne scars. Twenty-seven patients with atrophic acne scars underwent three sessions of randomized split-face treatment with P-DLA and NAFL at 4-week intervals. Patients were followed up at 1, 2, and 3 months after the final treatment. Efficacy was assessed using the &#xc9;chelle d'&#xc9;valuation Clinique des Cicatrices d'Acn&#xe9; (ECCA) grading scale, the Investigator's Global Assessment (IGA) score, patients' self-rated improvement, and overall satisfaction. Treatment-related adverse reactions were recorded daily by patients until resolution. Both modalities demonstrated significant improvements in scar appearance based on ECCA score, IGA score, and patients' self-rated improvement (P&#x2009;<&#x2009;0.001). No statistically significant differences in efficacy were observed between the two treatments. However, the P-DLA group showed higher patient satisfaction (P&#x2009;=&#x2009;0.035) and a more favorable safety profile, including shorter durations of erythema and edema and the absence of crusting. Both P-DLA and NAFL were effective and safe for the treatment of atrophic acne scars, with similar efficacy. P-DLA offered better tolerability.

Humans↗
PubMed2004

Nonablative 1450-nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study.

BACKGROUND: There is presently little published data on the clinical effectiveness of nonablative lasers in the treatment of atrophic acne scars and the safety of their use in patients with darker skin types. OBJECTIVE: This study aims to determine the clinical effectiveness and safety of the nonablative 1450 nm diode laser with cryogen cooling spray in the treatment of facial atrophic acne scars in Type IV-V Asian skin. METHODS: This is a prospective non-comparative open study. 4 to 6 laser treatment sessions were performed on patients with atrophic acne scars. Final clinical assessment was performed 6 months after the last treatment. RESULTS: 57 patients were evaluated. Patient's self-assessment of scar improvement as compared with doctor's assessment was as follows: patients who completed 4 treatments (15.7% vs 6.6%), patients who completed 5 treatments (20% vs 7.9%) and patients those who completed 6 treatments (17.3% vs 5.0%). Main side effects were mild to moderate pain during the procedure, transient erythema, and hyperpigmentation which occurred in 39% of treated patients. CONCLUSION: The nonablative 1450 nm diode laser may be effective in achieving mild to moderate gradual clinical improvement in the treatment of facial atrophic acne scars. The procedure is associated with minimal downtime and is safe for use in darker skin types IV and V.

Acne Vulgaris↗
PubMed2004

Use of 1,320 nm Nd:YAG laser for wrinkle reduction and the treatment of atrophic acne scarring in Asians.

BACKGROUND AND OBJECTIVES: The role of 1,320 Nd:YAG in non-ablative skin rejuvenation in Asians is has not been established. Furthermore, no study has investigated the effectiveness of 1,320 Nd:YAG laser in the treatment of atrophic scarring in Asians. The objective of our study was to investigate the effectiveness of 1,320 Nd:YAG laser in wrinkle reduction and the treatment of atrophic acne scarring in Asians. STUDY DESIGN/MATERIALS AND METHODS: Twenty-seven female patients were included in the study: seven were treated for acne scarring and the others for wrinkle reduction. A 1,320 nm Nd:YAG laser (Cooltouch II, Roseville, CA) was used to treat both the cheeks and forehead for the patients with wrinkles, and both cheeks only for patients with atrophic acne scarring. All patients received treatment in the post-auricular areas. A spot size of 10 mm was used, and three passes were performed (two pre-cooling and one post-cooling). Patients were treated monthly for 6 months. All patients were subjectively assessed before and after their last treatment sessions using a structured questionnaire, and objectively assessed by the use of clinical photographs for by independent observers. A cutometer was used to assess viscoelasticity, and biopsies were taken at the post-auricular site for assessment by a pathologist. RESULTS: The overall degree of patients' satisfaction was rated as 4.9 (range 0-9.8) for wrinkle reduction and 4 (range 0-10) for acne scarring. In terms of objective assessment by independent observers, the degree of improvement was considered to be mild or no change in most cases. The independent pathologist who assessed the degree of improvement in terms of increased collagen production detected no change in 8 patients, mild improvement in 9, and moderate improvement in 10. There was also improvement in term of epidermal thickness in 13 cases. Assessment by viscoelasticity indicated a significant degree of improvement in most parameters in both groups of patients. Blistering occurred in five cases, all in the central facial areas, and post-inflammatory hyperpigmentation occurred in three cases. All cases of PIH resolved after the use of 4% hydroquinoine. There was no scarring or hypopigmentation. CONCLUSIONS: The 1,320 nm Nd:YAG laser is effective for wrinkle reduction and atrophic acne scar improvement, but to further enhance the clinical outcome a combination approach with another device such as IPL and a surgical technique such as subcision is necessary.

