Do you want to forget your pimpled past? It’s too easy to do. But to some, they are having a hard time to forget because right on their face is the reality that will always remind them of- the scars- a living reality of that pimpled past. However, with these new skin-smoothing skills, whatever kind of scars that might be, raised and red, flat or depressed, they will all be nothing.
Ice pick scars
These scars are deep holes in the skin which look like the skin has been pierced with an ice pick. Ice picks and other depressed scars are usually produced when our body produces too little collagen in response to an injury. According to Gerald Imber, MD, New York City plastic surgeon, ice pick scars are the result of infected sebaceous gland openings of the skin which usually are the most difficult to correct.
According to Judy Hellman, MD, New York City dermatologist, ice pick scars can be treated by excising the scar with little “punch” and stitching the defect closed. However, this treatment will only be applied for isolated ice pick scars. Dr. Hellman also said that treatment of this scar may be possible because of skin grafts whereby the skin from behind the ears is taken to fill the scar which will smoothen out by a laser or radiofrequency device. The Doctor’s first choice when it comes to multiple ice pick scars is those devices that use radiofrequency energy.
According to her, radiofrequency devices help build collagen from inside to outside in which this collagen helps fill the scars from within. However, series of treatment is advised. In order to do this, the procedures must be with the use of local anesthesia which is effective to all types of skins. In 2015 issue of the Journal of Cosmetics, Dermatologist Sciences and Applications, Dr. Hellman, in a study, found out the death of the scars is associated with the use of around four treatments with the use of the radiofrequency device. Another study in 2016 which is a supplementary of the 2015 issue of the same journal revealed that the results of the radiofrequency, although some who use it had touch-ups, held up for up to two years.
These kinds of scars have the tendency to be broader and boxier than ice picks although they are also depressed scars. Since boxcar scars are also depressed scars, like ice picks, they also exist when the collagen that is produced is too little during the healing of the wound.
According to new York City assistant professor Nada Elbuluk, MD of New York University Langone Medical Center, boxcar scars can be treated by energy-based skin with a laser, radiofrequency, or an ultrasound device because these devices worked by producing new collagen below the surface of the skin.
She added that depending on the extent of the scar, there may be a series of treatments that should be done. For a lesser extent, chemical peels can also be used. In addition to this, according to Dr. Elbuluk, with either of the above procedure, a great result can be achieved using a retinoid to help the growth of cell turnover and further improve collagen. For some depressed scars, Bellafill and other injectable fillers such as fat can also be of great help. The U.S. Food and Drug Administration approved the Bellafill as the only current filler to help raised depressed scars.
By adding volume and boosting collagen formation underneath the surface, the so-called one-two punch, it creates a supportive collagen. According to Dr. Jennifer Levine, MD, facial plastic surgeon of New York City, Bellafill and other injectable helps fill in scars but is effective and better for one scar. The result of the filler can endure up to 18 months. Dr. Levine added that it is much better to resurface the face with a laser, radiofrequency, or another energy-based treatment if the person’s cheek is full of depressed scars.
These kinds of scars are also categorized as depressed scars that have smooth edges and appear as tiny hills and valleys.
To treat rolling scars, according to Dr. Imber it needs micro fat injections to be followed by micro-needling with platelet-rich plasma (PRP). Through Microneedling, tiny wounds or pinpricks can be created in the skin enabling the natural and controlled healing processing of the body boosting the internal production of collagen. It also enables the channels of the skin to open up giving platelet-rich plasma- the factor that would heal a person’s own blood- and skin care products straight to the deeper layers of the skin where they are most needed.
Platelet-rich plasma has proteins and other factors for growth. PRP is produced by consuming some of the blood, separating the proteins and other growth elements, and putting it back by injecting it directly to the scar. Dr. Imber added that the purpose of this is to enable the collagen layer to be formed underneath the depression to level it up to the surrounding skin. It produces great results but multiple treatments are needed for its achievement. In January this year, 2017, this procedure is proved by a newly discovered study issued in Aesthetic Plastic Surgery that depressed scars can be improved by fat plus PRP with the help of laser skin resurfacing. The study further revealed that with the help of the treatment the social life and the relationship of those with scars are placed into better-quality.
These scars, according to Dr. Elbuluk, appear to be reddish and pinkish for lighter and for darker skin type, respectively. Keloid scars are categorized as raised scars.
Still, according to Dr. Elbuluk keloid scars can be flattened by the injections of steroids. Skin active inflammation can be inferred when the scar has discoloration or when it turns red. The objective is to remove this inflammation with the use of certain lasers like pulsed dye laser by directly targeting blood vessels. With the help of cryosurgery, the tissue of the scar freezes, sloughing it off. However, this may produce pigmentation cases for people who have darker complexion who are already prone to keloids.
Before scars are formed, it must be prevented with the use of treatment scar-minimizing such as Mederma and/or silicone gel scar sheets. Pigmentation surrounding a keloid scar can also be reduced with vitamin C serums like Perricone MD Vitamin C Ester Serum, Kiehl’s ‘Clearly Corrective’ Dark Spot Solution, Kiss My Face C The Change (Ester C Serum), or Skinceuticals C E FERULIC® vitamin C serum.
This is caused by acne-related inflammation characterized by a dark spot or discoloration.
According to Dr. Imber, this is treated by using 4 percent hydroquinone, a topical bleaching that directly applied to a dark spot, and sunblock, a product needed to prevent the worsening of hyperpigmentation due to too much sunlight absorption.
According to Dr. Elbuluk, in order to increase cell turnover, glycolic acid products that eliminate dark spots as well as the upper-most layer of the skin, and retinoids, and other possible treatments such as the bleaching agent hydroquinone can also be used.
She said that glycolic acid chemical peels can also be used with higher doses when in the office compared with the doses used at home. However, if peels don’t work, usually the next procedure is to use lasers for the improvement of hyperpigmentation.
Dr. Levine describes these as the combination of above-mentioned scars. The scars may come first into reddish color; others are pale, to ice pick then to box scar.
The doctor added that multiple treatments are needed because the combination of the scars should be considered and that the improvement will only be 50 percent even after a year or two of treatments. Nonetheless, Dr. Hellman advised the public that even if the change is not perfect or 100 percent effective, it must be appreciated that a person’s self-confidence and self-esteem makes a difference with less visible or deep scars on him or her skin. The person just needs patience because there is always a room for improvement for every kind of scar.
Dr. Levine advised that for combined scars, one may opt for series treatments with picosecond lasers, newer technologies with less downtime than older lasers, like Picosure or use of the FRAX 1550 Fractional non-ablative laser. Unlike the older ablative lasers that remove the top layers of the skin requiring significant downtime, these newer non-ablative lasers pass through the upper layers of the skin to heat the deeper tissues, stimulate collagen and smoothes the appearance of the scar without causing so much damage to the skin.
Prevention is Key
Although we cannot be so sure that after having acne we can develop a scar, we are still at risk to have them. After the inflammation of acne, its marks cause scars especially when it is not given attention. In addition to this, picking, squeezing or popping zits as well as a cause by genetics can also be the reason for scars. Dr. Levine said that as much as possible acne must be treated early in order to avoid greater risk for the greater scar. Share this post with your friends!