TABLE 1.

Pearls for evaluation

HISTORY

Which aspects of the patient's scarring are the most bothersome to him/her?

How distressed is the patient about his or her scars?

What are the patient's goals for treatment?

Have any prior procedures been performed to treat the scars?

Has the active acne cleared completely? How recently did the acne clear?

Was isotretinoin used? How recently was it discontinued?

Is there a history of postinflammatory hyperpigmentation (PIH)?

Is there a history of keloids or hypertrophic scars?

PHYSICAL EXAMINATION

Direct overhead lighting is optimal

Have a mirror for the patient to point out lesions

Evaluate for active acne

Define types of scars (icepick, rolling, boxcar, severely atrophic/sclerotic)

Assess color (hypopigmentation, hyperpigmentation, purple/red discoloration)

Assess depth of the lesions

Stretch skin to see if scars disappear

Palpate for underlying fibrosis

Evaluate skin type (types III–V have increased risk of PIH with most procedures)