The 160-participant trial tested calcium hydroxylapatite filler plus CO2 ablative fractional laser for atrophic acne scars. It was published in 2026 and found stronger scar improvement with the combination than with laser alone.
Atrophic acne scars are sunken scars left after acne damages collagen. Calcium hydroxylapatite, called CaHA, is an injectable filler that supports skin structure. CO2 ablative fractional laser, called AFL, removes tiny columns of skin to trigger repair.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resource:
- Register through Crossref’s official page — Use this page to review requirements and register directly.
Table of Contents
- What did the combination involve?
- How much did scars improve?
- Which scar types responded best?
- What were the side effects and recovery?
- Who might ask a clinician about it?
- Frequently Asked Questions
What did the combination involve?
Group A received AFL first, then two CaHA filler sessions spaced one month apart. The filler course started one month after laser treatment. Group B received AFL alone, according to the Crossref abstract record.
The design was prospective, single-center, and randomized. It enrolled 160 adults with atrophic acne scars. Participants were assigned to Group A or Group B for comparison.
How much did scars improve?
Both groups had significantly lower global scarring scores than at baseline. The drop was significantly larger in the CaHA-plus-AFL group than with AFL alone, according to the Crossref abstract record.
That result matters because laser alone already helps many scars. The added benefit came on top of that response. Readers should compare their own scar pattern to the subtypes below before assuming the same gain.
Which scar types responded best?
Combination therapy improved all scar subtypes measured. Boxcar scars have broad, sharp-edged pits, while rolling scars create wavy dips. Icepick scars are narrow, deep pits.
Boxcar and rolling scars improved to a comparable degree. Both improved more than icepick scars, according to the Crossref abstract record. People with mainly icepick scars may need a different plan.
What were the side effects and recovery?
Both groups had mostly mild events such as pain, swelling, crusting, and short-term redness. CaHA injections added a risk of bruising at the injection sites. That trade-off came with faster fading of longer-term laser effects.
Long-term redness cleared 3.8 weeks sooner with the combination. Darkening after inflammation cleared 3.7 weeks sooner. Faster recovery can matter for work, school photos, and events. Readers should watch for these issues after either approach:.
- increasing pain, spreading redness, pus, or fever after treatment
- blisters, raw areas that worsen, or dark patches that spread
- bruising or lumps after filler that do not settle as advised
Who might ask a clinician about it?
The trial covered adults treated for atrophic acne scars at one center. Its protocol was approved by the Deyi Skin Ethics Review Committee under the 1964 Declaration of Helsinki, as described in the Springer Nature article.
The authors rate the evidence Level II and call for longer follow-up on long-term safety. Single-center, short-term results are most relevant to boxcar and rolling scars. Ask a dermatologist whether your scar mix, skin tone, downtime needs, and filler history fit that profile.
Frequently Asked Questions
Did laser alone help?
Yes. Both groups improved from baseline, but the CaHA-plus-laser group improved more.
Does the combination erase icepick scars?
It improved them, but less than boxcar and rolling scars in this trial.
Is recovery easier with the combination?
Long-term redness and darkening faded weeks sooner, although filler added bruising risk.