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    Old 07-18-2002, 12:52 PM   #1
    Hombre
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    Post Scar treatments

    UPDATED 7-24-02 WITH NEW INFORMATION

    Just remember all of these treaments have worked well for some people and have not worked at all for others. I share this research to help YOU make your own comparisons and to educate people in the process.

    From reading various other boards and internet sites I compiled this list of common scar treatments. PLEASE correct my mistakes as I am not a doctor but I did want there to a post that summarizes things for us. After additions or corrections maybe we can make a new post where people can look for an overview of scar treatments. I tried to be conservative and not promote one treatment over any other.

    LEVEL 1 up to 20% improvement depending on scar severity

    *Microdermabrasion
    exfoliates dead skin by blasting crystals in small rows across the face. Improves texture, but is not a scar treatment per se.
    *Derma-sanding uses a sterile type of sand paper and is sometimes used in conjunction with certain surgeries listed below.

    *Light peels (AHA) (lactic – from sour milk, Tartaric – from grapes, Glycolic – from sugarcane, Malic – from fruit)– removes dead skin, the new skin that comes in is tighter and skin is noticeably smoother for a few days or weeks. Glycolic is the most popular because it has the smallest molecular structure so can penetrate the skin easier. If you are on certain prescriptions this can cause additional damage to your skin.

    *Topical creams (elcina, collagin builders, dermatique, Neosporin, Cellex-C,etc) – Some people claim they see results, others do not. Cellex-C and Elcina require at least 3 months to see results. Dermanew makes skin feel smoother but doesn’t help scars.

    LEVEL 2 20-60% improvement depending on scar severity
    *Cool Touch / Smoothbeam – removes 5 –20 micrometers of skin. (Skin is approx. 100 micrometers thick) Has very variable results per patient. Requires several treatments. Most people don’t notice any improvement the first treatment but occasionally some see good results from day 1.

    *TCA peels (A “Blue” peel is 30% TCA)– removes top layer skin,the tightness from the new layer of skin lasts longer but some patients see scars return weeks or months later. Some derms refuse to do over 20% because of the risk of increased scarring.

    *Injections
    – collagen or fat transfers (can leave skin bumpy and only last a few weeks or months).
    – Artecoll – Not yet approved in the U.S. but thought to be more permanent. Sometimes leaves bumps, usually requires several treatments. Some patients say that if you have severe scarring or have never had resurfacing done you will need countless shots over a long period of time. Slight possibility of pinprick scarring since it is injected subdermally.
    – Saline – raises the epidermis, allowing collagen to fill in the gap, also breaks down the collagen fibers under scars that “pull” the skin in (indentations).
    – Isologen – Your own collagen is cultivated in a lab using fibroblasts (the cells that make collagen) taken from your own skin behind your earlobe. Then it is injected into your scars. Still under review, only a few doctors are authorized to perform this currently.
    – Silicone. Some people are swearing by this new type of silicone which must be injected in tiny droplets or else it can harden. Takes up to 3 sessions, is thought to be permanent, but does “retreat” slightly thus taking up to 3 sessions. This type of silicone is FDA approved only for use in certain retinal procedures but can be used “off label” for acne scars. Therefore no dermatologist will advertise this in a brochure since the FDA had strict laws against off label promotion. No chance of it entering the bloodstream if injected correctly.


    LEVEL 3 up to 70 % improvement – depending on scar severity

    *Punch Excision – the scar is surgically punched out, stitched back up for a week, healing time can be 6 months to a year, a new scar may actually form.

    *Subcisions – suture type threads are inserted “under” the scar tissue and tied in a knot above the skin, then covered with tape. This raises the epidermis and allows collagen to form in the space under the raised skin. Sometimes a back and forth scraping motion is used with a needle to cut up the root tissue holding the scar down. This causes a blood clot which takes 2 months to heal. During the healing process collagen forms. The process is often repeated for maximum results. Some people have dramatic improvement but others have seen the scars recur in a few weeks or months.

    LASERS (can be effective at stimulating collagen, doesn’t abrade the skin but vaporizes it instead. Upon re-epithilialization the new skin will have more collagen and fibroblasts than the skin which was removed.
    *Erbium/N-light- not for deep scars, often used as a precursor to CO2 to smooth scar edges but not scars themselves - much less thermal damage/downtime than C02

    *CO2 The “big gun” of lasers. removes 20 –60 micrometers of skin, causes 150 micrometers of thermal damage. This level of thermal damage promotes more collagen growth. Results depend on depth and number of passes. Can cause pinkness that lasts for years and an inability to tan and dramatic susceptibility to sunburn that lasts for years. Can take 6 or 7 months after treatment for the collagen to build up final level. Years later the deeper scars may reappear.


    LEVEL 4 (for deeper scars – preformed by cosmetic surgion)

    Dermabrasion - freezes then sands off the skin with a sanding abrasive machine. Not always permanent. Weeks of downtime.

    Dermabrasion w/ Laser - An aggressive approach for most dramatic results. Sometimes they are preformed the same day sometimes a few weeks apart.

    Face Lift – the skin is undermined (lifted from the face) so the scar tissure that anchors itself to the flesh is lifted reducing the depth of the scarring.

    Notes:
    -Skin renews on a 30 day cycle (cell turnover). Therefore you need to use an SPF of 15 or higher for 30 days after any peel.
    -Lower cheek and jaw area scars can defy treatment, are prone to scabbing and have longer healing times.
    -Some patients and doctors insists that it is necessary to “prep” the skin with retin-a treatments or glycolic acid several weeks before a TCA peel or laser surguery.
    Many before and after pics use lighting or makeup to accentuate the scars in the before and hide them in the after. Also some after pictures are taken when the skin is still swollen and thus the scars are unnaturally puffed out. Yes this is deceptive advertising but it does happen.
    Skin is a living organ (not a piece of furniture) and must be treated very carefully and most of all with respect. If it’s in the middle of a lifecycle change (puberty or pregnancy for example) the results may be worse than when you started.



