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Acne and Acne Scar Treatment

Acne vulgaris (AV) is a chronic, inflammatory disease of the pilosebaceous unit affecting approximately 85% of the population between the age of 12-24 years and is the most common skin disease. It generally affects the face, back, chest and shoulder areas where sebaceous glands are more densely located. It is clinically characterized by comedones, erythematous papules, pustules, nodules, and rarely cysts. Although not life threatening, it can lead to social phobia and depression with its physical and psychological effects.

The pathogenesis of the disease is multifactorial. The pathophysiological factors responsible for acne development are grouped under four main titles: abnormal follicular keratinization, excessive sebum production, increase in Propionibacterium acnes (P. acnes) colonization and development of inflammation in the follicles.

Although acne vulgaris is a self-limiting disease, it needs to be treated as it can leave scars and cause psychological problems. Topical treatments are usually adequate for mild acne but topical and systemic treatments should be used together in patients with moderate to severe lesions. Treatment is based on the age of the person and the severity of the acne. Effect of the treatment is evaluated in about 6-8 weeks. A new treatment is decided on if no significant benefit is observed.

Acne scars are a common cosmetic problem, especially in those with nodulocytic acne. There are many treatment options for acne scars such as chemical peeling, dermaroller/dermapen, PRP, mesotherapy, salmon DNA, various lasers, and needle radiofrequency methods. However, the most successful method has been fractional lasers in various studies. The combination of fractional lasers with PRP has been shown to accelerate wound healing and lead to more successful results.

The recommended application frequency is every 3 weeks for chemical peeling, dermaroller/dermapen, PRP and every 4 weeks for fractional radiofrequency and needle radiofrequency. Performing the applications during the winter months and as 4-8 sessions, depending on the width and depth of the scar, is recommended. Redness and mild edema on the acne scars following the application is normal. Darkening of the skin can be seen for 1-2 weeks, especially in those with a dark skin type. Moisturizing the area and protecting it from the sun after the application are extremely important.