Efficacy and Safety of Combined Subcision and Autologous Platelet-Rich Plasma Therapy for Atrophic Acne Scars

Abstract

Background: Atrophic acne scars constitute a prevalent sequela of acne vulgaris, exerting substantial psychosocial morbidity, particularly among individuals with Fitzpatrick skin phototypes III–V, which predominate in South Asian populations. Objective: This study aimed to evaluate the efficacy and safety profile of combined subcision and autologous platelet-rich plasma (PRP) therapy in patients with mild-to-moderate atrophic acne scars across one, three, and six treatment sessions. Methods: A prospective observational study with repeated-measures design enrolled 50 patients (approximately 150 assessment time-points). Treatments were administered at 4-week intervals. Standardized assessments included patient-perceived percentage improvement, dermatologist-assessed percentage improvement, Clinician and Patient Global Aesthetic Improvement Scale (GAIS) scores, skin texture and tone ratings, and overall satisfaction. Adverse events were prospectively documented. Results: A clear dose-dependent therapeutic response was observed. Mean patient-perceived improvement increased from 11.14% ± 3.39% (1 session) to 19.43% ± 8.19% (3 sessions) and 28.34% ± 7.09% (6 sessions). Corresponding dermatologist-assessed improvement from 20.92% ± 3.26% to 29.11% ± 7.79% and 41.91% ± 5.37%, respectively. Mean Clinician GAIS scores progressed from 3.06 to 4.00 and 4.02. Overall satisfaction improved from 3.90 ± 1.56 to 5.51 ± 0.85 and 8.10 ± 1.54 on a 10-point scale. Recommendation rate was 100%. Side effects were mild and transient, with no serious adverse events or recurrence noted at 6-month follow-up. Conclusion: Combined subcision and PRP represents an efficacious and safe modality for the management of atrophic acne scars in Fitzpatrick skin types III–V, demonstrating progressive benefit with increasing treatment sessions.