Acne Vulgaris↗
PubMed2005

Improvement of atrophic acne scars with a 1,320 nm Nd:YAG laser: retrospective study.

BACKGROUND: Facial acne scarring has been treated with multiple methods with varying degrees of improvement. Although the 1,320 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has been widely used to improve photoaging, studies analyzing its effects on atrophic acne scarring are limited. OBJECTIVE: To evaluate the efficacy of a dynamic cryogen-cooled 1,320 nm Nd:YAG laser for the treatment of atrophic facial acne scars in a larger cohort of patients with long-term follow-up. METHODS: Twenty-nine patients (skin phototypes I-IV) with facial acne scarring received a mean of 5.5 (range 2-17) treatments with a 1,320 nm Nd:YAG laser. Objective physician assessment scores of improvement were determined by side-by-side comparison of preoperative and postoperative photographs at a range of 1 to 27 months (mean 10.4 months) postoperatively. Subjective patient self-assessment scores of improvement were also obtained. RESULTS: Acne scarring was significantly improved by both physician and patient assessment scores. Mean improvement was 2.8 (p < .05) on a 0- to 4-point scale by physician assessment and 5.4 (p < .05) on a 0- to 10-point scale by patient assessment. No significant complications were observed. CONCLUSIONS: Nonablative laser skin resurfacing with a 1,320 nm Nd:YAG laser can effectively improve the appearance of facial acne scars with minimal adverse sequelae.

Acne Vulgaris↗
PubMed1999

Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars.

BACKGROUND: The recent development of high-energy pulsed CO2 lasers that minimize thermal injury to uninvolved adjacent structures has revolutionized the manner in which atrophic facial scars are recontoured. Significant improvement of atrophic scars with laser resurfacing has clearly been demonstrated; however, the exact timing for assessment of skin for further treatment has varied due to the unknown amount of time needed after laser scar resurfacing to effect maximal collagen formation and remodeling. OBJECTIVE: The aim of this study was to determine the immediate and long-term (12-18 months) histologic and clinical effects of atrophic acne scars after CO2 laser resurfacing in order to provide physician guidelines for postoperative clinical assessment for retreatment. METHODS: Sixty patients (50 women, 10 men, mean age 38 years, skin types I-V) with moderate to severe atrophic facial scars were evaluated. Nineteen patients received regional cheek treatment and 41 patients received full-face resurfacing with a high-energy pulsed CO2 laser. Independent clinical assessments of treated scars were performed at 1, 6, 12, and 18 months and blinded histologic analyses were made of skin biopsies immediately prior to and after laser resurfacing, and at 1, 6, 12, and 18 months postoperatively in six patients. RESULTS: Significant immediate and prolonged clinical improvement in skin tone, texture, and appearance of CO2 laser-irradiated scars was seen in all patients. Average clinical improvement scores were 2.22 (69%) at 1 month, 2.1 (67%) at 6 months, 2.37 (73%) at 12 months, and 2.5 (75%) at 18 months. Continued collagenesis and subsequent dermal remodeling were observed on histologic examination of biopsied tissue up to 18 months after surgery. CONCLUSION: Continued clinical improvement was observed as long as 18 months after CO2 laser resurfacing of atrophic scars, with an 11% increase in improvement observed between 6 and 18 months postoperatively. We propose that a longer postoperative interval (12-18 months) prior to assessment for re-treatment be advocated in order to permit optimal tissue recovery and an opportunity for collagen remodeling.

