Atrophic scars resulting from acne, chickenpox, or trauma often remain visible despite dermatological treatment. Their characteristic feature is a depression in the skin caused by a loss of collagen and elastic fibers.
Filling them with hyaluronic acid is a non-surgical and fast correction method that provides immediate improvement in appearance and stimulates natural skin regeneration. This procedure combines volumetric action with biostimulation, resulting not only in visual smoothing but also in improving skin quality at the cellular level.
Mechanism of Action
Filling scars with hyaluronic acid is based on three synergistic mechanisms:
- Mechanical lifting and filling of the depression
- A highly plastic gel is injected directly under the scar, allowing it to be lifted to the level of the surrounding skin.
- Biostimulation of fibroblasts and collagen rebuilding
- The puncture and HA itself stimulate dermal skin cells to synthesize collagen type I and III as well as elastin, supporting scar remodeling.
- Improvement of skin hydration and elasticity
Hyaluronic acid strongly binds water, leading to improved skin tension and overall tissue structure.
The filling effect lasts from 12 to 24 months, and in many cases, subsequent treatments require less product due to improved skin condition.
When to Consider?
Indications for the procedure include:
- Acne scars types: rolling and boxcar
- Scars from chickenpox or infectious diseases
- Post-traumatic and surgical scars with volume loss
- Scars from corticosteroid treatments
- Smoothing skin texture post-laser treatments or dermabrasion
- Consider the treatment if:
- Scars affect your self-esteem and confidence
- You seek a non-invasive solution with immediate results
- You value a therapy that combines aesthetics with regeneration
Treatment Effects
Filling scars with hyaluronic acid yields multidimensional results – both immediate and long-lasting. Here's what to expect:
- Immediate effects (visible right after the procedure):
- Elevation of skin depressions – physically raising the scar floor to the level of surrounding skin
- Smoothing of skin surface – visible improvement in structure, reducing the contrast between healthy and scarred skin
- Evening out skin tone around the scar – improved blood circulation and shadow dispersion within the scar area
- Improved skin tension and hydration – thanks to hyaluronic acid's hydrophilic properties
Long-term effects (within 4-8 weeks and beyond):
- Stimulation of collagen and elastin synthesis – HA and the injection process stimulate fibroblasts to produce support proteins
- Rebuilding of the intercellular matrix – the skin around the scar becomes more elastic, dense, and firm
- Reduced scar visibility at rest and in motion – the skin regains natural elasticity
- Increased skin smoothness – skin texture becomes more uniform and pleasant to touch
- Reduction in future treatment sessions – with regular stimulation, the scar undergoes favorable structural changes, reducing the need for large amounts of product
- Improved well-being and psychological comfort – confirmed improvement in quality of life for acne scar patients after HA filling
Combining Treatments
Combining hyaluronic acid filling with other regenerative and rebuilding methods allows for synergy – faster, more effective, and deeper skin rebuilding. Here are specific combinations along with their justification and recommended timing of use:
- Microneedling (e.g., Dermapen 4.0)
→ When: 2-4 weeks after filling or in a series before the procedure
→ Why: Intensifies regenerative processes, stimulates fibroblasts to produce collagen, and improves skin texture. Enhances the long-term effect of filling.
- Platelet-Rich Plasma (PRP) Therapy or CGF/CD34+ stem cells
→ When: 1-2 weeks after HA or combined – in separate sessions of the same treatment series
→ Why: Accelerates tissue regeneration and dermal skin rebuilding, reduces inflammation, stimulates angiogenesis and healing. A great complement to HA action.
- Autologous exosomes
→ When: after the first phase of regeneration (3-4 weeks after HA)
→ Why: Exosomes are advanced signaling molecules that stimulate skin cells for self-repair and accelerate scar remodeling. Recommended especially for deep changes and mature skin.
- CO2 or Er:YAG Fractional Laser (ablative)
→ When: 6-8 weeks after filling or before starting HA therapy
→ Why: The laser exfoliates and rebuilds the skin surface, improving its tone, structure, and tension. HA works best when the scar is released and the skin surface is softened.
- Medical Peels (TCA, mandelic acid, glycolic acid)
→ When: 3-4 weeks after HA treatment
→ Why: Removes dead skin cells, supports renewal, and improves the absorption of active ingredients. Enhances skin tone and gently flattens the scar surface.
- LED Therapy / red light / biophotonic
→ When: immediately after the procedure or in the following days
→ Why: LED light reduces redness, promotes healing, improves cell metabolism, and enhances skin biostimulation effectiveness.
These combinations are used sequentially or in associated protocols, depending on the scar severity and skin condition.
Filling atrophic scars with hyaluronic acid is a safe and effective method that combines immediate aesthetic correction with long-term regeneration. Through modern injection techniques and individual selection of products, achieving natural, harmonious results is possible – without a recovery period. It's a solution for individuals who want to not only conceal imperfections but also effectively improve skin structure and quality.