Poly-L-Lactic Acid Threads Versus Platelet-Rich Plasma for Post-Traumatic Atrophic Scars

Acne Atrophica, PRP

acne scars, PRP, subscision, threads

This study compares the efficacy and safety of poly-L-lactic acid (PLLA) threads versus platelet-rich plasma (PRP), both combined with subcision, in the treatment of post-traumatic atrophic scars. Patients with post-traumatic atrophic scars were allocated to either a single session of subcision followed by PLLA thread insertion or four monthly sessions of subcision combined with PRP injection. Clinical improvement, patient satisfaction, adverse effects, and histopathological changes were assessed during a 3-month follow-up period.

Post-traumatic atrophic scars result from abnormal healing following skin injury and may cause significant cosmetic and functional impairment. Subcision releases the fibrous bands tethering the scar to deeper tissues and may improve the response to additional treatments. PLLA threads are biodegradable materials that can stimulate collagen production, while PRP contains concentrated platelets and growth factors that may enhance tissue repair and remodeling. This comparative study was conducted at the Dermatology and Venereology Department, Tanta University Hospital. Patients diagnosed with post-traumatic atrophic scars for at least one year and who had not received treatment during the preceding six months were enrolled. Patients with keloids, immunosuppression, coagulative or thrombophilic disorders, or chronic diseases were excluded. Participants were divided into two equal treatment groups. Group A received a single session of subcision followed by insertion of poly-L-lactic acid threads. Group B received subcision combined with PRP injection for four sessions at one-month intervals. Clinical photographs were obtained before treatment and three months after treatment. Clinical improvement was assessed by two blinded dermatologists using the Global Aesthetic Improvement Scale, while patient satisfaction and treatment-related complaints or adverse effects were also recorded. Skin biopsies were obtained from six patients before treatment and three months after treatment and evaluated using hematoxylin and eosin and trichrome staining to assess histopathological changes. All patients were followed for three months. The study was approved by the Research Ethics Committee of the Faculty of Medicine, Tanta University, with approval number 32889/01/19, and informed consent was obtained from all participants.

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