Acne Vulgaris↗
PubMed1996

Resurfacing of atrophic facial acne scars with a high-energy, pulsed carbon dioxide laser.

BACKGROUND: Treatment of atrophic acne scars has been limited to the use of such traditional treatments as dermabrasion and chemical peels for many years. Recently, the addition of high-energy, pulsed carbon dioxide (CO2) lasers to the treatment armentarium has created renewed enthusiasm for cutaneous resurfacing due to their ability to create specific thermal injury with limited side effects. OBJECTIVE: To determine the effectiveness of a high-energy, pulsed CO2 laser in eliminating atrophic facial scars and to observe for side effects. METHODS: Fifty patients with skin phototypes I-V and moderate to severe atrophic facial acne scars were included in the study. Each patient received one high-energy, pulsed CO2 laser treatment using identical laser parameters by the same experienced laser surgeon. Baseline and 1-, 4-, 8-, 12-, and 24-week postoperative photographs and clinical assessments were obtained in all patients. Textural analysis of skin before and after laser irradiation were obtained in 10 patients to confirm clinical impressions. Clinical evaluations were conducted independently by two blinded assessors. RESULTS: There was an 81.4% average clinical improvement observed in acne scars following laser treatment. Skin texture measurements of laser-irradiated scars were comparable to those obtained in normal adjacent skin. Side effects were limited to transient hyperpigmentation lasting an average of 3 months in 36% of patients. Prolonged erythema (2 months average) was usual and considered to be a normal healing response. No hypertrophic scarring was observed following laser treatment. CONCLUSION: High-energy, pulsed CO2 laser treatment can safely and effectively improve or even eliminate atrophic facial scars and provides many benefits over traditional treatment methods.

Acne Vulgaris↗
PubMed2004

Treatment of atrophic facial acne scars with the 1064-nm Q-switched Nd:YAG laser: six-month follow-up study.

OBJECTIVES: To quantitatively assess improvement in acne scarring after a series of nonablative laser treatments and to determine efficacy at 1-, 3-, and 6-month follow-up after treatment. DESIGN: Before-after trial of consecutively selected patients. SETTING: Private practice at the Laser and Skin Surgery Center of New York, New York. PATIENTS: Eleven patients with mild to moderate atrophic acne scarring were treated. INTERVENTIONS: A 3-dimensional optical profiling imaging system was used to assess skin topography before, during, and after treatment. Patients were treated with a 1064-nm Q-switched Nd:YAG laser and reassessed after 3 treatment sessions and at 1, 3, and 6 months after the fifth treatment session. MAIN OUTCOME MEASURES: The skin roughness analysis was quantified at baseline and at each follow-up interval. Pain, erythema, and petechiae formation were assessed on 3-point scales. RESULTS: At midtreatment (1 month after the third treatment session), an 8.9% improvement in roughness analysis was seen. This improvement increased to 23.3%, 31.6%, and 39.2% at 1, 3, and 6 months after the fifth treatment, respectively. Patients reported mild to moderate pain with treatment. The only adverse effects noted were transient erythema and mild pinpoint petechiae. CONCLUSIONS: Treatment with the nonablative 1064-nm Q-switched Nd:YAG laser results in significant quantitative improvements in skin topography in patients with mild to moderate atrophic acne scars. Continued incremental improvements were noted at 1-, 3-, and 6-month follow-up, indicating ongoing dermal collagen remodeling after the treatment.

Acne Vulgaris↗
PubMed2002

Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method.

