Atrophic scars resulting from acne, chickenpox, or injuries often remain visible despite dermatological treatment. Their characteristic feature is the indentation in the skin surface caused by a loss of collagen and elastic fibers.
Filling them with hyaluronic acid is a non-surgical and fast correction method, providing an immediate improvement in appearance and stimulating natural skin regeneration. This procedure combines volumizing action with bio-stimulation, resulting not only in visual smoothing but also in improving skin quality at a cellular level.
Mechanism of Action
Filling scars with hyaluronic acid is based on three synergistic mechanisms:
- Mechanical lifting and filling of the indentation - The highly plastic gel is injected directly under the scar, allowing it to be raised to the level of the surrounding skin.
- Biostimulation of fibroblasts and collagen rebuilding - The injection and the hyaluronic acid itself stimulate the skin's 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 effect of the filling lasts from 12 to 24 months, and in many cases, subsequent treatments require less product due to improved skin condition.
When is it Worth Using?
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 therapy
- Smoothing skin surface after laser treatments or dermabrasion
Consider the procedure if:
- Scars affect your self-esteem and confidence
- You are looking for a non-invasive solution with immediate effects
- You value therapy that combines aesthetics with regeneration
Effects of the Procedure
Filling scars with hyaluronic acid brings multidimensional results - both immediate and long-lasting. Here's what to expect:
Immediate effects (visible right after the procedure):
- Lifting of skin indentations - physically raising the scar floor to the level of the surrounding skin
- Smoothing of the skin surface - visible improvement in structure, reducing the contrast between healthy and scarred skin
- Evening out skin tone around the scar - better blood flow and dispersion of shadows within the scar area
- Improvement in skin tension and hydration - due to the hydrophilic properties of hyaluronic acid
Long-term effects (within 4-8 weeks and later):
- Stimulation of collagen and elastin synthesis - HA and the injection process stimulate fibroblasts to produce supportive proteins
- Remodeling of the intercellular matrix - the skin around the scar becomes more elastic, dense, and firm
- Reduced visibility of the scar at rest and in motion - the skin regains its natural elasticity
- Increased skin smoothness - skin texture becomes more uniform and pleasant to the touch
- Reduction in the number of future treatments - 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 the quality of life of patients with acne scars after HA filling
Combining the Procedure
Filling atrophic scars with hyaluronic acid is an effective procedure on its own, but even better and longer-lasting results are achieved by combining it with other regenerative techniques. The appropriate combination depends on the type of scars, skin condition, and expected effects. Below are the most effective combinations - with the recommended timing:
- 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. Strengthens the regenerative effect and improves skin density, reducing structural irregularities. Excellent preparation for HA or as a maintenance procedure.
- Platelet-rich plasma therapy (PRP) or CGF/CD34+ stem cells
→ When: 1-2 weeks after HA or combined - in separate sessions within the same treatment series or in series before the filling procedure
→ Why: Accelerates tissue regeneration and dermal remodeling, reduces inflammation, stimulates angiogenesis and healing. Excellent complement to HA action.
- Autologous exosomes
→ When: after the initial regeneration phase (4-6 weeks after HA) or as part of combined therapy with PRP/CGF
→ 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: 3-8 weeks before HA filling
→ Why: Laser reduces hyperkeratosis, stimulates collagen, and softens the scar, preparing it for filling. HA works best when the scar is released and the skin surface is softened. Applying the laser after HA can degrade the product, so resurfacing is done first, followed by hyaluronic acid injection.
- Micro-needle radiofrequency (fractional RF)
→ When: 4-6 weeks before HA if the scar is deep and fibrotic, or 6-8 weeks after HA as a reinforcing therapy
→ Why: RF micro-needling acts deeply on the dermis, stimulating collagen production and remodeling the scar from within. Excellent for boxcar and rolling scars. Increases the effectiveness of subsequent filling.
- Medical peels (TCA, mandelic acid, glycolic acid, retinol)
→ When: 3-4 weeks after HA or in cycles before starting filling therapy
→ Why: Gently exfoliates the epidermis and stimulates skin regeneration. Improves skin tone, texture, and absorption of active ingredients - especially in the case of acne scars with discoloration.
- LED therapy / red light / biophotonic
→ When: immediately after the procedure or in the following days
→ Why: LED light reduces redness, supports healing, improves cellular metabolism, and enhances skin biostimulation efficiency.
These combinations are applied sequentially or in associated protocols, depending on the advancement of scars and skin condition.
Filling atrophic scars with hyaluronic acid is a safe and effective method that combines immediate aesthetic correction with long-term regeneration. Thanks to modern injection techniques and individual selection of products, achieving natural, harmonious results is possible - without a recovery period. This is a solution for those who want to not only conceal imperfections but also genuinely improve skin structure and quality.