Acne scar treatment with fibroblasts and PRP

Atrophic acne scars are depressions in the skin left when acne damages collagen. There is no definitive treatment, so dermatologists combine methods: fractional laser, subcision and regenerative treatments such as platelet-rich plasma (PRP), hyaluronic acid and cultured fibroblasts. The aim is to rebuild the lost collagen under the scar.

What are fibroblasts and why use them?

Fibroblasts are the skin cells that make collagen. In fibroblast therapy, a small sample of the patient's skin is taken, the fibroblasts are grown in a laboratory, and they are injected back into the scars. Because they are the patient's own cells, the aim is to restore collagen where it is missing.

What did the fibroblast study find?

In a 2025 split-face pilot study led by Professor Nilforoushzadeh's group, eight patients had a fibroblast and PRP suspension injected on one side of the face and PRP alone on the other, in three sessions two weeks apart. After six months:

• skin thickness increased much more on the fibroblast side (a median change of 32.57 against 5.33);
• elasticity, hydration, fine pores, and scar volume and area improved significantly more with the combination;
• large pores and spots improved on both sides to a similar degree.

The authors conclude that the combination may be a new and effective approach. With eight patients, it is a pilot result that needs larger trials.

What about PRP with hyaluronic acid?

A second split-face trial of 15 patients treated acne scars with fractional CO2 laser followed by PRP, non-cross-linked hyaluronic acid or both. Patients and physicians were most satisfied with the combination. The same approach has been tested for burn scars; see PRP and hyaluronic acid for scars.

Which treatment is right?

It depends on the type and depth of the scars, skin type and how much downtime is acceptable. Rolling scars, boxcar scars and ice-pick scars respond differently, so the plan usually combines methods. For how these treatments fit into regenerative care more broadly, see the regenerative dermatology guide.