BACKGROUND: Acne scarring is a common complication of acne and yet no appropriate and effective single treatment modality has been developed. We suggest a technique consisting of the focal application of higher trichloroacetic acid (TCA) concentrations by pressing hard on the entire depressed area of atrophic acne scars. This technique is called chemical reconstruction of skin scars (CROSS) by the authors. OBJECTIVE: To evaluate the clinical effects of CROSS on atrophic acne scars in dark-complexioned patients. METHODS: An analysis was conducted of 65 patients with atrophic acne scars who were treated with CROSS in our hospitals between July 1996 and July 2001. Thirty-three patients were treated with 65% TCA CROSS and 32 patients were treated with 100% TCA CROSS. All patients had Fitzpatrick skin types IV-V. RESULTS: Patient treatment data indicated that 27 of 33 patients (82%) (the 65% TCA group) and 30 of 32 patients (94%) (the 100% TCA group) experienced a good clinical response. All patients in the 100% TCA group who received five or six courses of treatment showed excellent results. Good satisfaction rates in the 65% and 100% TCA groups were recorded. There were no cases of significant complication. CONCLUSION: CROSS is a safe and very effective single modality for the treatment of atrophic acne scars with no significant complications.

Acne Vulgaris↗
PubMed2002

Treatment of atrophic facial acne scars with a dual-mode Er:YAG laser.

BACKGROUND: Scar revision with CO2 and Er:YAG lasers has become popular in recent years. Reports on the newest (modulated, dual-mode) Er:YAG systems have been limited mostly to the treatment of photodamaged skin and rhytides. OBJECTIVE: To prospectively evaluate the efficacy and safety of a dual-mode 2940 nm Er:YAG laser for atrophic scar revision. METHODS: Twenty-five consecutive patients with moderate to severe atrophic facial acne scars received treatment with a dual-mode Er:YAG laser. Clinical assessments using a standard grading scale and photographic documentation were performed at 1, 3, 6, and 12 months postoperatively. Postoperative recovery was monitored and the rate of side effects and complications recorded. RESULTS: Average clinical grading scores reflected good to excellent response of atrophic scars to the dual-mode Er:YAG laser system. Side effects and complications were limited to transient hyperpigmentation and acne flare-ups. No hypopigmentation or scarring was seen. Prolonged erythema (longer than 1 month) was observed in 1 patient (4%). CONCLUSION: Dual-mode Er:YAG laser skin resurfacing is a safe and effective modality for the treatment of atrophic facial scarring.

Acne Vulgaris↗
PubMed2003

Atrophic and a mixed pattern of acne scars improved with a 1320-nm Nd:YAG laser.

BACKGROUND: Acne scar correction remains a challenge to the dermatologic surgeon. With nonablative laser resurfacing, this correction is imputed to dermal collagen remodeling and acne scar reorganization. Although atrophic acne scars tend to respond to laser treatment, the deeper ice pick and boxcar scars tend to be laser resistant. OBJECTIVE: To investigate the treatment of atrophic and a mixed pattern of facial acne scars, we evaluated a 1320-nm Nd:YAG laser. Twelve subjects with atrophic facial acne scars (N=6) or a combination of atrophic and pitted, sclerotic, or boxcar scars (N=6) received three laser treatments. Physician and patient acne scar ratings were performed at baseline and at 6 months after the last treatment. Acne scars were rated with a 10-point severity scale. RESULTS: Mean acne scar improvement was 1.5 points on physician assessments (P=0.002) and 2.2 points on patient assessments (P=0.01). Acne scars were rated more severely by patients than by the physician at all intervals. There were no noted complications at 6 months. CONCLUSION: The 1320-nm Nd:YAG laser is a safe and effective nonablative modality for the improvement of atrophic and a mixed pattern of facial acne scars.

Acne Vulgaris↗
PubMed2000

Postacne scarring: a review of its pathophysiology and treatment.

