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<< Etiologic factors and causes
<< Pathology
<< Types
<< Prevention
<< Medications and removal methods
.....<< Skin reconstruction
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| Repair damaged skin and acne scars |
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How to treat scarring and skin damages resulted from acne is of great concern to patients with moderate to severe acne. Failed or inadequate treatment of acne is a major cause in development of scarring. The same distress acne patients experience may follow with its disfiguring sequels. The incidence of these sequels is not known. It is frequently stated that acne scarring results from severe inflammatory nodulocystic acne lesions occurring deep in the dermis. Although it may exist with only minor more superficial acne. It is very likely that some patients are further prone to scars based the factors that define their skins. Of paramount importance that acne should be treated early and adequately. See also the review of american academy of dermatology on skin scarring resulted from acne. Following factors may be stated as involved in etiology and introduced as causes of acne scars.
The following wound healing scenario may explain the pathology and formation of acne scars. Acne as well as any other cause for a minor wound may follow the same pathway. The initial step is defined by a structured series involving inflammatory cells. This succession of episodes is arranged by neutrophils. Subsequently, macrophages elaborate a variety of cytokines, which create an environment prone to granulation tissue constitution. Eventually, migration of fibroblasts coincide with proliferation and recapitulation by depositing new collagen. Simultaneously, production of new capillaries is triggered by some factors released in the wound section. A problem arises when this organized cascade is disrupted by its anabolic and catabolic phases. An overreacting wound healing response may happen, creating a bulgy lesion of fibrotic tissue. Alternatively, deleted connective tissue is deficiently replaced and forms a pitted appearance resembling the surface of a golf ball. In either case, the scar often is a legacy of skewed healing process. Pathology of spots and discolorations resulted from acne, however, have less correlation with anabolic and catabolic stages, rather, skin pigmentation changes arise prominently. Types of acne scars are the most important factor in determining its appropriate treatmnet. There are basically two types of scars. One is associated with propagated tissue generation and the other is associated with some tissue loss Types with increased skin tissue: Keloids: They present as smooth, firm, irregularly shaped lesions. Upper body or angle of the jaw are more prone to these type of facial scarring. Skin of dark-complexions (black skin) is more predisposed to develop hypertrophic scars. They could be regarded as thick, raised, lobulated fibrotic plaques. Types with increased skin tissue rarely observed with acne even in prolonged severe cases. Types with loss of skin tissue: Acne spots: Flat discolorations either brown or red.They are more likely to fade away either gradually without treatment or using fading creams. Post inflammatory pigmentations are classified in the same category. Blocks of pink hyperpigmentations seen following skin breakouts and more likely prolonged acne. Ice-pick lesions: They may be superficial or deep, fairly linear but irregular and generally turn out on the cheeks. These lesions are variably resistant to the treatments and the more penetrating they are the longer it takes to be healed totally. Acne lesions can lead to ice pick scars. Depressed fibrotic scars: They present as large with sharp margins and steep sides. Their base is rigid, white and can not be stretched. They may result from severe lesions such as cystic and nodular forms of acne. Read more on depressed scars and their management. Atrophic scar macules: This type of lesions manifest as soft, distensible, ivory-white in color and small in size (few millimeter in diameter). Acne is recurrently associated with atrophic scars. Acne scars are result of improper deposition of collagen and elastin and insufficient wound repair process. Lining epithelium is not flat and atrophic but hyperplastic. Healing them involves inducement of the skin's repair mechanisms and rebuilding elastin and other fibers. Overall they have a good prognosis. They do not expand in size or number over time. However, aging has an adverse effect on acne caused scarring and render them more pronounced. The more acne inflammation persists the more likely development of scarring is. Treatment promptly in its course is the best method for prevention of acne damages. Use of anti oxidants as a preventive method especially vitamin E is still viewed with skepticism, some studies even report a harmful effect. Powerful anti oxidants such as alpha lipoic acid when employed alone works with no success. A favorable medication for acne essentially address the following problems: An elevated sebum synthesis, overproduction of epithelial cells lining follicles, bacterial involvement, more inflammation in acne sites. Read also next page for more prevention tips. Another treatment that has been used by Mayo is application of butulinum toxin to help more effective of natural repair system by reducing muscle tension around the wound. It seems that muscle spasm has a detrimental effect on realinneation of collagen fibers even if we could for a moment ignore a decrease in blood circulation and inflammatory response secondary to muscle spasm. Read more on botulinum and its effect for a better healing of a wound and less scar generation. acne scarring repair, different removal techniques for facial restoration Most have heard of chemical peels, dermabrasion, silicone injections, collagen implants and laser treatment since these have been widely publicized in the lay press for treating acne scarring. For the patient whose acne has recently cleared, it is worthy to know that scars tends to become less apparent with time and that any consideration of cosmetic surgery must be deferred for some time. Post inflammatory pigmentations tend to disappear in a few months. So post inflammatory pigmentations in most cases resolves spontaneously. It ought to be pointed out that lesions on the body does not tend to improve as readily and is conventionally less amenable to cosmetic surgery. Read more: Topical treatments (creams/serums/skin products), Oral treatments: Retinoic acid, alpha and beta hydroxy peels, potent anti oxidants such as alpha lipoic acid creams are widely discussed and debated in treatment of acne sequels inculding acne hyperpigmentation spots, scars and lack of skin uniformity. Among medications for acne scars is retinoic acid cream. Despite showing some degree of improvement, its use alone does not bring about a dramatic conversion. Skin dryness and redness are among complications. Here is