Combined use of microfocused ultrasound and a calcium hydroxylapatite dermal filler for treating atrophic acne scars: A pilot study

J Cosmet Laser Ther. 2018 Oct;20(5):301-306. doi: 10.1080/14764172.2017.1406606. Epub 2018 Feb 5.


Background: An unfortunate consequence of severe acne is scarring, which can have serious psychosocial consequences. Available methods for treating acne scars have varying degrees of effectiveness.

Objective: This nonrandomized, retrospective pilot study assessed the safety and effectiveness of combining microfocused ultrasound with visualization (MFU-V; Ultherapy®) and a calcium hydroxylapatite dermal filler (CaHA; Radiesse®) for treating atrophic acne scars.

Methods: Healthy subjects 35-55 years old with moderate-to-severe facial acne scars were enrolled. MFU-V was applied bilaterally using two transducers with focal depths of 3.0 and 1.5 mm. Using a cross-hatch pattern, 75 treatment lines were applied 2-3 mm apart. Immediately afterward, the same areas were injected with 1.5 mL of CaHA diluted with 1.5 mL of lidocaine 2% without epinephrine. Scar severity changes were assessed by two independent physicians using the Goodman Acne Scar Scale at post-treatment Day 90. Subject satisfaction was assessed with a questionnaire.

Results: Treated subjects (N = 10) achieved significant overall improvement in baseline acne scar severity (P = 0.002). When stratified by severity, a clear trend was apparent with the greatest improvement observed among subjects with severe scars. Subjects were very satisfied (n = 9) or satisfied (n = 1) with their aesthetic results. No adverse events were observed.

Conclusions: Combining MFU-V and diluted CaHA is effective for treating atrophic acne scars.

Keywords: Atrophic acne scars; calcium hydroxylapatite filler; microfocused ultrasound; pilot study.

MeSH terms

  • Acne Vulgaris / complications*
  • Adult
  • Cicatrix / etiology
  • Cicatrix / therapy*
  • Combined Modality Therapy / adverse effects
  • Dermal Fillers / adverse effects
  • Dermal Fillers / therapeutic use*
  • Durapatite / adverse effects
  • Durapatite / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Pilot Projects
  • Retrospective Studies
  • Severity of Illness Index
  • Ultrasonic Therapy / adverse effects
  • Ultrasonic Therapy / methods*


  • Dermal Fillers
  • Durapatite