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Pilot Study Investigating the Efficacy of Fat Grafting as a Treatment for Male and Female Facial Acne Scarring

Primary Purpose

Acne Scars - Mixed Atrophic and Hypertrophic, Acne

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Fat Grafting
Sponsored by
University of Texas Southwestern Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acne Scars - Mixed Atrophic and Hypertrophic

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Men and women 18 to 50 years of age having general good health.
  2. Individuals deemed by the Investigator to have a significant amount acne scarring on the face and that desire correction of this condition.
  3. Individuals willing to withhold aesthetic therapies to the areas of the hand being treated or judged to potentially impact results by the Investigator (e.g. soft tissue fillers and/or any resurfacing procedures, botulinum toxin, injectable fillers, microdermabrasion, IPL (intense pulsed light), peels, laser treatments, and tightening treatments, etc.) for the duration of the study. Waxing and threading is allowed but no laser treatments outside of the study.
  4. Individuals that are willing to provide written informed consent and are able to read, speak, write, and understand English.
  5. Individuals willing to sign a photography release.
  6. Willingness to cooperate and participate by following study requirements for the duration of the study and to report any changes in health status or medications, adverse event symptoms, or reactions immediately.

Exclusion Criteria:

  1. Individuals diagnosed with known allergies to general skin care products.
  2. Individuals who have presence of an active systemic or local skin disease that may affect wound healing.
  3. Individuals with sensitivity to topical lidocaine.
  4. Individuals who have physical or psychological conditions unacceptable to the Investigator.
  5. Individuals who have a recent history of significant trauma to the areas to be treated (< 6 months).
  6. Individuals who have severe or cystic active and clinically significant acne on the area(s) to be treated. Clinically significant acne is defined as a subject whom has > 5 active inflammatory acne lesions (including acne conglobate, nodules, or cysts) in either the right or left treatment area.
  7. Individuals who have a recent or current history of inflammatory skin disease, infection, unhealed wound or clinically significant acne in the proposed treatment areas.
  8. Individuals who have a history of systemic granulomatous diseases, active or inactive, (e.g. Sarcoid, Wegeners, TB, etc.) or connective tissue diseases (e.g. lupus, dermatomyositis, etc.).
  9. Individuals who currently have or have a history of hypertrophic scars, or keloid scars.
  10. Individuals who currently have cancerous or pre-cancerous lesions in the areas to be treated and/or with a history of skin cancer.
  11. Individuals who have the inability to understand instructions or to give informed consent.
  12. Individuals who have had microdermabrasion or glycolic acid treatment to the treatment area(s) within one month prior to study participation or who will have this treatment during the study.
  13. Individuals who have a history of chronic drug or alcohol abuse.
  14. Individuals undergoing concurrent therapy that, in the Investigator's opinion, would interfere with the evaluation of the safety or efficacy of the study device.
  15. Individuals who, in the Investigator's opinion, have a history of poor cooperation, noncompliance with medical treatment, or unreliability.
  16. Individuals who have a history of the following cosmetic treatments in the area(s) to be treated:

    • Skin tightening procedure within the past year;
    • Injectable filler of any type within the past:

      • 12 months for Hyaluronic acid fillers (e.g. Restylane)
      • 12 months for Ca Hydroxyapatite fillers (e.g. Radiesse)
      • 24 months for Poly-L-Lactic acid fillers (e.g. Sculptra)
      • Ever for permanent fillers (e.g. Silicone, ArteFill)
    • Neurotoxins within the past three months;
    • Ablative resurfacing laser treatment;
    • Non-ablative, rejuvenative laser or light treatment within the past six months;
    • Surgical dermabrasion;
    • Had a chemical peel or dermabrasion, of the dorsum of the hand within four weeks
  17. Individuals with a history of using the following prescription medications:

