Atrophic Acne Scars, Including Scars Less Than 1.5 Mm, May Undergo Spontaneous Regression: A Cohort Study

Abstract

To the Editor: Atrophic scarring is the most common subtype of acne scarring and results from poor wound healing in response to sebaceous follicle damage and collagen destruction caused by prolonged acne inflammation. Although acne scar grading classification systems exist, available data on the natural evolution of atrophic acne scars are sparse. In this retrospective study, we sought to address if the size of atrophic acne scars influences their ability to undergo spontaneous resolution over time. High-quality, standardized digital photographs of untreated facial acne were obtained at baseline (week 0) and week 12 from a previous split-face pulsed dye laser acne treatment study. Participants with Leeds acne severity scale rating\2 (mild acne), history of oral retinoid use within 1 year prior to study enrollment, other acne treatment within 1 month of study entry, microdermabrasion within 3 months of study, a history of laser resurfacing, or use of nonsteroidal anti-inflammatory medications within 10 days prior to study were excluded. The study included 21 participants (6 female and 15 male) with a median age of 21 years. Six participants