Complications
Severe acne may leave residual atrophic or hypertrophic scars in previously involved areas. There are a number of treatments for scarring, including excision or ablative methods. Newer treatments include fractionated CO₂ and resurfacing with fractional laser therapy.[83][84] Microneedling is also emerging as a possible treatment for acne scarring.[85][86] Systematic reviews position microneedling as a safe and effective alternative to more invasive procedures such as laser skin resurfacing and deep chemical peeling.[87][88] Further studies are needed to fully evaluate its benefit. Glycolic acid peels may also be beneficial.[34]
Referral to a consultant dermatologist may be warranted for severe scarring that persists for more than one year after a patient’s acne has cleared.[34]
Dyspigmentation can occur, especially in patients with darker skin types. It tends to be transient. Post-inflammatory hyperpigmentation can last for months. Sun protection is the mainstay of treatment. Laser therapy can also be used.
Acne can have a negative psychological impact due its association with low confidence, low self-worth, and social isolation. Risk of depression, anxiety, and suicidal ideation is significantly greater in adolescents and adults with acne than in those without.[10][19]
Aggressive treatment of acne is important to reduce the risk of long-term mental health disorders. Psychiatric screening or referral should also be considered.[2]
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