Therapeutic potential of hyaluronic acid and polylactic acid for the treatment of atrophic scars

The prevalence of atrophic scars and their significant impact on the quality of life of patients make them a pressing concern in dermatology and aesthetic medicine. Atrophic scars are caused by pathological remodeling of connective tissue, which is characterized by a decrease in the number and structural disorganization of collagen and elastic fibers accompanied by the degradation of extracellular matrix components and a significant weakening of cell proliferation processes. Considering the underlying pathogenesis of atrophic scarring, treatment approaches should be based on stimulation of neocollagenesis and dermal remodeling to reduce the scar depth and achieve the smooth skin relief. Injectables have been shown to effectively address atrophic scarring by augmenting depressed scars and visually smoothing the skin surface. These products not only facilitate aesthetic improvement of dermal scar defects but also concurrently stimulate active proliferation of fibroblasts, thereby inducing neocollagenesis. These properties underscore the pathogenetic rationale for incorporating injectable hyaluronic acid (HA) and poly-L-lactic acid (PLLA) into the treatment of atrophic scars. Numerous clinical studies confirm the high efficacy of these products in improving atrophic scarring associated with acne, trauma, medical conditions, and surgical treatment. The clinical cases presented demonstrate the high efficacy and safety of HA and PLLA in the treatment of atrophic scars, including mature postoperative scars and striae. Of particular note is an example of successful hybrid correction of significant asymmetry and contour deformities in the lateral thigh area of a patient who had undergone two liposuctions, highlighting the versatility of these treatment options. The clinical examples in this article also confirm the high efficacy and safety of HA and PLLA in treating atrophic scarring, specifically mature postoperative scars and stretch marks, including those covering large areas of the body. Particularly noteworthy is the case of hybrid correction for severe asymmetry and contour deformities of the lateral thighs in a patient who had previously undergone two liposuction procedures.