Combined treatment of atrophic scars using radiofrequency microneedling and hyaluronic acid fillers with subcision

Introduction. Atrophic scars may be associated with significant psychological stress and a substantial negative impact on quality of life. Despite the great relevance of the atrophic scars therapy, existing treatment methods do not always provide their complete elimination. Aim. To study the efficacy of combined therapy of atrophic scars with radiofrequency microneedling (RF-MN), subcision and hyaluronic acid filler injection. Materials and methods. Ten female patients aged 28–44 years with a clinical diagnosis of atrophic scars were randomly assigned to two groups. Group 1 received RF-MN alone, while Group 2 received a combination treatment comprising RF-MN, subcision, and hyaluronic acid injections. Clinical effectiveness was assessed using the Goodman-Baron scar rating scale and the Global Aesthetic Improvement Scale (GAIS). Ultrasound was used to determine the changes in dermal thickness. The volume of depressions and skin texture were measured using the Antera 3D®. The safety of the treatment was evaluated by recording adverse events. Results. The combined method demonstrated superior efficacy compared to RF-MN alone in the majority of efficacy parameters. In Group 2, a statistically significant reduction in Goodman-Baron scale was observed in 100% of patients (p = 0.026). 3D measurements of the face demonstrated a more pronounced improvement in skin texture in Group 2 relative to Group 1. Statistically significant changes (p = 0.027) in the Face-Q scale were exclusively observed in the group that received the combined treatment. Ultrasonic imaging demonstrated a restoration of dermal thickness following treatment. No serious adverse events were observed. Expected local adverse events (pain, erythema, swelling, and bruising) were mild and resolved spontaneously within 1–7 days. Conclusion. The combined treatment with RF-MN followed by subcision and hyaluronic acid filler injections demonstrated its efficacy in patients with atrophic scars.