Introduction: Management of atrophic acne scars remains challenging, and conventional treatments often yield suboptimal or inconsistent outcomes. Stromal vascular fraction (SVF), a cell-rich fraction derived from adipose tissue, has recently gained attention as a promising regenerative therapy. Several previous studies have reported benefits of SVF when combined with other treatment modalities; however, its stand-alone efficacy for atrophic acne scars has not been clearly investigated. In addition, molecular evidence supporting the regenerative effects of SVF in acne scar treatment remains limited.
Methods: This randomized, evaluator-blinded, split-face clinical trial was conducted in 14 patients with bilateral facial atrophic acne scars. One side was treated with intradermal SVF injection, while the contralateral side received normal saline (NS). Clinical outcomes were assessed using scar counts, Évaluation Clinique des Cicatrices d'Acne (ECCA) scores, Scar Global Assessment (SGA) scores, and standardized photography at baseline, 5 weeks, and 10 weeks. Skin biopsies were analyzed via immunohistochemistry for markers of epidermal regeneration (cytokeratin 14, cytokeratin 15, p63, integrin β1) and dermal remodeling (collagen I, elastin, vimentin).
Results: At 10 weeks after initial treatment, the SVF-treated side showed a significantly greater reduction in total scar count compared to the NS-treated side (56.4% vs. 13.2%, p < 0.001). Scar subtype analysis revealed that all scar types (ice pick, boxcar, and rolling) responded more favorably to SVF treatment, with large effect sizes (Cohen's d > 0.99). ECCA and SGA scores were also significantly decreased on the SVF-treated side. Immunohistochemical analysis revealed marked upregulation of epidermal progenitor markers and increased deposition of collagen I, elastin, and vimentin in the SVF-treated tissue.
Conclusion: We clinically demonstrated that SVF injection improves atrophic acne scars and simultaneously revealed its regenerative mechanisms involving epidermal and dermal remodeling. This supports the use of SVF as an evidence-based treatment modality for atrophic acne scars.
Trial registration: ClinicalTrials.gov Identifier, NCT07094958.
Keywords: Acne; Atrophic acne scar; Stem cell; Stromal vascular fraction; Therapeutics.
Acne scars are common and can be difficult to treat effectively. In this study, researchers tested whether a treatment using stromal vascular fraction (SVF), a mixture of cells taken from a person’s own fat tissue, could help improve acne scars on its own. Fourteen patients with facial acne scars took part in the study. Each person received SVF injections on one side of the face and saltwater (saline) injections on the other side for comparison. After 10 weeks, the SVF-treated side showed a greater reduction in the number and severity of scars. When scar tissue samples were examined under a microscope, the SVF-treated skin showed increased activity of skin-repairing cells and higher levels of collagen, elastin, and other supportive proteins that help the skin heal and rebuild itself. These results suggest that SVF promotes both surface and deeper skin regeneration and may be a promising new treatment option for atrophic acne scars.
© 2025. The Author(s).