Atrophic Acne ScarNCT07199608
Subcision With CO₂ Laser or PRP vs Subcision Alone in Atrophic Acne Scars
A study testing subcision, subcision+fractional co2 laser and subcision+PRP in people with Atrophic Acne Scar, run by Assiut University at 1 site in Egypt.
Trial summary
Acne vulgaris is an inflammatory disease of pilosebaceous unit ,leading to different types of scars including atrophic, hypertrophic and keloidal. Atrophic scars are the most common type ,affecting about 75-90% of acne scar cases and can be ice pick, rolling or boxcar in morphology . Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Atrophic Acne Scar
- What is being tested?
- subcision, subcision+fractional co2 laser and subcision+PRP
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 1 siteEgypt
- Study dates
- Nov 2025to Jan 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- - Adult patients of both sexes with mild to severe atrophic post-acne scars.
Who cannot join
- - Age < 18 years
- Pregnant or lactating women
- Active inflammatory acne or infection in treatment area
- Premalignant or malignant lesions
- Photosensitive dermatoses
- Coagulation defects or blood disease
- History of keloid scars
- Systemic retinoid use in previous 6 months
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
Assiut University Hospitals, Dermatology Department
Asyut, Asyut Governorate
Yasmeen Gamal Abdel Halim, master, 01024164345, Yasmine.17289582@med.aun.edu.eg
Yasmeen Gamal Abdel Halim
About this study
Official title: A Combined Subcision Approach With Either Fractional CO₂ Laser or Platelet-rich Plasma Versus Subcision Alone in the Treatment of Atrophic Post-acne Scars
Acne vulgaris is an inflammatory disease of pilosebaceous unit ,leading to different types of scars including atrophic, hypertrophic and keloidal. Atrophic scars are the most common type ,affecting about 75-90% of acne scar cases and can be ice pick, rolling or boxcar in morphology . Theses scars may cause significant impact such as depression, anxiety , and reduced quality of life. multiple treatment modalities exist, including lasers ,chemical peels, dermabrasion, microneedling, subcision and platelet rich plasma. Subcision is a well established technique that improves rolling and boxcar scars by releasing fibrotic strands. Fractional co2 laser induces dermal remodeling and collagen neogenesis, while PRP enhances wound healing and collagen induction through growth factors. Combinig subcision with either co2 laser or PRP may enhance treatment efficacy compared to subcision alone.
rational : Subcision alone may provide limited improvement in some patients. Fractional CO₂ laser and PRP are promising adjunctive modalities that could enhance collagen remodeling and improve cosmetic outcomes. Evaluating their combined effect versus subcision alone will help determine the most effective and safe approach for managing atrophic post-acne scars.
aim of work:To compare the efficacy and safety of combined subcision with either fractional CO₂ laser or platelet-rich plasma versus subcision alone in the treatment of facial atrophic post-acne scars.
Read the detailed description
Type of the study: Prospective, comparative, split-face study. - Study Setting: The study will be done in Assiut University Hospital ,dermatology department ,after obtaining approval from ethics committee of Faculty of Medicine, Assiut University in Assiut, Egypt.
Sample Size Calculation:
Based on determining the main outcome variable, the estimated minimum required sample size is 42 cases (21 in each group). Sample size was calculated using G*Power software version 3.1.9.7, based on the following assumptions: The main outcome is the difference in mean Goodman and Baron quantitative scar score between two independent groups of patients: those treated with Subcision + PRP and those treated with Subcision + Fractional CO₂.
Based on clinical experience and after reviewing the literature, a large difference was assumed.
The main statistical test is a one-tailed independent t-test to detect the difference between two means.
Effect size = 0.8 Alpha = 0.05 Power = 0.80
All patients will undergo subcision on both sides of the face, patients will be randomly divided into two groups:
group I (21 patients)-subcision combined with platelet rich plasma injection at right side of the face and subcision alone at the other side.
group II (21 patients)-subcision combined with fractional CO2 at right side of the face and subcision alone at the other side .
Each side will be randomly selected by choosing a sealed opaque envelope containing a card labeled with either laser or PRP representing the right split face side treatments.
Each patient will undergo three sessions with one month interval in between. Patient preparation
- Each patient's entire face will be disinfected with alcohol and cleaned with saline.
- Anesthesia will be injected subcutaneously with 2% lidocaine
- A sharp needle inserted at a shallow angle, with the blade facing upward, at the periphery of the scarred area to create a pathway to facilitate the entry of the blunt cannula.
