Dual-plane hyaluronic acid treatment for atrophic acne scars

J Cosmet Dermatol. 2020 Jan;19(1):69-74. doi: 10.1111/jocd.12991. Epub 2019 May 10.


Background: Acne is a common condition that affects up to 80% of all adolescents. Scarring may affect some 95% as a function of severity and delay before treatment. The pathogenesis includes enzymatic degradation of collagen fibers and subcutaneous fat.

Objective: This study aimed to treat atrophic acne scars using the Dual-Plane injection of Hyaluronic Acid.

Methods: A total of 12 patients with moderate-to-severe atrophic acne scars were treated with a novel NAHYCO™ based Hyaluronic Acid filler, using a dual-plane technique for two treatment sessions at a 4-week interval. Results were objectively assessed by two blinded Dermatologists and subjectively evaluated by the patients themselves.

Results: A total of 8 out of the 12 patients reported moderate improvement, two indicated marked improvement and two rated minimal improvement. Dermatologists' mean global evaluation score was 2.5 ± 0.43.

Limitations: The small sample size and regional nature of a single-center study. Nevertheless, both the expert dermatologists' and the patients' evaluations of standardized high-resolution medical photographs were consistent, suggesting that this inherent bias was negligible.

Conclusion: The treatment led to impressive improvement in the depth of the scars, suggesting that this technique can result in safe and rapid amelioration of atrophic acne scars in only two sessions.

Keywords: acne scar; atrophic; hyaluronic acid; hybrid cooperative complexes.

MeSH terms

  • Acne Vulgaris / complications*
  • Adult
  • Atrophy / diagnosis
  • Atrophy / etiology
  • Atrophy / therapy
  • Cannula
  • Cicatrix / diagnosis
  • Cicatrix / etiology
  • Cicatrix / therapy*
  • Dermal Fillers / administration & dosage*
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Injections, Subcutaneous / instrumentation
  • Injections, Subcutaneous / methods
  • Male
  • Middle Aged
  • Needles
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult


  • Dermal Fillers
  • Hyaluronic Acid