Subcision With Injection of Poly Deoxyribonucleotide Versus Subcision With Injection of Non-cross Linked Hyaluronic Acid in Rolling Acne Scars Treatment : A Split Face Randomized Controlled Clinical Trial

The aim of this study is to evaluate and compare the efficacy and safety of two different injectable agents combined with subcision for treating rolling acne scars. In this split-face clinical trial, each participant will receive subcision on both sides of the face. One side will then be treated with an injection of Polydeoxyribonucleotide (PDRN), while the other side will receive an injection of non-cross linked Hyaluronic acid (HA). The clinical outcomes and improvement in scar appearance will be assessed and compared between both treatments

Inclusion Criteria: 1. Moderate to severe mainly rolling acne scars per validated scale (Goodman \& Baron Grade 3-4) 2. Scars must be bilaterally distributed, allowing for split-face comparison 3. Stable acne (no active nodulocystic lesions, pustules, or recent outbreaks for ≥6 months) 4. No scar treatments (e.g., fillers, laser, microneedling) within the past 12 months 5. All skin types. 6. Both genders above 18 years old Exclusion Criteria: 1. Systemic retinoid treatment within the last 6 months 2. Active inflammatory acne 3. Lidocaine sensitivity 4. Pregnancy and lactation 5. Severe systemic illness or malignancy 6. Use of anticoagulant or antiplatelet medications (unless cleared) Use of oral isotretinoin within the past 6 month 7. Herpes libialis, bacterial infection, other infections such as HBV, HCV or HIV 8. Tendency to keloid formation 9. Allergy to fish and salmon