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Pilot Study of Combination Treatment With Subcision, Human Adipose Tissue-Derived Exosomes and Powdered Polydioxanone for Atrophic Acne Scars

28 oktober 2026 uppdaterad av: COSMEDICIAN AP SDN BHD

Adipose-Derived Stem Cell Exosomes and Powdered Polydioxanone as Adjuncts to Subcision for Atrophic Acne Scars: A Prospective Split-Face Pilot Study

This pilot study compared two treatments for depressed acne scars: subcision alone and subcision followed by injections containing exosomes derived from human fat-derived stem cells and powdered polydioxanone (PDO). Subcision is a procedure that releases bands of tissue beneath the skin that pull acne scars downward.

Twelve adults with acne scars on both sides of the face participated at one clinic in Kuala Lumpur, Malaysia. Each participant received subcision alone on the left side and subcision with the additional injections on the right side. Three treatment sessions were performed four weeks apart, with a final assessment at Week 12.

The study examined whether adding the injections improved acne scar severity and overall appearance compared with subcision alone. Skin quality, treatment discomfort, recovery time, and unwanted effects were also assessed. A dermatologist who did not know which treatment each side received evaluated standardized photographs. This small study was intended to provide preliminary information to help plan larger studies.

Studieöversikt

Detaljerad beskrivning

This prospective, single-centre, non-randomised, assessor-blinded, split-face comparative pilot study evaluated the addition of human adipose-derived stem cell exosomes (hADSC-Exos) and powdered polydioxanone (PDO) to subcision for atrophic acne scars.

The split-face design allowed comparison of the treatments within the same participant. Treatment allocation was fixed: the left side received subcision alone, and the right side received the same subcision procedure followed by injection of the combined hADSC-Exos/PDO formulation. Participants were aware of treatment allocation.

Twelve participants were enrolled through convenience sampling at FFIMT Clinic, Kuala Lumpur, Malaysia. No formal efficacy sample-size calculation was performed because prior treatment-effect and variability estimates were unavailable. The pilot sample was selected to provide preliminary estimates of treatment effects, variability, and feasibility for subsequent studies.

Treatment sessions took place at Weeks 0, 4, and 8. On the combination-treatment side, 2.5 mL of the prepared hADSC-Exos/PDO suspension was injected into the subdermal plane after scar release. The final clinical assessment occurred at Week 12, four weeks after the third treatment.

Standardized facial photographs were obtained at baseline and Week 12 under consistent lighting, positioning, and camera settings. An independent dermatologist, blinded to treatment allocation and assessment time point, performed the photographic assessments. Participant assessments, treatment diaries, and investigator clinical assessments provided additional information on perceived improvement, skin quality, procedural pain, recovery, and treatment-emergent adverse effects.

The study received UCSI University Institutional Review Board approval before recruitment, and all participants provided written informed consent before study procedures.

Studietyp

Interventionell

Inskrivning (Faktisk)

12

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Kuala Lumpur
      • Kuala Lumpur, Kuala Lumpur, Malaysia, 50088
        • FFIMT Clinic

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 55 år (Vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. Adults aged 18 to 55 years, of any sex, ethnicity, or nationality.
  2. Bilateral atrophic acne scars of clinically comparable severity.
  3. No acne-scar treatment during the three months before enrollment.
  4. Able to understand the study information and willing to provide written informed consent.

Exclusion Criteria:

  1. Active inflammatory acne.
  2. Active herpes labialis.
  3. Human immunodeficiency virus (HIV) infection.
  4. Hepatitis B infection.
  5. History of keloid or hypertrophic scar formation.
  6. Bleeding disorders.
  7. Pregnancy or lactation.
  8. Previous facial surgery.
  9. Current systemic isotretinoin use or use within the six months before enrollment.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Subcision Alone - Left Facial Side

The left facial side of each participant received subcision alone using a blunt-tip cannula to release fibrotic adhesions beneath atrophic acne scars. Three sessions were performed at Weeks 0, 4, and 8.

