What question did this study set out to answer?

This research aims to evaluate the effectiveness and safety of autologous cell-based therapies for atrophic acne scars.

March 14, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Efficacy and safety of autologous cell-based therapies for atrophic acne scar treatment: an updated systematic review and meta-analysis with in-depth methodological and clinical insights

SZShuang Zhang YRYanxia Ren XHXudong Hong

Key Points

This research aims to evaluate the effectiveness and safety of autologous cell-based therapies for atrophic acne scars.
Conducted a systematic search of multiple databases for RCTs and split-face studies.
Focused on therapies including stromal vascular fraction and ReCell compared to control treatments.
Primary outcome measured was the change in ECCA grading score.
Performed random-effects models for data pooling.
Eighteen studies with 500 participants showed significant ECCA score reduction (SMD = −1.25).
SVF-based therapies had the largest effect size (SMD = −1.40).
Higher patient satisfaction in intervention groups (RR = 1.45).
Greater scar depth reduction (MD = −0.25 mm) and accelerated wound healing (MD = −2.5 days).
Lower adverse events incidence in treatment groups (RR = 0.70).

Abstract

Background Atrophic acne scars represent a therapeutic challenge with significant psychosocial impact. Autologous cell-based therapies, such as stromal vascular fraction (SVF) and the ReCell® system, aim to address the underlying dermal matrix deficiency through regenerative mechanisms. This systematic review and meta-analysis provides an updated and comprehensive quantitative synthesis of their standalone efficacy and safety. Methods We conducted a systematic search of multiple databases (PubMed, Embase, Cochrane Library, CNKI, Wanfang) from inception to December 2025 for randomized controlled trials (RCTs) and split-face studies comparing autologous cell therapies (SVF, ReCell, fat grafting) with control treatments (e.g., saline, laser alone) for atrophic acne scars. The primary outcome was the change in the ECCA grading score. Secondary outcomes included patient satisfaction, objective scar metrics, healing time, and adverse events. Data were pooled using random-effects models. Results Eighteen studies involving 500 participants were included. Autologous cell therapies significantly reduced ECCA scores compared to controls (Standardized Mean Difference SMD = −1.25, 95% CI: −1.80 to −0.70, p 0.001; I 2 = 65%). Subgroup analysis indicated the largest effect size for SVF-based therapies (SMD = −1.40). Patient satisfaction was significantly higher in intervention groups (Risk Ratio RR = 1.45, 95% CI: 1.24–1.70). Objective outcomes also favored cell therapies, with greater scar depth reduction (Mean Difference MD = −0.25 mm, 95% CI: 0.41 to −0.10) and accelerated wound healing (MD = −2.5 days, 95% CI: 3.9 to −1.1). The overall incidence of adverse events was lower in the intervention groups (RR = 0.70, 95% CI: 0.50–0.98). Conclusion Autologous cell-based therapies, particularly SVF, are effective and safe for improving atrophic acne scars, offering superior clinical, patient-reported, and safety outcomes compared to standard controls. The integration of detailed methodological insights provides a valuable evidence base to guide clinical protocol optimization and future research focused on standardization and long-term efficacy.

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