Study of efficacy and safety of low-intensity pulsed ultrasound alone versus low-intensity pulsed ultrasound combined with hyaluronic acid for atrophic acne scars: a split-face comparative study

Background Acne scarring can profoundly affect mental health, necessitating effective treatments. Low-intensity pulsed ultrasound (LIPUS) and hyaluronic acid (HA) have shown potential in wound healing and tissue regeneration. Objective This study aimed to compare the efficacy and safety of LIPUS alone versus LIPUS combined with HA for treating atrophic acne scars. Patients and methods A single-blinded, prospective, split-face study was conducted on 20 adults with postacne atrophic scars. Scar assessment was performed using Goodman and Baron’s Qualitative Global Grading system and Goodman’s quantitative grading system. Patients completed the Facial Acne Scar Quality of Life questionnaire before and 3 months post-treatment. One side of the face received LIPUS alone, while the other received LIPUS combined with HA, with treatments administered three times weekly for 1 month. Results Both methods were effective, with no significant difference in outcomes at 3 and 12 months. Significant improvements were observed in scar appearance, patient satisfaction, and quality of life, with boxcar scars improving the most, followed by rolling scars. No serious side effects were reported. Conclusion LIPUS is a promising, safe, and cost-effective treatment for atrophic acne scars. Sonophoresis using HA showed better results, although they were not statistically significant. Further research is needed to optimize treatment parameters and explore combination therapies.