Energy-based devices for the treatment of Acne Scars: 2022 International consensus recommendations.


Journal

Lasers in surgery and medicine
ISSN: 1096-9101
Titre abrégé: Lasers Surg Med
Pays: United States
ID NLM: 8007168

Informations de publication

Date de publication:
01 2022
Historique:
received: 24 09 2021
accepted: 03 10 2021
pubmed: 1 11 2021
medline: 28 1 2022
entrez: 31 10 2021
Statut: ppublish

Résumé

Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.

Sections du résumé

BACKGROUND AND OBJECTIVES
Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs.
STUDY DESIGN/MATERIALS AND METHODS
An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence.
RESULTS
The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome.
CONCLUSION
Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.

Identifiants

pubmed: 34719045
doi: 10.1002/lsm.23484
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

10-26

Informations de copyright

© 2021 Wiley Periodicals LLC.

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Auteurs

Fares Salameh (F)

Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Peter R Shumaker (PR)

VA San Diego Healthcare System and University of California, San Diego, California, USA.

Greg J Goodman (GJ)

Department of General Practice, Monash University, Clayton, Victoria, Australia.

Leah K Spring (LK)

Micrographic Surgery and Surgical Oncology, SkinCare Physicians, Chestnut Hill, Massachusetts, USA.

Meghan Seago (M)

VA San Diego Healthcare System and University of California, San Diego, California, USA.
Micrographic Surgery and Surgical Oncology, Scripps Clinic, La Jolla, California, USA.

Murad Alam (M)

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Firas Al-Niaimi (F)

Aalborg University, Aalborg, Denmark.

Daniel Cassuto (D)

Private Practice, Milan, Italy.

Henry Hl Chan (HH)

Private Practice and Department of Medicine (Dermatology), University of Hong Kong, People's Republic of China.

Christine Dierickx (C)

Skinperium Clinic, Luxembourg, Luxembourg.

Matthias Donelan (M)

Department of Surgery, Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, Boston, Massachusetts, USA.

Gerd G Gauglitz (GG)

Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany.

Merete Haedersdal (M)

Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.

Andrew C Krakowski (AC)

Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania, USA.

Woraphong Manuskiatti (W)

Department of Dermatology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.

William B Norbury (WB)

Department of Surgery, University of Texas Medical Branch, Shriners Hospital for Children-Galveston, Galveston, Texas, USA.

Rei Ogawa (R)

Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.

David M Ozog (DM)

Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA.

Uwe Paasch (U)

Department of Dermatology, Venereology, and Allergy, University of Leipzig, Leipzig, Germany.

E Victor Ross (E)

Scripps Clinic, San Diego, California, USA.

Matteo Tretti Clementoni (MT)

Laserplast, Milan, Italy.

Jill Waibel (J)

Miami Dermatology and Laser Institute, Miami, Florida, USA.

Ardeshir Bayat (A)

Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, University of Manchester, England, UK.
MRC-SA Wound Healing Unit, Hair & Skin Research Laboratory, Division of Dermatology, University of Cape Town, Cape Town, South Africa.

Boncheol Leo Goo (BL)

Naeum Dermatology and Aesthetic Clinic/Skin Rehabilitation Center, Seoul, Korea.

Ofir Artzi (O)

Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

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