Approach to treatment

Acne is rarely serious, but it often causes emotional distress and can lead to acne-caused lesions of the skin. With the right acne treatment, you can often keep breakouts under control. Measures can also be taken to reduce scars left by blemishes. Untreated or non-responsive skin breakouts (severe acne) may results in acne scar formation, a scenario more difficult to treat. Some figures of acne never cause scar development, however, severe forms are very likely to be followed by acne scarring. Also rosacea in some individuals is more prone to occurrence of a scar, which may suggest genetic factors as a predisposing factor. Mechanical stimulation of lesions is another mode of causing damage ,at cellular level, in sebaceous follicles in dermis level. Appropriate acne treatment early and adequately is the best preventive method. Severe acne can be treated using combination therapy, tretinoin and benzoyl peroxide washes are one of the choices.

Scar Pathology

Injury to the skin triggers wound healing mediations. Injury and consequent skin tissue repair mechanisms cause the formation of new tissues, initial scarring. Migration of inflammatory molecules at the site of injury (acne also cause an inflammation and small injury at the sebaceous follicle level, severe cases is usually associated with more inflammation) and their repair will followed by a disordered site. This means when the job of these molecules is done they leave a repair site with an structure similar to a form of fibrous tissue, or eroded tissue. Forming tissue is the sequel of improper deposition of collagen and elastin and insufficiency of wound healing system. Epithelium lining acne scars is not flat and atrophic but hyperplastic. Healing them involves stimulation of the skin's healing process and rebuilding collagen and elastin tissue.

Hypertrophic scars are pink, raised, firm, erythematous, characterized by a decreased expression of collagenase (the enzyme that breaks collagen). Hypertrophic lesions occur when collagen synthesis exceeds collagen lysis during the remodeling phase of wound healing. The result is formation of thick collagen bundles consisting of fibroblasts and fibrocytes. Despite obvious tissue proliferation, these lesions remain within the confines of the original integumental injury. Hypertrophic scars and their keloid counterparts usually form in body areas that exhibit slow wound healing or in pressure-dependent or movement-dependent areas. Scarring tends to form within the first month following injury. Approximately one third of patients report pruritus and dysesthesia. Unlike keloids, hypertrophic skin damages may regress over time. Most scarring developed as a result of acne is ice pick scar. In particular, cystic acne, red tender nodules tend to leave this type of scarring. Ice pic scars are generally depressed lesions with uneven surface.

In contrast, a keloid is raised, nodular, more reddish scar that appear firmer than hypertrophic irregularities. Keloids exhibit a prolonged proliferative phase, which results from an inherited metabolic alteration in collagen. The result is thick hyalinized collagen fibers. Unlike hypertrophic scar, keloids extend beyond wound margins and do not regress over time. Keloids also contain increased hyaluronidase. Formation may occur over weeks or years following the initial trauma. Although they occur in all skin types, keloids are most common in patients with darker skin.

Available modalities:

There are no direct association between types of acne lesions and likelihood of acne scar development. However, cystic acne with inflammation tend to leave sequelae more readily. At the beginnings acne scars present redder and thicker, then gradually fade. In a few months they heal spontaneously without any cure. It would be wise to wait sometime before considering any treatment for acne scars. Most at home or office procedures for treating acne scars one way or another, rely on skin renewal. Among removal methods laser resurfacing, dermabrasion and chemical peels reach their ultimate goal through epidermal resurfacing and renewal. Acne scar type and depth are two important factors in determining the outcomes of these removal methods. Deep scars as a result of acne not completely disappear using these maneuvers.

Available skin resurfacing modalities have improved over the years. The older, less successful treatments such as dermabrasion and chemical peeling have been replaced by the use of resurfacing infrared lasers such as CO2 lasers13 and, more recently, erbium lasers14 to better remove and tighten the skin. However, none of these recent skin resurfacing modalities guarantee complete eradication of an acne scar.

An understanding that replacement of the diminished structures in the dermis and subcutaneous tissues is necessary in severe cases has led to the development of superior dermal and subcutaneous augmentation techniques. Dermal grafting, lipocytic dermal injectables, fat transfer and, presently, the implantation of autologous collagen are examples of dermal and subcutaneous augmentation techniques. Foriegn tissue augmentation is also possible by injectables such as of bovine collagen and hyaluronic acid, among the most popular ones.

