Acne vulgaris is a ubiquitous problem affecting 80 percent of people ages 11 to 30 years, with many patients experiencing some degree of scarring. This review focuses on atrophic scars, the most common type of acne scar. We briefly address the cellular sequelae that lead to scar formation and the initial evaluation of patients with acne scars. We then discuss an algorithmic approach to the treatment of acne scarring based on the classification of scars into erythematous and atrophic types. Lastly, we discuss the future treatment of acne scars and ongoing clinical trials. ACNE VULGARIS IS A UBIQUITOUS PROBLEM, affecting up to 80 percent of people ages 11–30 and five percent of adults 30 years and older in India. While epidemiologic data on acne scarring vary, many patients experience some degree of scarring. Here, we address the most common type of acne scar— the atrophic scar— and discuss options for amelioration in a comprehensive manner. Heterogeneity in study design, assessment scales, and level of evidence regarding efficacy for various treatment options make comparative conclusions difficult. In clinical practice, a tailored combination approach using multiple modalities is optimal.
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