IntroductionPost-traumatic facial scarring represents a significant clinical challenge in dermatologic surgery, with the atrophic variant posing particular therapeutic difficulties[1–3]. The initial months following re-epithelialization constitute a critical remodeling phase characterized by dynamic and often unpredictable biological processes, during which the natural resolution of inflammation and the reorganization of collagen architecture can lead to substantial spontaneous improvement [4]. This inherent biological variability, recently quantified through hierarchical Bayesian analysis of wound biomechanics, complicates the assessment of any therapeutic intervention applied during this formative period [5].Current therapeutic paradigms for atrophic scarring predominantly target mature, established scars, typically after a stabilization period of 6 to 12 months [1,2]. Conventional modalities such as laser resurfacing, dermal fillers, and microneedling can be effective but are often costly, invasive, and primarily address established scar features rather than actively guiding the initial healing process. Growing evidence supports the potential for intervention during the immature phase (the period prior to stabilization), with systematic reviews demonstrating that laser-based treatments initiated within the first three months post-wounding can significantly improve scar outcomes [6]. Among autologous options, fat transplantation has shown promise but carries substantially higher complication rates due to its invasive nature [7], highlighting the clinical need for effective yet safer immature-stage treatment options.Analogous to its well-documented, synergistic role in enhancing the survival and integration of autologous fat grafts [8], autologous platelet-containing plasma (ACP) offers a safe, minimally invasive approach for soft tissue repair. Building on this principle of biostimulation, ACP intervention during the immature phase of a cutaneous wound has been proposed as a strategy to act synergistically with endogenous healing processes. The ensuing formation of a protein-rich fibrin matrix is posited to serve as a regenerative scaffold that enhances cellular recruitment and signaling [9]. Despite growing interest, a recent scoping synthesis of the available clinical literature highlights a marked scarcity of studies specifically addressing ACP and platelet-rich plasma (PRP) usage in immature post-traumatic scars, with most reports limited to small case series, heterogeneous protocols, and insufficient product characterization [10]. This limited evidence base also lacks robust longitudinal data employing objective and quantitative outcome measures, which are essential to reduce observational bias and enable meaningful comparisons, particularly given the difficulty of distinguishing true therapeutic effects from spontaneous maturation during the immature phase.We present the case of a young male with post-traumatic immature facial scarring, defined as scars in the early remodeling phase that remain biologically active with ongoing collagen, and extracellular matrix reorganization [11]. This report provides a longitudinal assessment using both patient-reported outcomes and objective digital image analysis. Although the single-case design cannot disentangle the specific contribution of ACP from natural scar maturation, the intervention was well tolerated, with no adverse events, and was associated with observable clinical improvement over time. The primary objective is not to establish definitive efficacy, but to quantitatively document scar evolution under ACP exposure during the immature phase, supporting procedural safety and providing hypothesis-generating data in an area of limited and heterogeneous clinical evidence [10].
