Longer follow-up of the 2026 160-participant trial must show whether smoother texture lasts, whether scars relapse, and whether late pigment changes appear beyond 3-6 months. The trial found calcium hydroxylapatite filler plus CO2 ablative fractional laser effective and safe, with best results for boxcar and rolling atrophic scars. Atrophic acne scars are depressed scars left after acne heals. They affect adolescents and adults with moderate-to-severe facial pitting, especially mixed boxcar and rolling types, who want smoother texture once acne is controlled.
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Official resource:
- Read the 160-patient CaHA plus CO2 laser randomized trial — Verify the efficacy, safety, and short follow-up findings behind the longer-term claims.
Table of Contents
- What the 160-person combination tested
- Who saw the clearest benefit
- Why short follow-up is not enough
- What longer tracking and care should include
What the 160-person combination tested
The trial assigned 160 people with atrophic scars to calcium hydroxylapatite, called CaHA, plus CO2 ablative fractional laser versus control. CaHA is an injectable filler that supports tissue structure.
CO2 ablative fractional laser resurfaces skin in tiny columns to trigger remodeling. Springer Nature reports that the combined approach was an effective and safe multimodal treatment in the 2026 report Springer Nature report. The same report describes synergy: CaHA aids scar remodeling while supporting recovery after laser and reducing adverse events compared with laser alone.
Who saw the clearest benefit
People with moderate-to-severe depressed facial scars saw the most relevant gains. Benefit was strongest for boxcar scars, which have broad flat bases and sharp edges, and rolling scars, which create wave-like dips from tissue tethering.
Prior randomized evidence found ablative fractional CO2 resurfacing alone safely improves moderate-to-severe atrophic scars. Higher laser energy may improve change but can increase side effects, which makes combination strategies important for balancing results and tolerance.
Why short follow-up is not enough
The trial was single-center with short follow-up. That design cannot confirm durability, recurrence risk, late hyperpigmentation, or full collagen remodeling over time.
Springer Nature made the same point in a related combination trial, calling for larger multicenter study with longer follow-up dermatology combination report. For readers, this means early smoothness is promising but not proof of lasting correction.
What longer tracking and care should include
Longer studies should track ECCA scores, satisfaction, pigment change, and relapse beyond 3-6 months. ECCA scores grade scar number and severity.
Satisfaction shows whether visible change matters in daily life. An MDPI systematic review found most patients gain 30-70 percent scar-appearance improvement, while redness, swelling, crusting, and post-inflammatory darkening usually resolve within weeks MDPI systematic review. Practical steps during that period include:.
- Keep active acne controlled before scar procedures
- Use daily sun protection to lower pigment-change risk
- Expect staged correction rather than complete erasure
- Ask how results, photos, and pigment will be checked at 6 and 12 months
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