A 160-person trial published in 2026 found calcium hydroxylapatite filler plus CO2 ablative fractional laser improved atrophic acne scars, with the clearest results for boxcar and rolling types. Atrophic scars are depressed scars caused by tissue and collagen loss, so the headline is not proof that any laser-plus-filler works for every scar. The study compared the CaHA-plus-laser combination against laser-centered control care. Readers with these scars can use the result as a starting point for a clinic conversation, not as a promise of the same outcome.
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Table of Contents
- What the combination involved
- Which scars responded best?
- Why laser alone can disappoint
- How to avoid overreading the headline
What the combination involved
The trial enrolled 160 subjects at Dexi medical aesthetic clinic Deyi Skin from December 2023 to March 2025, according to Springer Nature's Aesthetic Plastic Surgery in the trial report. Participants were randomly assigned to an observation group or a control group.
The observation group received calcium hydroxylapatite, called CaHA, injection plus CO2 ablative fractional laser, called AFL. The control group received laser-centered care for comparison, as described by Springer Nature's Aesthetic Plastic Surgery in the combination treatment report.
Which scars responded best?
Atrophic scars fall into icepick, boxcar, and rolling types, according to Dermatology Times reporting on scar classification. Icepick scars are narrow and deep.
Boxcar scars have sharper edges and rolling scars have broader, wavy depressions. The authors concluded the combined CaHA-plus-AFL regimen was effective and safe, with optimal results for boxcar and rolling subtypes. That distinction matters because a person with mainly icepick scars is looking at a different problem than the headline result.
Why laser alone can disappoint
AFL alone often needs multiple sessions and can cause post-inflammatory redness and darkening, especially in darker skin tones. Response may also be weaker for rolling and icepick scars.
The practical point is recovery, not just scar filling. In this trial, CaHA injection appeared to aid post-laser recovery by reducing adverse events.
How to avoid overreading the headline
Results came from one clinic over one period, so they may not transfer to other devices, operators, skin types, or longer follow-up. A clinic using a different laser, filler, spacing, or aftercare plan is offering a different treatment. Bring these checks to a consultation:.
- Ask which subtype dominates your scars: icepick, boxcar, rolling, or mixed.
- Ask what exact filler, laser settings, sessions, and follow-up the clinic uses.
- Ask about redness and pigmentation risk for your skin tone and history.
- Ask what recovery support is included and what would delay the next session.
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