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.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

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 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

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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