(Acne) scars

Scars: disrupted collagen architecture as the treatment target

Scars are the end result of a wound-healing process in which the skin's normal collagen structure is not fully restored. Depending on the cause, the depth of the wound and the individual skin response, different types of scar can form: atrophic scars, where tissue has been lost, hypertrophic scars, where excess collagen has been produced, and — in the most pronounced cases — keloid scars, which extend beyond the original wound margins.

Each type calls for a different treatment strategy. Treatment depth, energy intensity and the choice of technology are determined by the type of scar, its age, the patient's skin tone and expectations around recovery and outcome.

Technologies for scar treatment

Fractional lasers form the core of professional scar treatment. Non-ablative systems such as the MOSAIC 3D create thermal microcolumns in the dermis without removing the epidermis — suitable for the gradual improvement of atrophic scars, acne scars and superficial skin irregularities, with limited downtime. They are also the safest choice as a first step in patients with a higher skin tone or a lower tolerance for a recovery period.

The ablative fractional laser in the eCO2 (Ultraclear) removes microscopic columns in the upper skin layer and thereby triggers a stronger collagen response. This system is indicated for deeper, atrophic acne scars and pronounced skin irregularities — with a more marked and more quickly visible result, but a longer recovery period.

Picosecond technology in the PicoSure Pro and the Picoplus works through photomechanical stimulation and is effective for superficial atrophic scars, with particular added value for the pigment component in red or discoloured scars. The limited thermal damage also makes it suitable for patients with darker skin types, where ablative lasers carry more risk.

RF Microneedling with the Genius® offers a complementary mechanism: controlled heat delivery deep in the dermis via microneedles stimulates the production of new collagen and elastin. This makes it particularly effective for atrophic scars on the body or in areas that require more caution with laser, such as the neck or décolleté.

LED therapy with the Healite II™ is used as a supporting treatment: the 830nm LED light modulates the inflammatory response after laser treatment and speeds up the recovery process — increasing the effectiveness of the overall treatment pathway.

The Pro Deep applicator on the ETHEREA-MX® delivers deep RF aimed specifically at dermal repair and can be used as an addition to fractional laser treatment for pronounced atrophic or hypertrophic scars.

Special attention: hypertrophic scars and keloids

Hypertrophic scars and keloids call for a particularly cautious approach. Ablative lasers are initially contraindicated here — they can amplify the excessive collagen production. Non-ablative fractional systems and RF microneedling are safer in these cases, ideally combined with other treatment modalities. The treatment strategy must be determined individually for each patient, taking into account the location, the type and the family history of scar formation.

The practice perspective

Scar treatment is an indication that usually calls for a layered, multi-stage treatment pathway. Patients with pronounced acne scars, surgical scars or burn scars generally need several sessions spread over months. This generates a stable, recurring flow of treatments and creates the opportunity to build a long-term treatment relationship.

Combining non-ablative and ablative fractional treatment, supplemented with picosecond or RF microneedling, gives practitioners the flexibility to treat every scar type and every patient appropriately — from cautious entry-level treatments to intensive resurfacing protocols.

Medi-Invest supports you in building a considered treatment strategy for scars — including clinical training per system, practice protocols and long-term technical follow-up.