    • Accutane or other systemic retinoids within the past six months;
    • Topical Retinoids within the past two weeks;
    • Prescription strength skin lightening devices (e.g. hydroquinone, tretinoin, AHA, BHA and polyhydroxy acids, 4-hydroxyanisole alone or in combination with tretinoin, etc.) within four months;
    • Any anti-wrinkle, skin lightening devices, or any other device or topical or systemic medication known to affect skin aging or dyshcromia (devices containing alpha/beta/poly-hydroxy acids, vitamin C, soy, Q-10, hydroquinone; systemic or licorice extract (topically), Tego® Cosmo C250, gigawhite, lemon juice extract (topically), emblica extract, etc.) within two weeks;
    • Antiplatelet agents/Anticoagulants (Coumadin, Heparin, Plavix, chronic NSAID use); and/or
    • Psychiatric drugs that in the Investigator's opinion would impair the subject from understanding the protocol requirements or understanding and signing the informed consent.
  18. Individuals who are nursing, pregnant, or planning to become pregnant during the study according to subject self-report.
  19. Individuals having a health condition and/or pre-existing or dormant dermatologic disease on the body (e.g., psoriasis, rosacea, eczema, seborrheic dermatitis, vitiligo, hyper or hypo-skin pigmentation conditions such as post inflammatory hyperpigmentation) that the Investigator or designee deems inappropriate for participation or could interfere with the outcome of the study.
  20. Individuals with a history of immunosuppression/immune deficiency disorders (including HIV infection or AIDS) or currently using immunosuppressive medications (e.g., azathioprine, belimumab, cyclophosphamide, Enbrel, Imuran, Humira, mycophenolate mofetil, methotrexate, prednisone, Remicade, Stelara.) and/or radiation as determined by study documentation.
  21. Individuals with an uncontrolled disease such as asthma, diabetes, hyperthyroidism, medically significant hypertension or hypothyroidism. Individuals having multiple health conditions may be excluded from participation even if the conditions are controlled by diet, medication, etc.
  22. Individuals with any planned surgeries, overnight hospitalization, and/or invasive medical procedures during the course of the study.
  23. Individuals who have observable suntan, nevi, excessive hair, etc. or other dermal conditions on the back of the hand that might influence the test results in the opinion of the Investigator or designee.
  24. Individuals who have any condition, which in the opinion of the Investigator makes the patient unable to complete the study per protocol (e.g. patients not likely to avoid other cosmetic treatments to the treatment area; patients not likely to stay in the study for its duration because of other commitments, concomitant conditions, or past history; patients anticipated to be unreliable, or patients who have a concomitant condition that may develop symptoms that might confuse or confound study treatments or assessments).

Sites / Locations

  • University of Texas Southwestern Medical Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Fat Grafting for Acne Scar Treatment

Arm Description

This single-center, clinical trial will assess the efficacy and tolerability of the autologous fat grafting when used on men and women with acne scars on the face.

Outcomes

Primary Outcome Measures

Facial Photograph Assessments
Photographs will be used to evaluate efficacy of treatment. The photographs from final visit will be compared to their baseline photographs and visually evaluated by the study team. Acne scars on patients will be assessed using the Clinician's Global Assessment Improvement Scale (CGAIS)
Change in Volume (MiraVex)
MiraVex will be used to assess changes in volume of the subjects facial acne scars.
VISIA Complexion Analysis: Change in Spots
The VISIA will be used to objectively measure spots
VISIA Complexion Analysis: Change in wrinkles
The VISIA will be used to objectively measure wrinkles.
VISIA Complexion Analysis: Change in Texture
The VISIA will be used to objectively measure texture.
VISIA Complexion Analysis: Change in Pores
The VISIA will be used to objectively measure pores.
VISIA Complexion Analysis: Change in UV Spots
The VISIA will be used to objectively measure UV spots
VISIA Complexion Analysis: Change in Brown Spots
The VISIA will be used to objectively measure brown spots.
VISIA Complexion Analysis: Change in Red Areas
The VISIA will be used to objectively measure red areas
VISIA Complexion Analysis: Change in Porphyrins
The VISIA will be used to objectively measure porphyrins.
Transepidermal Water Loss (TEWL) Measurements: Change in Epidermal Layer
Measurements will be used to evaluate barrier function of the skin epidermal layer to determine progress of epidermal healing after treatment.
High Resolution Ultrasound: Change Dermal Thickness
Dermal thickness will be measured via high resolution ultrasound prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
High Resolution Ultrasound: Change in Epidermal Thickness
Epidermal thickness will be measured via high resolution ultrasound prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
BTC2000: Change in Skin Elasticity
Skin Elasticity will be measured via BTC2000 prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
BTC 2000: Change in Skin Laxity
Skin Laxity will be measured via BTC2000 prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
Histological Analysis
Relative changes in protein abundance in biopsies taken at post treatment compare to control or entreated group will be quantified using an image processing software based on fluorescence signal intensity. The change from baseline was calculated at each time frame.
Gene Expression
Biopsies of the treated are will be taken prior to treatment and post treatment for gene expression analysis. This analysis will identify gene expression related to collagen formation and increased cell turnover.
Change in Blood Flow
Blood Flow will be measured via optical coherence tomography prior to treatment (baseline), 3 months and 6 months post treatment.
High Resolution Ultrasound: Change in Epidermal Density
Epidermal thickness will be masured via high resolution ultrasound prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.

