Fractional radiofrequency (RF) technology has been shown to be a gold standard therapy for acne scars. We have previously published clinical and histological results from the treatment of 8 patients with active acne and acne related scarring using a fractional RF device. Evidence of safety and efficacy was demonstrated, including long term follow-up clinical results from 4 patients, up to two years post last fractional treatment. In the current article we present histology evidence of acne scar skin renewal 3.5 years post treatment.