Dermabrasion could be of help for acne scar treatment resulted from accidents or disease. This measure can be performed in the dermatologic surgeon's office or in an outpatient surgical facility. It is used to improve severe forms of wrinkling as well as other skin conditions such as a sun damaged skin. Anesthesia should be given prior to operation. Cleansing and freezing of the skin is performed before using the abrasive device. A high-speed rotary instrument with an abrasive wheel or brush removes the upper layers of the skin and improves irregularities in the skin surface. Tissue healing occurs within one to two weeks after operation. Medications will be used to alleviate the pain associated with the treated skin. Pink to red skin will stay for as long as three to four weeks after dermabrasion. The skin will be smoother as a consequence, total eradication should not be expected. Superficial scars show more positive results.

The type of laser used is determined by the sequels that the laser aims to accomplish. Lasers can vaporize skin mantle wise, causing slight cellular damage to other tissue. Special scanning devices move the laser light across the skin in predetermined patterns, ensuring proper exposure. Removal of acne scarring, spots, lines around the eyes, mouth, and cheeks are the primary uses for laser operations. Smile lines or those associated with other facial muscles tend to reappear after laser resurfacing. Post-cure redness stays for several months. Laser scar resurfacing appears to achieve its best effects as a spot cure; patients expecting complete elimination of their skin lesions will not be satisfied. Complete removal is closely correlated with their prototypes.

Peeling: This involves the use of a chemical to remove epidermis, the most outermost layer of the skin, in order to smooth depressed acne scar and give the surface a more even color. It is most helpful for shallow superficial scar lesions. Peels are divided into three classes: superficial, medium-depth, and deep. The sort of peeling depends on the strength of the chemical used, and on how deeply it penetrates. The first are used for fine wrinkles, sun damage, rosacea, acne and extraneous healing. The medium-level peeling is used for more obvious wrinkles and sun damage, as well as for precancerous lesions like actinic keratoses and scar tissue. Deep peels are used for the most severe forms of wrinkling, scar revision and sun damaged skin.

Go to next page.

>> Hippocrates Home

>> About

>> Support

>> Contact

>> Aging Resources

>> Skin Firming

>> Under Eyes Concerns

>> Acne Review

>> Archives

>> Treatments

>> Men's Care

>> Anti Aging Products

Scar treatment by skin resurfacing, Hippocrates serums:

Collagen remodeling in dermis layer by skin resurfacing. 14% pure AHA's, hydroxy acids, resurfacing treatment renews your skin and retexturizes, facilitates healing of damaged skin

1% pure Retinol. Hipocrates acne scar treatment serum speeds the cell turnover of epidermis mantle and help with removal of acne damaged epidermis

3% BHAs. resurfacing serum minimizes pores, renews the skin and control acne

Kojic acid. Hippocrates treatment of acne scars eliminates freckles and acne spots and refine the skin by revealing a brighter, more even-toned complexion

Thyme, sage and chamomile. Hippocrates renewal serum
increases the skin circulation and oxygenation. As a consequence helps to activate the natural collagen synthesis of dermis. Tightens the pores, reactivates the natural defenses of the skin, control inflammation and heals the skin

Bioflavanoids, Green tea extract. The serum take advantage of these powerful anti oxidants to prevent the oxidation of lipids in the skin, which causes delays in collagen deteriorations. Hippocrates kit comprises two more elements in addition to one above, a healing cream and glycolic serum.

Treating acne scars using an at-home regimen is a lengthy treatment requires patience. However, Hippocrates has developed an skin care tailored for treating acne scars by bioengineering high-potency serums. This care changes your skin dramatically in about one month. What will be more noticeable is the glow and smoothness in your skin rather than acne scar. Deep scars may never disappear completely, yet, your skin will divert into a skin strikingly different in terms of overall smoothness and radiance. Read also frequently asked questions. Acne scarring revision kit takes six to twelve months to smooth away damaged lesions, depends on their depth. This treatment of acne scars works on the surface of the skin, epidermis, as well as deep within the dermis layer. It also benefits from retexturizing properties of retinol, AHAs (alpha hydroxy acids) such as glycolic acid and BHA's for skin revision damaged by acne.