Surgical treatment of facial acne scars based on morphologic classification: A brazilian experience

Background. Acne scar treatment remains a challenge in the medical literature. It is very difficult to compare the efficacy of different therapeutic approaches because of the lack of consensus regarding acne scar description and classification. Objective. To establish a morphologic classification of acne scars and to assess the efficacy of different therapeutic options based on scar type. Methods. During an 8-year period, 228 patients were prospectively studied. Their acne scars were morphologically classified and customized, staged rehabilitation programs were established for each patient. The assessment of treatment efficacy was conducted 18 months after the end of treatment and was based on patients' and physicians' opinions ranked on a semiquantitative basis as percentage of improvement from baseline. Results. Among the 168 patients who finished the study, 26 completed three stages of the treatment plan, and 142 were submitted to one or two therapeutic stages, depending on lesion types. Eighty-six percent of the patients considered the results excellent or good compared with 76% by the authors and 78% by three independent dermatologic surgeons. Conclusion. The classification and the staged therapeutic plan for acne scarred patients facilitated treatment and improved outcomes and may allow development of protocols by comparing results among different authors.