Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Acne scarring and the sequelae of acne (post-inflammatory hyperpigmentation) continue to be one of the most prevalent and psychologically distressing dermatological problems, and there is no single treatment modality that is consistently effective. This review collates the findings of ten recent publications (2022–2025), including narrative, systematic, randomized split-face, and Bayesian network meta-analyses on combined treatment strategies for acne scar and acne-sequelae treatment. The studies included were on energy-based devices (ablative and non-ablative fractional lasers, vascular lasers, intense pulsed light), procedural adjuncts (platelet-rich plasma, chemical peels, microneedling, dermal fillers, radiofrequency), and pharmacologic agents (oral isotretinoin, topical timolol, retinoids, hydroquinone, hormonal agents) used individually or, more commonly, in combination. In almost all studies, combination therapy performed better than monotherapy in validated scar-severity scores, lesion counts, and patient-reported satisfaction, with the two network meta-analyses showing combinations of laser and platelet-rich-plasma and laser and chemical peel as consistently top-ranked therapies. The adverse events of the combination protocols were nearly all trivial and temporary, similar to those of monotherapy. Despite this, the evidence is still limited in terms of the small and heterogeneous cohorts, inconsistent outcome measures, and short follow-up periods. This review found that using a combination of treatments is the most evidence-based treatment strategy for acne scar management. It emphasized the need for larger, standardized, multicentre trials to create formal clinical guidelines.