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Group A received two sessions of CaHA (1-month interval) after AFL 1 month, while Group B received AFL monotherapy. Efficacy was assessed by pre- and post-operation of standardized photographic images. Additionally, treatment-related adverse events (AEs) were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with baseline, the quantitative global scarring grading system scores decreased significantly in both groups (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), with greater reduction observed in group A (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). The acne scar rating scale analysis revealed the combination therapy\u2019s effectiveness across all scar subtypes (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and demonstrated comparable efficacy for boxcar and rolling scars (\n                      <jats:italic>p<\/jats:italic>\n                      = 1.000), both of which showed superiority to icepick scars (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Mild AEs are occurred in both group, such as pain, edema, crusting, and transient post-inflammatory erythema (PIE), CaHA injection may pose a risk of ecchymosis. Nevertheless, long-term PIE (lasting over 4 weeks) (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and post-inflammatory hyperpigmentation (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) in group A exhibited significantly shorter healing times, accelerated healing by an average of 3.8 weeks and 3.7 weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of CaHA with AFL demonstrates both efficacy and safety for atrophic acne scars, particularly boxcar and rolling subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence II<\/jats:title>\n                    <jats:p>\n                      This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.springer.com\/00266\" ext-link-type=\"uri\">www.springer.com\/00266<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00266-026-06142-1","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T19:44:32Z","timestamp":1783367072000},"page":"6345-6353","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Calcium Hydroxylapatite Combined with CO2 Ablative Fractional Laser for Atrophic Acne Scars: A Randomized Controlled Study"],"prefix":"10.1007","volume":"50","author":[{"given":"Weiliang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5494-5275","authenticated-orcid":false,"given":"Kai","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolei","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"issue":"6","key":"6142_CR1","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.jaad.2022.04.021","volume":"90","author":"T Jennings","year":"2024","unstructured":"Jennings T, Duffy R, McLarney M, Renzi M, Heymann WR, Decker A, et al. 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