Currently correction of atrophic scars on the skin of the face is of great interest. Despite the fact that there are many correction methods, devices and drugs on the market to solve this problem, unfortunately, there is no single scheme and tactics of treatment.
Therefore, every doctor faced with the need to treat atrophic scars starts from his clinical experience, the availability of this or that equipment in the clinic, as well as the drugs available in the arsenal.
In any case, working with various pathologies can be reduced to several stages – this is the opinion dermatologist, cosmetologist (NuAnce clinic, St. Petersburg), certified trainer of the Hyalual Institute in Russia Abdushukurova Malika Maksumovna.
The main stages of the treatment of atrophic scars and skin rehabilitation
The main goal of therapy for atrophic scars with subsequent skin rehabilitation – destroy old altered tissues and recreate the structure of the dermal layer due to neocollagenesis.
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Step by step, this process is as follows:
1. Normalization of trophism and improvement of microcirculation of the skin tissue for the proper functioning of skin cells and specifically fibroblasts of the dermal layer, because it is they who will have to develop new structural elements of the intercellular matrix.
2. Destruction of fibrous-changed areas and smoothing of the skin relief.
3. Completion of tissue deficiency by stimulating the production of its own elements of the intercellular matrix.
The main goal of therapy for atrophic scars with subsequent skin rehabilitation – destroy altered tissues and recreate the structure of the dermal layer due to neocollagenesis.
A case report: treatment of atrophic scars and skin rehabilitation after chemical peeling
Below is a clinical case of skin rehabilitation and treatment of formed atrophic scars after Jessner chemical peel.
Acne scars in modern cosmetology - problem solved
The reason for the formation of various kinds of scars is one or another damage to the skin, caused not only by acne, but also by chemical or thermal burns.
From the anamnesis:
A 27-year-old female patient, in July 2016, turned to a beautician with a complaint of unsatisfactory skin condition. According to the patient, she was disturbed by black dots, closed comedones. The beautician recommended a 3-layer Jessner peel treatment.
The next day after the peeling, the patient noticed red painful formations on the skin. Further, the picture began to grow and a large number of pustular elements appeared.
The patient was hospitalized in the ACU, underwent long-term treatment.
At the time of contacting me, a year after the peeling, the picture on examination was as follows: oily skin, enlarged pores, telangiectasia, on the cheeks on both sides – congestive spots and atrophic scars of rounded shape, different sizes.
The scars reached the edge of the lower jaw.
The combined use of laser therapy with redermalization was recommended.
But given the psycho-emotional state of the patient, it was decided to conduct monotherapy with Hyalual®; 1.1%, 1.8%, 2.2% from Hyalual.
The photo below shows the patient's clinical condition before therapy.
Procedure log:
1. Injection of Hyalual® 1.1% (2 ml) in a standard micropapular technique over the entire area of the skin of the face and neck.
2. After 2 weeks: injection of Hyalual® 1.1% (2 ml) – standard micropapular.
3. After 2 weeks: administration of Hyalual® 1.8% (2 ml). Subcision of each scar with 25G needles, leaving the drug in the wound, over the entire area of scarring; in a linear-retrograde technique (according to the type of reinforcement – along Langer lines) in order to create a frame and tension the skin.
4. After 1 month: injection of Hyalual® 2.2% (2 ml): linear retrograde reinforcement with scar subcision.
The results after four treatments are shown in the photo below.
5. After 6 months: injection of Hyalual® 1.1% (2 ml) – processing in micropapular technique over the entire area of the skin of the face and neck.
6. After 1 month: final treatment with Hyalual® 2.2% (1 ml) – work only on the area of the remaining minor cicatricial changes.
Anti-aging lifting of the deformation-edematous type
The patient's skin has become significantly smoother in texture. Traces of atrophic scars are hardly noticeable and are easily masked by ordinary decorative makeup.
The above case study demonstrates the high efficacy of monotherapy for atrophic scars using Hyalual products.
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