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.[82][83] Microneedling is also emerging as a possible treatment for acne scarring.[84][85] Systematic reviews position microneedling as a safe and effective alternative to more invasive procedures such as laser skin resurfacing and deep chemical peeling.[86][87] Further studies are needed to fully evaluate its benefit. Glycolic acid peels may also be beneficial.[34]
Referral to a specialist 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. Postinflammatory 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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