Dual‐plane hyaluronic acid treatment for atrophic acne scars

Severe atrophic acne scars (AAS) have serious negative effects on patients' mental health and quality of life. 1 Although many treatment options are available for mild-to-moderate AAS, such as laser therapy, radiofrequency therapy, subcision, dermal filler injection, dermabrasion, chemical peeling, punch excision, and platelet-rich plasma (PRP) therapy, 2 severe AAS remains the "Achilles's heel". 3 of acne scar treatment because of limited efficacy and side effects.Subcision is a common approach to release fibrous adhesions beneath the deep AAS, which bind the atrophic scars down.Neocollagenesis, followed by dermal trauma, contributes to scar elevation. 4 Therefore, subcision is effective for deep rolling scars.Dermal fillers provide direct and accurate augmentation to superficial AAS. Fillers raise the scar deficit to the level of the surrounding skin, making the scars less visible. [5][6][7] Adipose tissue has been successfully used as an ideal filling material for tissue augmentation because of its filling effect and regeneration potential. 8

Section: Introductionmentioning

confidence: 99%

Single session of combined microfat and subcision in the treatment of Grade 4 atrophic acne scars

Zhang

Huang

Yang

et al. 2022

“…Hyaluronic acid is currently the leading dermal filler type for cosmetic use due to both its efficacy and improved safety (low allergenicity, longevity, and ability to be reversed). Hyaluronic acid filler in previous atrophic scar studies showed high treatment satisfaction with only mild transitory erythema, bruising, and mild to moderate pain during injection 1‐7 . Goodman and Broek published the use of a modified tower technique, creating vertical posts through a retrograde injection bringing the HA up into the superficial dermis with resolution of over 70% of the scars 2 .…”

Section: Discussionmentioning

confidence: 99%

“…These trials of various hyaluronic acid fillers suggest high treatment satisfaction with minimal adverse effects such as transient and minimal erythema, bruising, swelling, and pain. 2,4,7,29 The first placebo-controlled clinical trial utilizing a HA filler to treat atrophic facial scars is vital to assess the efficacy of HA filler because inserting the needle without injection 25,27,30 or with saline injection 31,32 is a stand-alone treatment for atrophic scarring. Since HA filler must be injected with a needle, it would be impossible to rule out the injection method alone as a contributing factor to the improvement in the atrophic scarring.…”

Section: Introductionmentioning

confidence: 99%

A split‐face, blind, randomized placebo‐controlled clinical trial investigating the efficacy and safety of hyaluronic acid filler for the correction of atrophic facial scars

Siperstein

Nestor²,

Meran³

et al. 2022

Background: Hyaluronic acid fillers have been studied extensively for facial wrinkles; however, their efficacy for atrophic facial scars has yet to be analyzed in a prospective placebo-controlled study. Objective:To analyze the efficacy and safety of a hyaluronic acid filler for atrophic facial scars.Methods & Materials: Fifteen subjects were randomized to receive up to 1 ml of VYC-17.5 L on one cheek and up to 1 ml of saline on the other side, with an optional touch-up treatment. Subjects were graded by a live blind evaluator using the Quantitative Global Scarring Grading System (QGSGS) (J Cosmet Dermatol. 2006;5:48), the Global Aesthetic Improvement Scale (GAIS), and Canfield photo-analysis.Results: According to the blind evaluator, there was a significant reduction 90 days after the last treatment on the QGSGS for VYC-17.5L compared with saline (−6.6 VYC-17.5L vs −1.7 saline [t(28) = −4.3196, p = 0.008]). There was a smaller, but still significant reduction on the QGSGS for saline alone (10.4 to 8.6 [t(14) = −3.453, p = 0.004]). In addition, 93% (13/14) of subjects chose VYC-17.5L over saline treatment and reported an improvement on the GAIS. There were no serious side effects and all minor side effects resolved by Day 30. Conclusion:VYC-17.5L achieved significant improvements in rolling atrophic scars as compared to saline, though saline also had modest improvements.

“…Clinical efficacy of jet‐injected HA was conveyed by achieving a significant improvement in acne scar appearance along with a high degree of patient satisfaction 32,33 . The results were comparable to HA treatment of acne scars by various manual injection techniques 34,35 …”

Section: Clinical Effectsmentioning

confidence: 99%

“…32,33 The results were comparable to HA treatment of acne scars by various manual injection techniques. 34,35 F…”

Section: Clinic Al Effec Tsmentioning

confidence: 99%

Biochemical and physical actions of hyaluronic acid delivered by intradermal jet injection route

Vinshtok¹,

Cassuto

2020

Administration of exogenous hyaluronic acid (HA) by liquid jet injection is considered as a beneficial therapy for dermatology conditions. This paper reviews variety of the factors which would optimize the clinical output of hyaluronic acid in this treatment modality. A pneumatically accelerated jet penetrates the epidermis and spherically spreads micro‐droplets of HA in the dermis without significant damage to the tissue and blood vessels. Kinetic energy of the jet activates two parallel mechanisms of action—mechanical and biological—which act synergistically to initiate and augment the regenerative effect. Jet‐induced micro‐trauma stimulates collagen synthesis and tissue repair without inflammation. Aside from the biophysical stimulation of dermal fibroblast, the biomolecular properties of exogenous HA provide excellent clinical results for skin atrophy, remodeling of dermal scarring, and reverse formation of fibrotic tissue. The effect is mediated by HA‐specific cell receptors and depends on molecular weight and the rheological properties of HA polymer. Skin mechanical properties play a key role in predicting HA dispersion patterns. Tolerability and safety of the treatment approach are determined by the jet's physical impact on the tissue and/or by the safety profile of the injected material. Although pneumatic jet delivery of a hyaluronic acid has a limited use in clinical practice, this treatment approach has a strong potential for extended implementation in esthetic dermatology. The synergistic mechanism has significant advantages of predictable and rapid clinical outcomes with a low discomfort. Additional well‐designed investigations are required for establishing a scientific foundation and guidelines for this treatment modality.