A combined approach of subcision with either cross-linked hyaluronic acid or threads in the treatment of atrophic acne scars

J Cosmet Dermatol. 2022 Aug;21(8):3334-3342. doi: 10.1111/jocd.14675. Epub 2021 Dec 20.

Abstract

Background: Acne scars are one of the most common cosmetic concerns causing psychosocial distress.

Objective: To evaluate the efficacy of subcision versus its combination with either cross-linked hyaluronic acid (HA) or poly-l-lactic acid (PLLA) threads in the treatment of atrophic post-acne scars.

Methods: Forty patients of both genders with atrophic acne scars were subjected to subcision 1 month apart for 3 sessions. After the last session of subcision, the patients were reclassified randomly into 2 equal groups each received either HA or threads in one side of the face leaving the other side that underwent subcision before as a control. Clinical assessment was carried out by the physicians and patients. Photographs and skin biopsies were obtained. Follow-up was 6 months.

Results: A significant clinical improvement was achieved in 67.3% of patients after subcision alone compared to 94.1%, 82.4% of subcision combined with HA or threads, respectively. Patients' satisfaction was higher in the combined groups compared to subcision alone (p < 0.0001). Side effects were tolerable and transient.

Conclusion: Subcision combined with HA or threads could offer a higher significant clinical improvement of acne scars than subcision alone.

Keywords: hyaluronic acid; scar; soft tissue augmentation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris* / complications
  • Acne Vulgaris* / pathology
  • Atrophy / complications
  • Cicatrix* / etiology
  • Cicatrix* / pathology
  • Cicatrix* / therapy
  • Combined Modality Therapy
  • Female
  • Humans
  • Hyaluronic Acid / adverse effects
  • Male
  • Treatment Outcome

Substances

  • Hyaluronic Acid