more information on creams for eliminatin of scarring resulted from acne. Oral medications such as accutane are not very pleasing to most affected individuals and does not alter lesions to a noticeable extent. acne Scar excision (subcision): This surgical method of treatment uses a scalpel or punch to remove the damaged skin. Under local anesthesia, the lesion is excised and the skin edges are then sutured together. Excision is typically recommended to patients with deep pitted marks that are not amendable to the TCA technique. Good for deeper marks. Longer recovery time. Read more on this technique (excision-subcision) from medscape. Iontophoresis: New study suggests use of ionophoresis for atrophic scars usually resulted from acne with either tretinoin or estriol. In iontophoresis an ionizable drug is injected into the skin using an eletrical discharge without use of a needle. Microdermabrasion: Dermabrasion involves controlled surgical scraping that resurfaces the outermost layers of the skin to give a smoother appearance. It can be done over the full surface of the face or on small areas. Dermabrasion also may be done in conjunction with other cosmetic procedures such as a chemical peeling or face lift. Dermabrasion is used to treat a range of skin imperfections including: Wrinkles and frown lines, pre-cancerous skin growths (keratoses), face scarring (excluding burn scars, acne scars), post-surgery marks, skin pigmentation, sun damage, tattoos, age spots, facial freckles, acne discoloration spots and other forms. Acupuncture: Use of acupunture for acne scars repair is considered a new approach. Use of small, very thin needles in the skin causes a tiny injury at its site which is associated with an increase in skin microcirculation and stimulation of inflammatory mediators. Infiltration of cytokines is chemotactic for fibroblasts and production of new collagen. Acupuncture seems to be rather effective in improving appearance of atrophic acne scars. Facial acupuncture is becoming more popular not only for treatment of acne scars but for other rejuvenating purposes. resurfacing by laser for acne scars Another technique for acne
scar removal appear to be more with a desirable outcome in convex
regions of the face. Lateral cheek and the temples do not benefit
from this office procedure as much. Laser resurfacing treatments could be associated with hyperpigmentation (increased skin color)
or hypopigmentation (decreased skin color) for short or long term
in treatment vicinities. Scars, infection and persistent redness
are also possible side effects of laser resurfacing. With available medications these
could be controlled. Some clinical testing suggest that high-energy,
pulsed CO2 laser can safely and effectively improve or
even eliminate atrophic acne damages and provides many contributions
in contrast with traditional treatment means. Erbium, the latest
technique, has generated more satisfactory results which leads to
elimination of a superficial acne scarring and a reduction in other
forms of scars. One study suggests more effective result with laser punch-out method. Some research indicate that old severe scarring responds substantially less to laser treatments while newly formed
marks could almost completely vanish. This indicates that timing
of treatment could be significant. Laser also have been utilized
to treat acne particularly in patients who show sensitivity reactions
to medications for acne. Outcomes are not very promising though and cost is another consideration.
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© 2010 Hippocrates Canada, all rights reserved Related Information Links: | Acne | Chemical peeling | Laser | Punch Grafts | Surgical interventions | acne Scar Management| Topiramate to treat acne scarring | Hypertrophic Scars | More related pages: | Dermatology useful links | Plastic surgery | Men's Skin Health | Women's skin Health | Relaxing techniques | Skin and Diet | |
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>> PRODUCTS
>> APPLICATION OF acne SCAR SERUM >> APPLICATION OF GLYCOLIC PRODUCT
>> LASER SKIN
>> PRODUCT
>> KELOIDS >> ACUPUNCTURE |
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MOST POPULAR PAGES| Hippocrates skin resurfacing at-home regimen to smooth away acne scars and to reconstruct the skin : This kit has been bioengineered for collagen remodeling within dermis layer, stimulation of skin's natural healing mechanisms and skin resurfacing. Enriched with many anti aging elements, this kit alters skin tone and texture dramatically. Hippocrates acne scar serum for treating acne scars hyperpigmentation spots renews your skin and retexturizes the epidermis, facilitates removal of scar tissues. This resurfacing treatment serum minimizes and tightens the pores, smooth away cutaneous damages. Retexturizing acne scar treatment speeds the cell renewal of epidermis zone and assist with rapid evacuation of dead cells. Contains: Kojic acid, a natural ingredient, notably more friendly to the skin compare to its rival, hydroquinone, chosen in accordance with hippocrates harmony with nature. Hippocrates four-piece kit eliminates hyperpigmentation spots, freckles, discolorations resulted from acne and refine the skin by revealing a brighter, more even-toned complexion Acne scar treatment kit enhances the epidermal circulation and as a result helps to activate the natural collagen synthesis of dermal layer of the skin. Tightens the pores, reactivates the natural defenses of the skin and reduces the inflammation Contains: Bioflavanoids, Green tea extract and alpha lipoic acid. Acne scar kit take advantage of these powerful anti oxidants to eliminate hyperpigmentation spots and skin's discolorations as a result of acne. Skin oxidation of lipids may be prevented as well. This can results in delays in collagen deterioration. Those who still deal with active acne, may use another hippocrates formulation called, acne treatment. Even though this package targets comedones and acne breakouts, it has significant effect on elimination and treating acne scarring. Aging is another constituent, which deteriorates scarred skin. With aging, the facial skin starts to sag and seems to literally hang on the scars. The inelastic strands of scars bind the skin, giving it an uneven, more wrinkled appearance. This is amplified by other age-correlated transitions such as atrophy of facial skeletal muscles and loss of collagen and skin's connective tissue. The four-piece formula has been bioengineered to address all these insidious progressive changes. Acne scar treatment serum comes with three other formulations, Day Effect cream, Facial Exfoliater and Dermal Repair serum. The cream maintains work of the night serum during the day and while it is very healing to the skin, it has its own resurfacing properties and is intended for skin repair. To better understand how Dermal Repair serum works please follow the links on your right. See also our frequently asked questions for more info.
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