Secondary Outcome Measures

Full Information

First Posted
September 1, 2020
Last Updated
January 31, 2023
Sponsor
University of Texas Southwestern Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT04559022
Brief Title
Pilot Study Investigating the Efficacy of Fat Grafting as a Treatment for Male and Female Facial Acne Scarring
Official Title
Pilot Study Investigating the Efficacy of Fat Grafting as a Treatment for Male and Female Facial Acne Scarring
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
October 30, 2020 (Actual)
Primary Completion Date
June 10, 2022 (Actual)
Study Completion Date
December 14, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Texas Southwestern Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This single-center, clinical trial consists of a one autologous fat grafting treatment followed by 3-month and 6-month post-treatment visits in order to assess the efficacy of fat grafting when used by men and women with facial acne scars.
Detailed Description
This investigation, pilot study will evaluate the safety and efficacy of autologous fat grafting for the treatment of acne scarring. Overall assessment of clinical outcome and safety will be based clinic visits and evaluation of pre- and post- procedural photos. In conjunction with standard and close-up photography, we will also be using 3D imaging, cross-polarized imaging, UV imaging, high-resolution ultrasonography, optical coherence tomography, transepidermal water loss measurements, and/or BTC 2000 measurements. Additionally, we will be utilizing 0.33 mm skin biopsies to assess histological and genetic changes that occur below the skin surface as a result of this treatment. The subject's assessment of satisfaction will be characterized using a non-parametric assessment scale at each follow-up period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acne Scars - Mixed Atrophic and Hypertrophic, Acne

