Three-Part Acne Scar Protocol Shows Progressive Changes Through 139 Days
Key Takeaways
- A recent case series evaluated a 3-part protocol combining subcision, PEGDE-crosslinked hyaluronic acid (HA) with calcium hydroxyapatite (CaHA), and fractional 1470-nm diode laser treatment for facial atrophic acne scars.
- Among 20 patients, mean ultrasound-measured scar depth decreased 86% and mean scar diameter decreased 75% from baseline through day 139; all follow-up comparisons were P < .001.
- No serious or persistent adverse events were reported.
- Uncontrolled study design, small sample, limited skin phototypes, and absence of validated clinical or patient-reported outcomes limited applicability.
A multimodal protocol combining subcision, injectable treatment, and fractional laser therapy was associated with reductions in facial atrophic acne scar dimensions in a prospective case series published in Biomedicines.
Ultrasound Tracks Changes Through 139 Days
The study included 20 patients aged 18 to 42 years with moderate-to-severe facial atrophic acne scars and Fitzpatrick skin phototypes I to II. Investigators performed subcision with a 22-gauge cannula and injected 2 mL of PEGDE-crosslinked HA containing CaHA microparticles on day 0. Patients subsequently underwent fractional nonablative 1470-nm diode laser treatment on days 7 and 28. They then followed 2 scars per patient using 48-MHz high-frequency ultrasound, measuring scar depth and transverse diameter at baseline and days 28, 49, 77, and 139.
Mean scar depth decreased from 0.35 mm at baseline to 0.05 mm at day 139 (86% reduction). Mean scar diameter decreased from 4.27 mm to 1.06 mm (75% reduction). Linear mixed-effects models accounting for repeated measurements and clustering of scars within patients found significant reductions in both outcomes at every follow-up compared with baseline (all P < 0.001).
All 20 patients completed treatment, and investigators reported no serious or persistent adverse events. However, the study lacked a control group, blinded longitudinal assessment, validated clinical grading during follow-up, and patient-reported outcomes. Only patients with Fitzpatrick phototypes I to II were included, and follow-up was limited to 139 days. The design also cannot determine the individual contributions of subcision, filler, and laser treatment.
“In this single-arm case series, the combined subcision, PEGDE-crosslinked HA–CaHA filler, and fractional 1470 nm diode laser protocol was well tolerated and associated with progressive, sustained reductions in high-frequency ultrasound-measured scar depth and diameter,” the authors wrote. “As an uncontrolled, unblinded study without validated clinical grading or patient-reported outcomes, these findings are preliminary and require confirmation in larger, controlled trials.”
Source
Kubik P, et al. Biomedicines. 2026. Doi:10.3390/biomedicines14071441