The efficacy of combined diluted calcium hydroxylapatite‐based filler and an energy‐based device in the treatment of facial atrophic acne scars

Abstract

Background and Objectives

Treatment options for atrophic acne scars include the use of various energy‐based devices (EBDs) and dermal fillers.

Aim

To evaluate the level of improvement and safety of four treatment modalities for atrophic acne scars employed in our center.

Methods

We reviewed the medical records of all acne scar patients treated between 2013‐2016 with one of four treatment modalities: ablative fractional CO2 laser (FACL), the radiofrequency (RF) bipolar device, the 1540 nm non‐ablative fractional laser (NAFL), and the injection of diluted calcium hydroxylapatite (CaHA). The EBDs were used as monotherapy or in combination with diluted CaHA. Two non‐involved dermatologists and the patients evaluated the aesthetic improvement achieved following the various modalities. The patients also rated their satisfaction, numbered the days of post‐treatment downtime, and reported any adverse effects.

Results

In total, 352 patients (mean age 28.7±8.7, 65.6% females) were treated for acne scars. The integrated mean dermatologists' and patients' GAS scores were the highest for the patients treated with the combined FACL‐CaHA modality at separate sessions (P < 0.001). Patients treated with FACL reported more side effects and longer downtime and duration of erythema.

Conclusions

The combination of a diluted CaHA‐based filler injection followed by fractional ablative CO2 laser in separate treatment sessions yielded better aesthetic improvement compared to the other tested modalities.

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