Treatment of Atrophic Facial Acne Scars with PEG-Crosslinked Hyaluronic Acid–CaHA

Acne vulgaris affects approximately 80% of individuals between the ages of 11 and 30 and often results in persistent acne scarring that can negatively impact psychosocial well-being, leading to anxiety and reduced self-esteem. This study aimed to evaluate the safety and clinical outcomes associated with the use of PEG-crosslinked hyaluronic acid with calcium hydroxyapatite in patients with facial acne scars. Twenty healthy female volunteers (aged 18–42) underwent a single session combining subcision with a 22G cannula and the simultaneous administration of 2 mL of PEG-crosslinked hyaluronic acid with calcium hydroxyapatite. Participants with recent retinoid use, excessive tanning, or relevant medical conditions were excluded. Skin elasticity, scar depth, and scar diameter were measured at baseline and on days 28 and 90 after treatment. Significant improvements in skin texture and a visible reduction in acne scars were observed. Cutometric analysis demonstrated increased skin elasticity, while high-frequency ultrasound imaging showed an average 21% reduction in scar diameter and a 61% reduction in scar depth by day 90. No adverse effects were reported. A single session combining subcision with a 22G cannula and the simultaneous administration of PEG-crosslinked hyaluronic acid and calcium hydroxyapatite was shown to be safe and to be associated with clinically and instrumentally observed improvements. The filler provides temporary volumization of atrophic or thinned facial soft tissues, resulting in visible aesthetic improvement and favorable patient-reported outcomes. These findings support the potential role of this minimally invasive approach in the management of patients with acne scars.