Combined Treatment of Rolling Acne Scars in Ethnic Skin Using Extensive Subcision, Trichloracetic Acid Peel, and Fractional Ablative Erbium Laser

Successful treatment of acne scars in ethnic skin requires procedures that are safe and effective with a low incidence of hyper or hypopigmentation postoperatively. OBJECTIVE: In this study, the safety and efficacy of a combined treatment protocol including tumescent anesthesia, subcision, trichloracetic acid peel, and fractional erbium laser resurfacing was evaluated. METHODS: This is a retrospective study of 56 patients (22 women and 34 men) with predominantly rolling acne scars and Fitzpatrick skin Types IV–VI who were treated using a combination of tumescent anesthesia, extensive subcision, fractional ablative erbium laser, and a blending 20% trichloracetic acid (TCA) peel. RESULTS: The mean improvement after a single treatment, assessed by 3 independent evaluators (2 dermatologist and 1 dermatology physician assistant), was 2.52 (SD = 1.04) on a scale of 1 to 4. CONCLUSION: The combination of tumescent anesthesia, extensive subcision, fractional ablative erbium laser resurfacing, and a blending 20% TCA peel (combined procedure) is both safe and effective in the treatment of rolling acne scars in ethnic skin types with acceptable temporary adverse effects.