Hair follicle micro-particle skin grafting induces scar remodeling via PI3K-AKT signaling: a randomized clinical trial

Effective treatment of mature scars remains a clinical challenge due to limited remodeling strategies. This study evaluated the efficacy and mechanisms of hair follicle micro-particle skin grafting in a prospective trial involving 40 scar patients. (Trial registration: Chinese Clinical Trial Registry, PID300363) Participants were allocated to receive either FUE-derived hair follicle micro-graft transplantation combined with punch excision or punch excision alone. After six months, the transplantation group showed significantly greater reductions in scar volume, lower Vancouver Scar Scale scores at 3 and 6 months, and better alleviation of pain and itching compared to controls. Histological analysis revealed that transplantation induced epidermal thickening, enhanced cell proliferation, and increased type IV collagen deposition at the epidermal-dermal junction. Transcriptomic profiling further revealed that these regenerative effects were associated with activation of the PI3K-AKT signaling pathway, suggesting a potential role in scar remodeling. These findings demonstrate that hair follicle micro-particle grafting is a clinically effective approach for scar remodeling, offering a promising therapeutic strategy to improve both aesthetic and functional outcomes.