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fat Grafting for Acne Scar Treatment
Arm Type
Other
Arm Description
This single-center, clinical trial will assess the efficacy and tolerability of the autologous fat grafting when used on men and women with acne scars on the face.
Intervention Type
Procedure
Intervention Name(s)
Fat Grafting
Intervention Description
This single-center, clinical trial will assess the efficacy and tolerability of the autologous fat grafting when used on men and women with acne scars on the face.
Primary Outcome Measure Information:
Title
Facial Photograph Assessments
Description
Photographs will be used to evaluate efficacy of treatment. The photographs from final visit will be compared to their baseline photographs and visually evaluated by the study team. Acne scars on patients will be assessed using the Clinician's Global Assessment Improvement Scale (CGAIS)
Time Frame
Baseline and 6 Months
Title
Change in Volume (MiraVex)
Description
MiraVex will be used to assess changes in volume of the subjects facial acne scars.
Time Frame
Baseline and 6 Months
Title
VISIA Complexion Analysis: Change in Spots
Description
The VISIA will be used to objectively measure spots
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in wrinkles
Description
The VISIA will be used to objectively measure wrinkles.
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in Texture
Description
The VISIA will be used to objectively measure texture.
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in Pores
Description
The VISIA will be used to objectively measure pores.
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in UV Spots
Description
The VISIA will be used to objectively measure UV spots
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in Brown Spots
Description
The VISIA will be used to objectively measure brown spots.
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in Red Areas
Description
The VISIA will be used to objectively measure red areas
Time Frame
Baseline, 3 Months, and 6 Months
Title
VISIA Complexion Analysis: Change in Porphyrins
Description
The VISIA will be used to objectively measure porphyrins.
Time Frame
Baseline, 3 Months, and 6 Months
Title
Transepidermal Water Loss (TEWL) Measurements: Change in Epidermal Layer
Description
Measurements will be used to evaluate barrier function of the skin epidermal layer to determine progress of epidermal healing after treatment.
Time Frame
Baseline, 3 Months and 6 Motnhs
Title
High Resolution Ultrasound: Change Dermal Thickness
Description
Dermal thickness will be measured via high resolution ultrasound prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
Time Frame
Baseline, 3 Months and 6 Months
Title
High Resolution Ultrasound: Change in Epidermal Thickness
Description
Epidermal thickness will be measured via high resolution ultrasound prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
Time Frame
Baseline, 3 Months and 6 Months
Title
BTC2000: Change in Skin Elasticity
Description
Skin Elasticity will be measured via BTC2000 prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
Time Frame
Baseline, 3 Months and 6 Months
Title
BTC 2000: Change in Skin Laxity
Description
Skin Laxity will be measured via BTC2000 prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
Time Frame
Baseline, 3 Months and 6 Months
Title
Histological Analysis
Description
Relative changes in protein abundance in biopsies taken at post treatment compare to control or entreated group will be quantified using an image processing software based on fluorescence signal intensity. The change from baseline was calculated at each time frame.
Time Frame
Baseline, 3 Months and 6 Months
Title
Gene Expression
Description
Biopsies of the treated are will be taken prior to treatment and post treatment for gene expression analysis. This analysis will identify gene expression related to collagen formation and increased cell turnover.
Time Frame
Baseline, 3 Months and 6 Months
Title
Change in Blood Flow
Description
Blood Flow will be measured via optical coherence tomography prior to treatment (baseline), 3 months and 6 months post treatment.
Time Frame
Baseline, 3 Months and 6 Months
Title
High Resolution Ultrasound: Change in Epidermal Density
Description
Epidermal thickness will be masured via high resolution ultrasound prior to treatment (baseline), 3 months and 6 months post treatment. The change from baseline was calculated at each time frame.
Time Frame
Baseline, 3 Months, and 6 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Men and women 18 to 50 years of age having general good health. Individuals deemed by the Investigator to have a significant amount acne scarring on the face and that desire correction of this condition. Individuals willing to withhold aesthetic therapies to the areas of the hand being treated or judged to potentially impact results by the Investigator (e.g. soft tissue fillers and/or any resurfacing procedures, botulinum toxin, injectable fillers, microdermabrasion, IPL (intense pulsed light), peels, laser treatments, and tightening treatments, etc.) for the duration of the study. Waxing and threading is allowed but no laser treatments outside of the study. Individuals that are willing to provide written informed consent and are able to read, speak, write, and understand English. Individuals willing to sign a photography release. Willingness to cooperate and participate by following study requirements for the duration of the study and to report any changes in health status or medications, adverse event symptoms, or reactions immediately. Exclusion Criteria: Individuals diagnosed with known allergies to general skin care products. Individuals who have presence of an active systemic or local skin disease that may