Prospective and randomized comparative study of calcium hydroxylapatite vs calcium hydroxylapatite plus HIFU in treatment of moderate‐to‐severe acne scars

Abstract

Acne scars are the most common sequelae of the severe inflammatory process of acne. They affect almost 95 percent of patients with acne vulgaris, which is prevalent in more than 90 percent of adolescents. 1,2 Scars are characterized by a loss or damage of tissue, vary in morphological characteristics such as shape, size, and depth, 3 and are graded as various types such as rolling, boxcar, and ice pick. Furthermore, they can be erythematous at the early stage, or may get purplish or pigmented as they develop. 4,5 In most patients, acne scars are mixed types and distributed around the face. A standard tool for assessing atrophic scars is the four-grade Goodman and Baron classification. 6 Managing acne scars is a challenge, 7-10 and therapies are divided into nonsurgical and surgical. The former includes anti-acne agents, 11,12 chemical peels, 13 microneedling, 14-17 and ablative 18 and nonablative fractional 19-22 and nonfractional 23 lasers, as well as autologous growth factors. 24-27 The latter include subcision, 28-30 autologous cell regeneration, 31 and autologous adipose-derived stem cells. 32

Bioactive Materials for Soft Tissue Repair

“…Due to its composition, which resembles the inorganic bone tissue, hydroxyapatite (HA) is a material with multiple potential uses that can be developed as nanoparticles or assembled into nanostructures thus functioning as scaffolds with physical, chemical, mechanical and biological features tailored for different tissue targets, particularly for hard tissue regeneration. In spite of this prevalence, HA has been recently explored also for purpose of enhanced skin care, particularly when employed as nanoparticles embedded in bio-organic matrixes, where the high dilution of the inorganic phase can help to achieve bio-stimulatory effects improving skin quality, firmness and rejuvenation, as well as sustaining skin regeneration upon damages derived from exposure to sun, from contact with various harmful chemical substances or due to acne (Antonino and Francesco, 2021). In this respect it was found that HA can act as excellent skin barrier, particularly useful when the protective stratum corneum results damaged and provide insufficient ability to contrast harmful environmental effects or water loss (Gaudinat, 2007).…”