Atrophic acne scars represent one of the most challenging sequelae of acne, with a profound aesthetic and psychosocial impact. Beyond permanent structural skin damage, acne scarring is strongly associated with emotional distress, reduced self-esteem, and social avoidance. As the pathophysiology of atrophic scars involves multiple mechanisms, combination-based therapeutic strategies have gained relevance in aesthetic medicine for addressing both tissue remodeling and quality-of-life impairment. This case report presents the outcomes of a combined therapeutic protocol for the management of atrophic acne scars. A young adult male presented with multiple atrophic scars predominantly affecting the malar and zygomatic regions, associated with mild active acne. The patient reported significant dissatisfaction with facial appearance and frequent reliance on digital filters during social interactions. The treatment protocol consisted of subcision associated with poly-L-lactic acid (PLLA) injection for collagen biostimulation, followed by sessions of microneedle radiofrequency performed under topical anesthesia. This multimodal approach aimed to promote dermal remodeling through mechanical release, neocollagenesis, and regenerative stimulation. The combined treatment was well tolerated, with no adverse events observed. Clinical evaluation demonstrated marked improvement in scar depth, contour regularity, and overall skin texture. In parallel with the structural skin improvement, the patient reported enhanced self-perception, increased confidence, and a reduction in psychosocial discomfort related to acne scarring. This case underscores the clinical value of combination-based regenerative approaches in the treatment of atrophic acne scars. By simultaneously addressing physical deformities and psychosocial burden, multimodal strategies may offer more comprehensive and meaningful outcomes in contemporary aesthetic medicine. 

Bruna Andrade is a Brazilian physician, Clinical Director of the Bruna Andrade Institute (IBA) and Director of ABME. She works in aesthetic medicine with emphasis on structured clinical protocols, energy-based technologies, regenerative strategies, and integrated, patient-centered medical care.