Triple steps acne scar revision technique: A new combination therapeutic modality for atrophic acne scars

Atrophic acne scarring is an unfortunate, permanent complication of acne vulgaris, associated with significant psychological distress.

A new complementary treatment of atrophic acne scars using subcision and injection of hybrid cooperative complexes of high and low molecular weight hyaluronan (hybrid H-HA/L-HA).

This study included eighty-two patients divided into two groups with predominantly atrophic acne scarring. Group 1 received subcision with saline injection, while group 2 received triple steps acne scar revision technique (TSASRT). After topical anesthesia, the procedure of combining subcision and hybrid H-HA/L-HA technique was done in which the first step started using subcision technique done to release fibrous cords at the dermal or deep dermal, subcutaneous plane using Nokor needles-18 g. The second step is to inject the scar's atrophic dermal component with a 29 g needle, applying an average amount of hybrid H-HA/L-HA (0.02-0.1 mL) to the dermal component. The third step was to fill the subcisied space with hybrid H-HA/L-HA (0.02-0.1 mL) using a 25 g cannula.

Clinical improvement was achieved in both groups. There were statistically significant improvements in the TSASRT versus subcision (p ≤ 0.05) in acne scar severity index and qualitative scarring grading system.

The triple step acne scar revision technique appears to be a safe and effective way to treat atrophic acne scars on the face.