affect wound healing. Individuals with sensitivity to topical lidocaine. Individuals who have physical or psychological conditions unacceptable to the Investigator. Individuals who have a recent history of significant trauma to the areas to be treated (< 6 months). Individuals who have severe or cystic active and clinically significant acne on the area(s) to be treated. Clinically significant acne is defined as a subject whom has > 5 active inflammatory acne lesions (including acne conglobate, nodules, or cysts) in either the right or left treatment area. Individuals who have a recent or current history of inflammatory skin disease, infection, unhealed wound or clinically significant acne in the proposed treatment areas. Individuals who have a history of systemic granulomatous diseases, active or inactive, (e.g. Sarcoid, Wegeners, TB, etc.) or connective tissue diseases (e.g. lupus, dermatomyositis, etc.). Individuals who currently have or have a history of hypertrophic scars, or keloid scars. Individuals who currently have cancerous or pre-cancerous lesions in the areas to be treated and/or with a history of skin cancer. Individuals who have the inability to understand instructions or to give informed consent. Individuals who have had microdermabrasion or glycolic acid treatment to the treatment area(s) within one month prior to study participation or who will have this treatment during the study. Individuals who have a history of chronic drug or alcohol abuse. Individuals undergoing concurrent therapy that, in the Investigator's opinion, would interfere with the evaluation of the safety or efficacy of the study device. Individuals who, in the Investigator's opinion, have a history of poor cooperation, noncompliance with medical treatment, or unreliability. Individuals who have a history of the following cosmetic treatments in the area(s) to be treated: Skin tightening procedure within the past year; Injectable filler of any type within the past: 12 months for Hyaluronic acid fillers (e.g. Restylane) 12 months for Ca Hydroxyapatite fillers (e.g. Radiesse) 24 months for Poly-L-Lactic acid fillers (e.g. Sculptra) Ever for permanent fillers (e.g. Silicone, ArteFill) Neurotoxins within the past three months; Ablative resurfacing laser treatment; Non-ablative, rejuvenative laser or light treatment within the past six months; Surgical dermabrasion; Had a chemical peel or dermabrasion, of the dorsum of the hand within four weeks Individuals with a history of using the following prescription medications: Accutane or other systemic retinoids within the past six months; Topical Retinoids within the past two weeks; Prescription strength skin lightening devices (e.g. hydroquinone, tretinoin, AHA, BHA and polyhydroxy acids, 4-hydroxyanisole alone or in combination with tretinoin, etc.) within four months; Any anti-wrinkle, skin lightening devices, or any other device or topical or systemic medication known to affect skin aging or dyshcromia (devices containing alpha/beta/poly-hydroxy acids, vitamin C, soy, Q-10, hydroquinone; systemic or licorice extract (topically), Tego® Cosmo C250, gigawhite, lemon juice extract (topically), emblica extract, etc.) within two weeks; Antiplatelet agents/Anticoagulants (Coumadin, Heparin, Plavix, chronic NSAID use); and/or Psychiatric drugs that in the Investigator's opinion would impair the subject from understanding the protocol requirements or understanding and signing the informed consent. Individuals who are nursing, pregnant, or planning to become pregnant during the study according to subject self-report. Individuals having a health condition and/or pre-existing or dormant dermatologic disease on the body (e.g., psoriasis, rosacea, eczema, seborrheic dermatitis, vitiligo, hyper or hypo-skin pigmentation conditions such as post inflammatory hyperpigmentation) that the Investigator or designee deems inappropriate for participation or could interfere with the outcome of the study. Individuals with a history of immunosuppression/immune deficiency disorders (including HIV infection or AIDS) or currently using immunosuppressive medications (e.g., azathioprine, belimumab, cyclophosphamide, Enbrel, Imuran, Humira, mycophenolate mofetil, methotrexate, prednisone, Remicade, Stelara.) and/or radiation as determined by study documentation. Individuals with an uncontrolled disease such as asthma, diabetes, hyperthyroidism, medically significant hypertension or hypothyroidism. Individuals having multiple health conditions may be excluded from participation even if the conditions are controlled by diet, medication, etc. Individuals with any planned surgeries, overnight hospitalization, and/or invasive medical procedures during the course of the study. Individuals who have observable suntan, nevi, excessive hair, etc. or other dermal conditions on the back of the hand that might influence the test results in the opinion of the Investigator or designee. Individuals who have any condition, which in the opinion of the Investigator makes the patient unable to complete the study per protocol (e.g. patients not likely to avoid other cosmetic treatments to the treatment area; patients not likely to stay in the study for its duration because of other commitments, concomitant conditions, or past history; patients anticipated to be unreliable, or patients who have a concomitant condition that may develop symptoms that might confuse or confound study treatments or assessments).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Kenkel, MD
Organizational Affiliation
UT Southwestern
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Pilot Study Investigating the Efficacy of Fat Grafting as a Treatment for Male and Female Facial Acne Scarring

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