Comparison of Efficacy of Carbon Dioxide Laser With Subcision Versus Platelet-Rich Plasma Bio-Fillers With Subcision for the Treatment of Atrophic Acne

NCT07752186 | Completed

• 1 other identifier: LahoreGeneralH17
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Atrophic Acne Scars

Keywords

Acne scarring; Atrophic acne scars; Rolling acne scars; Platelet-poor plasma gel; Plasma bio-filler

Outcome Measures

Primary Outcomes (2)

• 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.

  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.

  12 weeks after initiation of treatment.

Secondary Outcomes (2)

• Incidence of Treatment-Related Pain

  At 4, 8, and 12 weeks after initiation of treatment.

• Incidence of Treatment-Related Pigmentary Changes

  At 4, 8, and 12 weeks after initiation of treatment.

Study Arms (2)

Platelet-Rich Plasma Bio-Filler With Subcision

EXPERIMENTAL

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

Fractional Carbon Dioxide Laser With Subcision

ACTIVE COMPARATOR

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

Interventions

Platelet-Rich Plasma Bio-Filler With Subcision BIOLOGICAL

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.

Platelet-Rich Plasma Bio-Filler With Subcision

Fractional Carbon Dioxide Laser With Subcision DEVICE

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.

Fractional Carbon Dioxide Laser With Subcision

Eligibility Criteria

• Age: 15 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Patients of age 15-45 years,
• both genders,
• presenting with atrophic acne scars

You may not qualify if:

• Patients with photosensitive dermatosis, keloids, active acne, already taking steroidal, laser or trial treatment in last 6 months, hepatitis B or hepatitis C, hypothyroidism (TSH\>5IU), pregnant or breast feeding, skin infection or inflammatory skin disorders requiring systemic antimicrobials (on medical record).
• Patients with connective tissue disorders or hypersensitivity to lidocaine, taking antiplatelet therapy, bleeding tendencies (on clinical examination)

Sponsors & Collaborators

• Lahore General Hospital: lead

Study Sites (1)

Lahore General Hospital, Lahore

Lahore, Punjab Province, 54000, Pakistan

Location

Study Officials

• Kainat Haq

  Lahore General Hospital, Lahore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 3, 2026
• First Posted: August 7, 2026
• Study Start: August 10, 2025
• Primary Completion: February 10, 2026
• Study Completion: February 10, 2026
• Last Updated: August 7, 2026

Record last verified: 2026-08

Locations

PA (1)