- Subcision will be performed with an 18-gauge blunt cannula introduced at a 30° angle into the mid to deep dermis, then moved back and forth in a fan-like motion under the scar to release fibrous bands at the dermal or deep dermal, subcutaneous plane until the sound of bands breaking lost, and no resistance felt (endpoint).
- To establish hemostasis, firm pressure should be applied for at least 5 min.
- After subcision, the face should be cleaned with alcohol swabs and then sterile saline.
PRP side (group I): Right side of the face will be injected with PRP and the other by saline.
Fractional side (group II): Right side of the face will be treated with a fractional CO2 laser (10,600 nm) using post acne scar mode (DAESHIN ENTERPRISE CO2, LTD. (D.S.E) 105,207,Digital ro,Guro-gu, Seol, Korea).
Post procedure care All patients should be instructed to avoid sunlight exposure and to use sunscreen (SPF ≥ 50).
Cold compresses in first 24h-48h to avoid edema and ecchymosis. Use topical antibiotic ointment as mupirocin or fusidic acid. Analgesics as paracetamol to decrease the pain.
-Research outcome measures:
- Primary (main): Goodman \& Baron qualitative \& quantitative grading systems.
- Secondary (subsidiary):
Photography, quartile grading scale. dermoscopic evaluation (erythema, pigmentation, photodamage, follicular density) Data entry and analysis will be carried out using SPSS version 21. Descriptive statistics will be performed with frequency and percentages for categorical variables. Mean and standard deviation for normally distributed numerical variables, while median and interquartile measures for non-normally distributed numerical. Then analytic statistics will be done as the chi-square test for comparing independent categorical variables, and McNemar's test. If the data is normally distributed independent t-test, paired t-test, ANOVA, and Pearsons correlations tests will be used. If the data is not normally distributed Mann-Whitney, Kruskal-Wallis, Willcoxon signed-rank, Friedman, and Spearmans correlation tests will be used. Values will be considered significant when P values equal or less than 0.05.
- Conditions
- Atrophic Acne Scar
- Being tested
- subcision, subcision+fractional co2 laser, subcision+PRP
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
subcisionProcedure or surgery
patients will undergo subcision procedure alone using 18 gauge blunt cannula to release fibrous bands under atrophic acne scars.this group will serve as control comparator
subcision+fractional co2 laserProcedure or surgery
patients will undergo subcision procedure followed by fractional co2 laser applied to right side of face, the left side will receive subcision alone
subcision+PRPBiological
patients will undergo subcision procedure followed by intradermal injection of autologous PRP prepared from patients blood on right side.left side will receive subcision alone
| Study group | Role | What they receive |
|---|---|---|
| subcision alone | Active comparator | Not described Receives: Procedure: subcision |
| subcision+fractional co2 laser | Experimental | Not described Receives: Procedure: subcision+fractional co2 laser |
| subcision+platelet rich plasma | Experimental | Not described Receives: Biological: subcision+PRP |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Goodman and Baron quantitative acne scar score (Baseline vs 1 month post last session).
If the scale was lowered by: (Quantitative) 0-5 points, the reduction will be considered minimal 5-10 points, it will be considered moderate reduction 10-15 points, it will be considered good reduction >15 points, it will be considered very good reduction
Measured: 3 sessions per patient at 1-month intervals Follow-up: 1 month after last session
Secondary outcomes (1)
Quartile grading scale improvement - Dermoscopic evaluation (erythema, pigmentation, photodamage, follicle density)
0 = slight improvement if <25%
- = moderate improvement if 25-49%
- = significant improvement if 50-74%
- = marked improvement if >75
Measured: 3 sessions per patient at 1-month intervals Follow-up: 1 month after last session
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Sep 2025
- Study startNov 2025 (estimated)
- Primary completionNov 2026 (estimated)
- Study completionJan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Atrophic Acne ScarStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 42 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Yasmeen Gamal Abdel Halim Ahmed, Assiut University
- Investigators
- Azza Mahfouz Abdel Meguid, Study chair, Assiut UniversityReham Maher Abd El Gaber, Study director, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07199608
- Sponsor's protocol ID
- subcision in acne scars
- Status last verified
- Sep 2025
- First submitted
- 22 Sep 2025
- Last updated
- 3 Oct 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Tran BQ, Tran TNA, Doan EVL, Nguyen TTP, Nguyen HT. Simultaneous versus sequential fractional CO2 laser and subcision combination for management of post-acne atrophic scars: A split-face comparative study. J Cosmet Dermatol. 2024 Oct;23(10):3210-3221. doi: 10.1111/jocd.16395. Epub 2024 May 21.
