{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T19:59:57Z","timestamp":1783713597619,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Atrophic acne scarring is an unfortunate, permanent complication of acne vulgaris, associated with significant psychological distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>A new complementary treatment of atrophic acne scars using subcision and injection of hybrid cooperative complexes of high and low molecular weight hyaluronan (hybrid H\u2010HA\/L\u2010HA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included eighty\u2010two patients divided into two groups with predominantly atrophic acne scarring. Group 1 received subcision with saline injection, while group 2 received triple steps acne scar revision technique (TSASRT). After topical anesthesia, the procedure of combining subcision and hybrid H\u2010HA\/L\u2010HA technique was done in which the first step started using subcision technique done to release fibrous cords\u00a0at the dermal or deep dermal, subcutaneous plane using Nokor needles\u201018\u00a0g. The second step is to inject the scar's atrophic dermal component with a 29\u00a0g needle, applying an average amount of hybrid H\u2010HA\/L\u2010HA (0.02\u20130.1\u00a0mL) to the dermal component. The third step was to fill the subcisied space with hybrid H\u2010HA\/L\u2010HA (0.02\u20130.1\u00a0mL) using a 25\u00a0g cannula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical improvement was achieved in both groups. There were statistically significant improvements in the TSASRT versus subcision (<jats:italic>p<\/jats:italic>\u00a0\u2264\u00a00.05) in acne scar severity index and qualitative scarring grading system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The triple step acne scar revision technique appears to be a safe and effective way to treat atrophic acne scars on the face.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14944","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T09:38:26Z","timestamp":1648546706000},"page":"4659-4668","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Triple steps acne scar revision technique: A new combination therapeutic modality for atrophic acne scars"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3074-1347","authenticated-orcid":false,"given":"Ghada F.","family":"Mohammed","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Faculty of Medicine Suez Canal University  Ismailia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-6647","authenticated-orcid":false,"given":"Mohammed Saleh","family":"Al\u2010Dhubaibi","sequence":"additional","affiliation":[{"name":"Dermatology Department of Medicine College of Medicine Shaqra University  Dawadmi Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/14764170310001258"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.113451"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.2004.06078.x"},{"issue":"2","key":"e_1_2_10_5_1","first-page":"139","article-title":"Acne scarring: current treatment options","volume":"18","author":"Frith M","year":"2006","journal-title":"Dermatol Nurs"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440\u20100960.2001.00492.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104725.1995.tb00259.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12860\u2010015\u20100064\u20106"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/rej.2014.1654"},{"key":"e_1_2_10_10_1","unstructured":"Profhilo\u00ae Leaflet | ACE UK. 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