Evaluation of the Efficacy, Safety, and Satisfaction Rates of Platelet-Rich Plasma, Non-Cross-Linked Hyaluronic Acid, and Their Combination in Patients With Acne Scars Treated With Fractional Co2 Laser: A Randomized, Double-Blind, Split-Face Comparative Study Publisher



Roohaninasab M ; Jafarzadeh A ; Zare S ; Alavi S ; Zare S ; Nilforoshzade MA ; Behrangi E
Source: Aesthetic Plastic Surgery Published:2025

Abstract

Background: Acne is a common skin condition that often leads to atrophic scars, a major concern for patients. Treatments for these scars include fractional CO2 laser, subcision, and regenerative therapies like platelet-rich plasma (PRP) and hyaluronic acid injections. PRP, which concentrates platelets from the patient’s blood to release growth factors for enhanced healing, is prepared through centrifugation. Hyaluronic acid products provide hydration and have anti-inflammatory, antibacterial, and antioxidant benefits. This study investigates the effectiveness of PRP, non-cross-linked hyaluronic acid, and their combination in treating acne scars, addressing the significant impact of these scars on patients' quality of life. Method: Between 2023 and 2024, a double-blind, randomized clinical trial was conducted involving 15 patients aged 18 to 65 with atrophic acne scars at a dermatology clinic. Participants were divided into three groups: one group received a combination of platelet-rich plasma (PRP) and non-cross-linked hyaluronic acid on one side of the face, while the opposite side received either PRP alone, hyaluronic acid alone, or normal saline as a placebo. Two therapy sessions were held, with evaluations conducted at baseline, one month after the first session, and three months later, using biometric and ultrasound measurements to assess treatment efficacy. Results: Results indicated that while no significant differences were found in colorimetry, tewametry, and corneometry across groups, the PRP group had higher erythema and melanin indices in the third evaluation (three months after the first treatment session) compared to the PRP+non-cross-linked hyaluronic acid (HA) group. Conversely, the non-cross-linked HA group demonstrated superior scores in tewametry and melanin index compared to the PRP+HA group. In post-treatment evaluations, both patients and physicians reported higher satisfaction rates for the PRP+HA group compared to the PRP alone or the non-cross-linked HA group, highlighting a preference for the combination treatment. Conclusion: The combination of platelet-rich plasma and non-cross-linked hyaluronic acid presents a promising approach for the treatment of atrophic acne scars, demonstrating enhanced satisfaction rates and biometric improvements over individual treatments. Further studies are warranted to solidify these findings and refine treatment protocols. Level of Evidence I: Therapeutic study This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2025 Elsevier B.V., All rights reserved.