BACKGROUND: There has been a largely unheralded revolution in the number of techniques that can now be used in the treatment of atrophic postacne scarring. Atrophic scarring is the more common type of scarring encountered after acne. OBJECTIVE: To illustrate the range of techniques useful in the therapy of postacne scarring, their relative advantages and disadvantages, and their place in treatment. METHOD: A review of available techniques is used to illustrate the treatment of indented or atrophic acne scars. RESULTS: The individual architecture of the indented scar must be assessed so that treatment may be designed to maximize its improvement. A variety of new methods now exist, including newer resurfacing tools such as infrared lasers, dermasanding, and others in their infancy such as nonablative resurfacing and radiofrequency methods. A true explosion in autologous and nonautologous tissue augmentation and the advent of tissue undermining and the use of punch replacement techniques has added more precision and efficacy to the treatment of these scars. CONCLUSION: Atrophic postacne scars may be satisfactorily treated in many patients, but multiple methods are often required to ensure the best results.

Acne Vulgaris↗
PubMed2001

Blood transfer: the use of autologous blood as a chromophore and tissue augmentation agent.

BACKGROUND: Atrophic scars, whether traumatic, postsurgical, or postacne, are distressing and difficult to treat. A freely available autologous agent that provides medium- to long-term correction of this problem would be welcome. There are very few endogenous chromophores in the skin for laser or light energy to target. A benign exogenous pigment implanted in superficial scars may be useful in presenting such a target for light energy, allowing selective injury to these scars and the possibility of new collagen formation. OBJECTIVE: To report five representative case reports that describe elements of two new techniques that may be useful in the management of atrophic acne scarring. METHODS: After drawing blood from the patient, this was immediately reinjected into premarked areas of atrophic scars. If there was substantial tissue deficit, this was either followed by repeated injections of whole blood at monthly intervals on three occasions or until adequate correction was attained and oral antifibrinolysis medication dispensed in addition to the blood transfer (hematogenous augmentation of tissue or the HAT technique). In the other circumstance, where the deficit was superficial, blood was implanted high in the tissue and used as a target for vascular laser or intense pulsed light in a technique termed the blood augmentation (with or without) stimulation of tissues by irradiation with light or laser energy or the Bastille technique. This is again repeated as required. RESULTS: Reasonable short- to medium-term correction has been attained in all five cases and there seemed to be a progressive improvement with each injection session. With the Bastille technique case there seemed to be progressive improvement with time, with the result at 4 weeks being substantially better than that at 2 weeks or at baseline. CONCLUSION: These case reports suggest that blood may be a worthwhile augmentation agent and chromophore. Both these techniques deserve further investigation to determine the optimum parameters. They are so simple in their concept and technique that should they help to provide a medium- to long-term correction for atrophic scars and other depressions, such as expression lines and wrinkles, they would be worthwhile additions to existing dermatologic techniques.

Acne Vulgaris↗
PubMed2006

Histologic study of depressed acne scars treated with serial high-concentration (95%) trichloroacetic acid.

BACKGROUND: Acne scarring is a common manifestation that remains a therapeutic challenge to dermatologists, dermatologic surgeons, and plastic surgeons. Although multiple therapeutic modalities exist, treatment often remains inadequate. The use of high-concentration (95%) trichloroacetic acid (TCA) applied focally to atrophic acne scars has been described. OBJECTIVE: The current study confirms the utility of focal application of 95% TCA to acne scars in addition to a histologic examination of this technique. METHODS: Acne scars in three patients were treated with focal 95% TCA by serial application. Wooden applicators were used to apply TCA focally and repeated at 6-week intervals for a total of six treatments. Punch biopsies were performed at baseline and at 1 year postoperatively. Histologic examination was performed with routine hematoxylin/eosin, Masson trichrome, and Verhoeff-van Gieson staining. RESULTS: Clinical examination revealed apparent cosmetic improvement in both depth and appearance of acne scars. Patient satisfaction was high. Histologic examination demonstrated a decrease in the depth of acne scars. In addition, increased collagen fibers and fragmentation of elastic fibers were noted. There were no complications from the procedure. CONCLUSION: Focal application of high-concentration TCA to atrophic and "ice-pick" acne scars appears to produce clinical improvement. Histologic changes of this technique are described.

Acne Vulgaris↗