PubMed 38770894Abdelwahab AA, Omar GAB, Hamdino M. A combined subcision approach with either fractional CO2 laser (10,600 nm) or cross-linked hyaluronic acid versus subcision alone in atrophic post-acne scar treatment. Lasers Med Sci. 2022 Dec 24;38(1):20. doi: 10.1007/s10103-022-03677-y.
PubMed 36564573
Study at a glance
From the registry record, last updated by the sponsor on 3 Oct 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Combined Subcision Approach With Either Fractional CO₂ Laser or Platelet-rich Plasma Versus Subcision Alone in the Treatment of Atrophic Post-acne Scars
- ClinicalTrials.gov ID
- NCT07199608
- Acronym / sponsor ID
- subcision in acne scars
- Conditions
- Atrophic Acne Scar
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 42 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- Nov 2025 (estimated)
- Primary completion
- Nov 2026 (estimated)
- Study completion
- Jan 2027 (estimated)
- First posted
- 30 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Acne vulgaris is an inflammatory disease of pilosebaceous unit ,leading to different types of scars including atrophic, hypertrophic and keloidal. Atrophic scars are the most common type ,affecting about 75-90% of acne scar cases and can be ice pick, rolling or boxcar in morphology . Theses scars may cause significant impact such as depression, anxiety , and reduced quality of life. multiple treatment modalities exist, including lasers ,chemical peels, dermabrasion, microneedling, subcision and platelet rich plasma. Subcision is a well established technique that improves rolling and boxcar scars by releasing fibrotic strands. Fractional co2 laser induces dermal remodeling and collagen neogenesis, while PRP enhances wound healing and collagen induction through growth factors. Combinig subcision with either co2 laser or PRP may enhance treatment efficacy compared to subcision alone.
rational : Subcision alone may provide limited improvement in some patients. Fractional CO₂ laser and PRP are promising adjunctive modalities that could enhance collagen remodeling and improve cosmetic outcomes. Evaluating their combined effect versus subcision alone will help determine the most effective and safe approach for managing atrophic post-acne scars.
aim of work:To compare the efficacy and safety of combined subcision with either fractional CO₂ laser or platelet-rich plasma versus subcision alone in the treatment of facial atrophic post-acne scars.
Detailed description
Type of the study: Prospective, comparative, split-face study. - Study Setting: The study will be done in Assiut University Hospital ,dermatology department ,after obtaining approval from ethics committee of Faculty of Medicine, Assiut University in Assiut, Egypt.
Sample Size Calculation:
Based on determining the main outcome variable, the estimated minimum required sample size is 42 cases (21 in each group). Sample size was calculated using G*Power software version 3.1.9.7, based on the following assumptions: The main outcome is the difference in mean Goodman and Baron quantitative scar score between two independent groups of patients: those treated with Subcision + PRP and those treated with Subcision + Fractional CO₂.
Based on clinical experience and after reviewing the literature, a large difference was assumed.
The main statistical test is a one-tailed independent t-test to detect the difference between two means.
Effect size = 0.8 Alpha = 0.05 Power = 0.80
All patients will undergo subcision on both sides of the face, patients will be randomly divided into two groups:
group I (21 patients)-subcision combined with platelet rich plasma injection at right side of the face and subcision alone at the other side.
group II (21 patients)-subcision combined with fractional CO2 at right side of the face and subcision alone at the other side .
Each side will be randomly selected by choosing a sealed opaque envelope containing a card labeled with either laser or PRP representing the right split face side treatments.
Each patient will undergo three sessions with one month interval in between. Patient preparation
- Each patient's entire face will be disinfected with alcohol and cleaned with saline.
- Anesthesia will be injected subcutaneously with 2% lidocaine
- A sharp needle inserted at a shallow angle, with the blade facing upward, at the periphery of the scarred area to create a pathway to facilitate the entry of the blunt cannula.
- Subcision will be performed with an 18-gauge blunt cannula introduced at a 30° angle into the mid to deep dermis, then moved back and forth in a fan-like motion under the scar to release fibrous bands at the dermal or deep dermal, subcutaneous plane until the sound of bands breaking lost, and no resistance felt (endpoint).
- To establish hemostasis, firm pressure should be applied for at least 5 min.
- After subcision, the face should be cleaned with alcohol swabs and then sterile saline.
PRP side (group I): Right side of the face will be injected with PRP and the other by saline.
