Efficacy and Safety of Micro-Plasma Radiofrequency Combined With Subcision for Acne-Induced Atrophic Scars

BACKGROUNDPost-inflammatory hyperpigmentation (PIH) represents a major concern in the treatment of acne-induced atrophic scars, particularly among individuals with intermediate to dark skin phototypes (Fitzpatrick skin types III–V). Although micro-plasma radiofrequency (MPR) is theoretically associated with a lower risk of PIH, evidence regarding its use in type III skin remains limited.

OBJECTIVETo preliminarily evaluate the efficacy and safety of combined MPR and subcision in patients with Fitzpatrick skin type III atrophic acne scars, and to explore correlations among baseline characteristics, treatment variables, and postoperative outcomes.

METHODSWe retrospectively analyzed patients with acne-induced atrophic scars treated at our hospital between 2017 and 2024. Comprehensive clinical data, including demographic information, scar characteristics, treatment protocols, and posttreatment outcomes, were systematically collected. Treatment efficacy was evaluated by assessing improvements in scar appearance, while safety was monitored by documenting any adverse effects associated with the procedure.

RESULTSTwelve patients (mean age 25.2 ± 4.1 years) completed three treatment sessions. Crust separation occurred within 15 days in all cases, with erythema resolving within 60 days in 91.7%. The overall complication rate was 8.3% (one transient hyperpigmentation). By ECCA assessment, no patient achieved “Cure” (0%); 58.3% were “Markedly effective”, 33.3% “Effective” and 8.3% “Ineffective”, yielding a total effective rate of 91.6%. Patient satisfaction (GAIS) revealed 25% “very satisfied”, 50% “satisfied”, and 25% “less satisfied”, with an overall satisfaction rate of 75%. Notably, a discordance was observed between objective efficacy and subjective satisfaction.

CONCLUSIONSThis combination regimen showed preliminary evidence of favorable efficacy with a manageable PIH risk in type III patients, findings that warrant validation in larger, adequately powered cohorts in darker skin phototypes. The observed discordance between 91.6% objective efficacy and 75% satisfaction underscores the necessity of dual-endpoint assessment and expectation management in aesthetic scar treatment. Exploratory correlation analyses suggested potential associations between baseline demographic features, anesthesia selection, and treatment outcomes. These preliminary findings, if validated, may inform individualized treatment planning.

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