Stand-Alone Carboxytherapy Followed by Consolidation with Oral Hydrolyzed Marine Collagen Fragments: A Potential...

Carboxytherapy, via the Bohr effect, a denser dermal environment, and preserved fibroblast function, along with oral administration of bioactive marine collagen fragments that target fibroblasts, are regenerative strategies that could improve scar elasticity, thickness, and hydration. Their sequential combination might be an innovative approach.

In March 2024, a 56-year-old woman began treatment of a large, hypertrophic, partially retracted post-surgical scar in the nasojugal area at the level of the right nasal wing. Ablative techniques were strictly contraindicated; therefore, a regenerative, restructuring approach via carboxytherapy was chosen. A six-session carboxytherapy cycle was performed from October 10, 2024 (T0) to April 3, 2025 (T6). Each session, performed every 15 days, lasted approximately 10 minutes (flow rate: 60 mL/min, 30-G needle, temperature 45°C). Evaluations were conducted after the third (T3) and last (T6) sessions, using the Antera 3D device (quantitative three-dimensional objective analysis of scar depth, texture, erythrosis, and pigmentation) and the POSAS investigator and subject scoring scales. A final injection of persistent hyaluronic acid was performed on April 3, 2025. To support and strengthen the normalization of the scarring process, the first of a twice-yearly oral cycle of hydrolyzed marine collagen fragments began on October 23, 2025.

Over the six-month carboxytherapy treatment cycle, the scarred skin area showed significant improvement toward a normal appearance. The vascularity POSAS score (observer component) decreased from 7 at baseline to 3 at T6; the thickness and flexibility scores improved from 5 to 2 and from 7 to 3, respectively. Additionally, the POSAS pain and itching scores (patient component) decreased from 6 to 1.

Stand-alone carboxytherapy again appears to be an effective option for hypertrophic, structurally abnormal scars. While further investigations are underway, supplementation with hydrolyzed marine collagen fragments may help maintain the benefits of prior carboxytherapy.