Subdermal release of fibrotic scar adhesions using a 25-gauge, 50-mm blunt-tip cannula, with linear lancing and side-to-side fanning movements. Performed at Weeks 0, 4, and 8.

Experimentell: Subcision Plus hADSC-Exos/PDO - Right Facial Side

The right facial side of each participant received subcision followed by subdermal injection of 2.5 mL of a suspension containing human adipose-derived stem cell exosomes and powdered polydioxanone. Three sessions were performed at Weeks 0, 4, and 8.

Subdermal release of fibrotic scar adhesions using a 25-gauge, 50-mm blunt-tip cannula, with linear lancing and side-to-side fanning movements. Performed at Weeks 0, 4, and 8.

A suspension prepared by mixing 5 mL of human adipose-derived stem cell exosomes, containing approximately 15 billion particles, with 150 mg of powdered polydioxanone. A 2.5-mL volume of the prepared suspension was injected subdermally into the right facial side after subcision at each treatment session.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Atrophic Acne Scar Severity Using the Goodman and Baron Qualitative Acne Scar Grading System
Tidsram: Baseline (Week 0) and Week 16

Change from baseline to Week 16 in acne scar severity, assessed separately for each facial side by an independent blinded dermatologist using standardized photographs. The Goodman and Baron Qualitative Acne Scar Grading System grades severity from 1 to 4: grade 1 = macular scarring, grade 2 = mild scarring, grade 3 = moderate scarring, and grade 4 = severe scarring. Lower grades indicate less severe scarring. Changes will be compared between the combination-treatment side and the subcision-only side.

Baseline (Week 0) and Week 16

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Dermatologist-Rated Global Aesthetic Improvement Scale
Tidsram: Week 16

Overall aesthetic improvement of each facial side, assessed by the blinded dermatologist using the Global Aesthetic Improvement Scale: 1 = exceptional improvement, 2 = very improved, 3 = improved, 4 = unaltered, and 5 = worsened. Lower scores indicate greater improvement.

Week 16
Change in Participant-Rated Satisfaction With Facial Appearance
Tidsram: Baseline (Week 0) and Week 16

Participant-rated satisfaction with facial appearance before and after treatment, using a four-category self-satisfaction scale: 1 = poor (0-24%), 2 = good (25-49%), 3 = very good (50-74%), and 4 = excellent (75-100%). Higher scores indicate greater satisfaction.

Baseline (Week 0) and Week 16
Procedural Pain
Tidsram: Immediately after treatment at Weeks 0, 4, 8, 12 and through week 16

Participant-rated pain immediately after each treatment, measured using a Numeric Rating Scale from 0 = no pain to 10 = worst imaginable pain. Higher scores indicate greater pain.

Immediately after treatment at Weeks 0, 4, 8, 12 and through week 16
Duration of Post-Procedural Downtime
Tidsram: Following treatments at Weeks 0, 4, 8, 12 and through week 16

Duration of post-procedural downtime in days after each treatment session, recorded using participant treatment diaries and investigator assessments.

Following treatments at Weeks 0, 4, 8, 12 and through week 16
Change in Skin Colour Unevenness
Tidsram: Baseline (Week 0) and Week 16

Change from baseline to Week 16 in skin colour unevenness, assessed using the corresponding item of the Galderma Facial Skin Quality Assessment Scale. Severity is rated from 0 to 3: 0 = none, 1 = mild, 2 = moderate, and 3 = severe. Lower scores indicate more even skin colour.

Baseline (Week 0) and Week 16

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: Edmond Ng Siah Chye, MD, Msc, UCSI University

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 december 2023

Primärt slutförande (Faktisk)

1 september 2024

Avslutad studie (Faktisk)

1 januari 2025

Studieregistreringsdatum

Först inskickad

28 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

28 oktober 2026

Första postat (Faktisk)

3 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

3 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

28 oktober 2026

Senast verifierad

1 oktober 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • UCSI/IEC-2023-FMHS-0021(A)

Plan för individuella deltagardata (IPD)

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OBESLUTSAM

IPD-planbeskrivning

The team has not decided

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