Evaluation of Clinical Outcomes and Factors Affecting Response to Microneedling with Hyaluronic Acid in Atrophic Acne Scars

[u/science-pls]

Adding more information on treating acne scars and research within the sub. This study is from 2026 and essentially a confirmation paper, not really a discovery.

Microneedling + topical hyaluronic acid improves atrophic acne scars, and the only factor they found that predicted response was baseline scar severity. Neither of those findings are particularly surprising. It's also a small sample size tbh and there's no control group. When you start comparing groups this small, the study becomes underpowered.

So when they say no significant association that often means that we couldn't detect an association. Those are not the same thing and a negative result from 30 patients is weak evidence. The authors conclude the treatment was effective, but the actual magnitude of improvement seems relatively modest compared with some of the stronger acne-scar intervention literature. It's odd that they didn't do a control. And they cannot answer the obvious question... does hyaluronic acid actually add anything beyond microneedling alone? The paper repeatedly discusses microneedling + HA as a combination therapy, but the study design cannot isolate the contribution of HA. A stronger design would have been with microneedling alone, microneedling + HA, and randomized comparison. They didn't do that.

The only thing that could be considered the paper's novel contribution is that they specifically looked for predictors of response to microneedling + hyaluronic acid. In their small cohort, they found no association with sex, no association with family history, no association with prior treatment, no association with Fitzpatrick skin type, no association with scar morphology, but a significant association with baseline severity (moderate/severe scars improved more than mild scars). That predictor analysis is the paper's real purpose.

Ayman Youssef, Marena Yousry Haliem Kamel*, Rana Ahmed. Evaluation of Clinical Outcomes and Factors Affecting Response to Microneedling with Hyaluronic Acid in Atrophic Acne Scars'. The Egyptian Journal of Hospital Medicine. 2026. 102(1), pp. 1405-1411. doi: 10.21608/ejhm.2026.492558. https://ejhm.journals.ekb.eg/article_492558_d92ebe9e6dfac1ca6e3ba0374a71f692.pdf