Efficacy of Combined Subcision and Microfocused Ultrasound With Visualization for Improving Atrophic Acne Scars: A Split-Face Randomized Comparative Study
Natthachat Jurairattanaporn, Sonphet Chirasuthat, Suphagan Boonpethkaew, Sasipim Chaijaras, Pimsiri Anansiripun, Waritta Dararattanaroj, Panupong Pornsirianant, Natnicha Anuntaprayoon, Tanat Yongpisarn, Nawara Sakpuwadol, Vasanop VachiramonAbstract
Background
Subcision effectively treats atrophic acne scars but often requires combination therapy for optimal results. Microfocused ultrasound with visualization (MFU-V) induces neocollagenesis and may enhance outcomes, but prior studies are limited by small, non-randomized samples.
Objectives
This study aims to compare the efficacy and safety of combined subcision and MFU-V to subcision monotherapy in the treatment of atrophic acne scars.
Methods
Forty participants with mild-to-severe atrophic acne scars underwent a split-face randomized trial: one side received subcision monotherapy, the other combined subcision and MFU-V. Outcomes assessed at baseline, 1, 3, 6, and 9 months include depression volume (mm3), physician-graded acne scar severity, and patient-reported satisfaction, pain, and adverse events
Results
Direct between-group comparison of depression volume reduction did not reach statistical significance at any time point (p>0.05). Within-group analysis demonstrated a faster onset of statistically significant improvement in the combined therapy group at 6 months (p=0.036) compared with 9 months in the monotherapy group (p=0.007). Physician-graded acne scar severity showed statistically significant between-group differences, favoring combined treatment from 3 months follow-up onwards. Adverse events included ecchymosis (92.5%), edema (72.5%), and transient nodules (17.5%), all self-limited.
Conclusions
Both subcision monotherapy and combined subcision with MFU-V may be safe and effective treatments for atrophic acne scars. Although objective assessment of depression volume reduction did not yield statistically significant between-group differences, subjective physician evaluations revealed notable distinctions favoring the combined approach from 3 months onwards.