Fractional side (group II): Right side of the face will be treated with a fractional CO2 laser (10,600 nm) using post acne scar mode (DAESHIN ENTERPRISE CO2, LTD. (D.S.E) 105,207,Digital ro,Guro-gu, Seol, Korea).
Post procedure care All patients should be instructed to avoid sunlight exposure and to use sunscreen (SPF ≥ 50).
Cold compresses in first 24h-48h to avoid edema and ecchymosis. Use topical antibiotic ointment as mupirocin or fusidic acid. Analgesics as paracetamol to decrease the pain.
-Research outcome measures:
- Primary (main): Goodman \& Baron qualitative \& quantitative grading systems.
- Secondary (subsidiary):
Photography, quartile grading scale. dermoscopic evaluation (erythema, pigmentation, photodamage, follicular density) Data entry and analysis will be carried out using SPSS version 21. Descriptive statistics will be performed with frequency and percentages for categorical variables. Mean and standard deviation for normally distributed numerical variables, while median and interquartile measures for non-normally distributed numerical. Then analytic statistics will be done as the chi-square test for comparing independent categorical variables, and McNemar's test. If the data is normally distributed independent t-test, paired t-test, ANOVA, and Pearsons correlations tests will be used. If the data is not normally distributed Mann-Whitney, Kruskal-Wallis, Willcoxon signed-rank, Friedman, and Spearmans correlation tests will be used. Values will be considered significant when P values equal or less than 0.05.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| subcision alone | Active comparator | Procedure: subcision |
| subcision+fractional co2 laser | Experimental | Procedure: subcision+fractional co2 laser |
| subcision+platelet rich plasma | Experimental | Biological: subcision+PRP |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- - Adult patients of both sexes with mild to severe atrophic post-acne scars.
Key exclusion criteria (8 listed)
- - Age < 18 years
- Pregnant or lactating women
- Active inflammatory acne or infection in treatment area
- Premalignant or malignant lesions
- Photosensitive dermatoses
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| subcisionpatients will undergo subcision procedure alone using 18 gauge blunt cannula to release fibrous bands under atrophic acne scars.this group will serve as control comparator | Procedure or surgery | subcision alone |
| subcision+fractional co2 laserpatients will undergo subcision procedure followed by fractional co2 laser applied to right side of face, the left side will receive subcision alone | Procedure or surgery | subcision+fractional co2 laser |
| subcision+PRPpatients will undergo subcision procedure followed by intradermal injection of autologous PRP prepared from patients blood on right side.left side will receive subcision alone | Biological | subcision+platelet rich plasma |
Primary outcome
Change in Goodman and Baron quantitative acne scar score (Baseline vs 1 month post last session).
Time frame: 3 sessions per patient at 1-month intervals Follow-up: 1 month after last session
If the scale was lowered by: (Quantitative) 0-5 points, the reduction will be considered minimal 5-10 points, it will be considered moderate reduction 10-15 points, it will be considered good reduction >15 points, it will be considered very good reduction
1 secondary outcome
Quartile grading scale improvement - Dermoscopic evaluation (erythema, pigmentation, photodamage, follicle density)
Time frame: 3 sessions per patient at 1-month intervals Follow-up: 1 month after last session
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Oct 2025.
- Background: PubMed 38770894Tran BQ, Tran TNA, Doan EVL, Nguyen TTP, Nguyen HT. Simultaneous versus sequential fractional CO2 laser and subcision combination for management of post-acne atrophic scars: A split-face comparative study. J Cosmet Dermatol. 2024 Oct;23(10):3210-3221. doi: 10.1111/jocd.16395. Epub 2024 May 21.
- Background: PubMed 36564573Abdelwahab AA, Omar GAB, Hamdino M. A combined subcision approach with either fractional CO2 laser (10,600 nm) or cross-linked hyaluronic acid versus subcision alone in atrophic post-acne scar treatment. Lasers Med Sci. 2022 Dec 24;38(1):20. doi: 10.1007/s10103-022-03677-y.
- Related InfoLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Azza Mahfouz Abdel Meguid study chair
Assiut University
Reham Maher Abd El Gaber study director
Assiut University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing subcision, subcision+fractional co2 laser and subcision+PRP in people with Atrophic Acne Scar, run by Assiut University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 3 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Yasmeen Gamal Abdel Halim (01024164345, ysoo122221@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Goodman and Baron quantitative acne scar score (Baseline vs 1 month post last session). (time frame: 3 sessions per patient at 1-month intervals Follow-up: 1 month after last session). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07199608, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Oct 2025.