    [This message has been edited by Hombre (edited 07-24-2002).]

     
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    Old 07-18-2002, 03:17 PM   #2
    blueeyedbia
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    Thanks for all the information. This will help a lot of people!!!

     
    Old 07-18-2002, 03:22 PM   #3
    KC Lee
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    Hombre, that is a wonderful post. We should try to keep it at the top so everyone can read it.

     
    Old 07-18-2002, 06:18 PM   #4
    poohman
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    Thanks for the good info, Hombre.

    Have you seen something that suggest Artecoll will
    give a maximum improvement of 60%? I'm sure it depends on the type of scar, but don't you think it's possible to do much better?

    Also, weren't you doing saline treatments? How is that going? That topic has seemed to quiet down alot.

    Thanks.

     
    Old 07-18-2002, 07:31 PM   #5
    blueeyedbia
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    Hombre I was wondering if you knew anything about EXODERM LIFT. There is a recent post about it. Have you found any information about it??? I was just wondering if it really is effective as it claims.

    [This message has been edited by blueeyedbia (edited 07-18-2002).]

     
    Old 07-18-2002, 09:53 PM   #6
    Hombre
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    Poohman

    Some patients are reporting dramatic results with artecoll but I tried to be conservative with all the above procedures. One patient said that after a true dermabrasion, countless glycolic peels and 3 shots of artecoll she still didn't have as smooth skin as some of the other patients. Also there CAN be lumping. Artecoll is also used for other facial treatments besides scars and several treatments are often necessary. The body's immune system will try to encapsulate (surround) the "invading substance" and get rid of it but it takes time - around 3 months. That why sessions are often spaced 3 months apart so the doctor can see how much encapsulation took place. The theory behind artecoll for scars is that the body will create it own collagen to encapsulate the microspheres so that the results are permanent. I do think this procedure hold promise for many people.

    As for my saline injections, I had my second one this week and I go back in two weeks for my third. This time I noticed that the swelling didn't last for very long at all, maybe two hours. (I wonder if not as much was injected this time.) They did my neck this time and that looks a little better but has a lot of red dots from the procedure. My face did not have any red dots this time - so maybe it got used to it already. I can report a continuous subtle improvement, nothing dramatic so far, but this is a cumulative treatment and I hope my collagen continues building in the meantime. Thanks for asking!

     
    Old 07-18-2002, 10:07 PM   #7
    Hombre
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    Blueeyed

    Its very difficult to find reliable information on the exoderm lift but when I do I will post a summary. I have read that its as much as $4000 and some people recommend a doctor in Mexico.

    Basically there are three types of people who post about acne scar treatment.
    *Type I are people who are finally ready for treatment and are investigating options. They have questions and want to see who has actual experience with the procedure in question.

    *Type II are people who are in the middle of a particular treatment and are sharing their experiences, the ups and downs. This often creates an interesting thread as similar people compare notes. The problem is that only time will tell the longevity of the skin correction that they are experiencing.

    *That brings us to Type III. These are people who completed their treatment(s) long ago and are now living happily ever after. These people do not post. And if they do, they tend to be shot down and labled as advertisers in disguise.

    The majoritity of posts for the exoderm lift are Type I people asking what it is and is it as effective as the promotional website claims. I think soon there will be more people who have investigated this procedure and can shed light on it.



    [This message has been edited by Hombre (edited 07-19-2002).]

     
    Old 07-21-2002, 08:26 AM   #8
    blueeyedbia
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    Thanks again for posting all this scar information. It is one of the more helpful scars posts on this board. THANKS!

     
    Old 07-24-2002, 03:22 PM   #9
    Hombre
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    ***7/24/02***

    I have updated this post to include silicone, isologen, punch excision, and a few more notes at the bottom. I share it only out of a sense of mutual support and education.

     
    Old 08-25-2002, 01:32 PM   #10
    barbiedoll_fl
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    Most imformative post ever!

    I am currently researching the silicone injections. My derm. suggested it to me, because he knows how freakin picky I am. I am reading up on it first since there are some horror storeis on the net about it. Any additional info. is greatly appreciated.

     
    Old 01-09-2003, 01:24 PM   #11
    JenniferB
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    Does the scar treatment called "Mederma" work? I saw it in the store a few days ago and was wondering if anyone has had any luck with it. They sell it in stores like Walgreens.

     
    Old 01-09-2003, 01:29 PM   #12
    OlderAndWiser
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    I used it for a year with no results - also, it really makes your skin itch!

     
    Old 01-09-2003, 01:35 PM   #13
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    Glad I didn't buy it! Thanks!

     
    Old 01-22-2003, 04:52 PM   #14
    EMMANUEL
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    Thought I'd bump this, as it contains some useful information.

    ------------------
    May you have enough happiness to make you sweet, enough trials to keep you strong, enough sorrow to keep you human, and enough hope to keep you happy.

    Peace

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    May you have enough happiness to make you sweet, enough trials to keep you strong, enough sorrow to keep you human, and enough hope to keep you happy.

    Peace

    ~*Emma*~

     
    Old 01-22-2003, 09:22 PM   #15
    21withacne
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    Hombre-
    This was a fabulous post! Thanks so much for all the research and info. Found it very helpful. I have shallow scars (not deep at all) with lots of red marks. What do you rec?

    Thanks,
    21.
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