An interventional study of Platelet-Rich Plasma Bio-Filler With Subcision and Fractional Carbon Dioxide Laser With Subcision in Atrophic Acne Scars, sponsored by Lahore General Hospital. Completed at 1 site in Pakistan. Open to participants aged 15 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-08-07.
Sponsored by Lahore General Hospital · Not applicable, Interventional, and Treatment
This randomized controlled trial compared two combined treatment approaches for atrophic acne scars. A total of 100 patients aged 15-45 years were enrolled from the Department of Dermatology, Lahore General Hospital, Lahore, and were randomly assigned to one of two treatment groups. All participants underwent subcision, a minor procedure in which fibrous bands beneath depressed acne scars were released to elevate the scarred skin.
Participants in one group received platelet-rich plasma bio-filler injections after subcision. The bio-filler was prepared from each participant's own blood and was injected beneath the acne scars to provide volume and promote collagen formation. Participants in the other group received fractional carbon dioxide laser treatment after subcision. The laser created controlled microscopic skin injuries intended to stimulate collagen production and improve skin texture. Three treatment sessions were administered at 4-week intervals.
Treatment outcomes were assessed using the Patient and Observer Scar Assessment Scale at baseline and during follow-up. Treatment-related adverse effects, including pain, erythema, bruising, and changes in skin pigmentation, were also recorded. Treatment efficacy was defined as a reduction of more than 50% in acne scar severity.
Exclusion Criteria:
Participants received subcision using an 18-gauge cannula with forward-backward and fanning movements. After subcision, 0.1 mL of autologous plasma bio-filler was injected intradermally beneath each marked atrophic acne scar. Three treatment sessions were administered at 4-week intervals.
Biological: Platelet-Rich Plasma Bio-Filler With Subcision
Participants received subcision using an 18-gauge cannula with forward-backward and fanning movements. Subcision was followed by a single pass of fractional carbon dioxide laser treatment. Three treatment sessions were administered at 4-week intervals.
Device: Fractional Carbon Dioxide Laser With Subcision
Autologous plasma bio-filler was prepared from 20 mL of venous blood. The blood was centrifuged at 1,500 revolutions per minute for 10 minutes, followed by a second centrifugation at 3,000 revolutions per minute for 10 minutes. Approximately 4-5 mL of the upper plasma layer was collected, heated at 80-100°C for 5 minutes, and subsequently cooled at 0-6°C for 5 minutes to produce a viscous bio-filler. Following subcision, 0.1 mL of the bio-filler was injected beneath each marked scar. Three treatment sessions were provided at 4-week intervals.
After subcision, the treatment area received a single pass of fractional carbon dioxide laser using a pulse energy of 25 mJ, spot density of 144 spots/cm², pulse interval of 0.5 mm, and pulse duration of 0.1 milliseconds. Three treatment sessions were provided at 4-week intervals.
Change in Patient and Observer Scar Assessment Scale Score
Atrophic acne scar severity was assessed using the Patient and Observer Scar Assessment Scale. The scale was completed at baseline and at each follow-up assessment. The change in score from baseline was calculated for each participant and compared between the two treatment groups. A greater reduction from the baseline score represented greater improvement in acne scar severity.
Time frame: Baseline and 4, 8, and 12 weeks after initiation of treatment.
Proportion of Participants Achieving Treatment Efficacy
Treatment efficacy was defined as a reduction of more than 50% in atrophic acne scar severity compared with baseline. The reduction was determined using the Patient and Observer Scar Assessment Scale. The number and percentage of participants achieving treatment efficacy were calculated for each treatment group.
Time frame: 12 weeks after initiation of treatment.
Incidence of Treatment-Related Pain
Treatment-related pain was assessed at each follow-up visit and recorded as present or absent. The number and percentage of participants experiencing pain were compared between the two treatment groups
Time frame: At 4, 8, and 12 weeks after initiation of treatment.
Incidence of Treatment-Related Pigmentary Changes
Hypopigmentation or hyperpigmentation occurring in the treated area was assessed by clinical examination and recorded as present or absent. The number and percentage of participants developing pigmentary changes were calculated for each treatment group.
Time frame: At 4, 8, and 12 weeks after initiation of treatment.
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Lahore General Hospital