Atrophic scars - what are they?

An atrophic scar is a serious defect of the skin that negatively affects a person’s aesthetic appearance. The situation is aggravated by the fact that against the background of pathology, other changes associated with the patient’s emotional state occur. As a rule, this manifestation is accompanied by various psychological disorders, fears and complexes.

Treatment of atrophic scars requires a long period of time and patience. But the good news is that, thanks to medical advances, it has become possible to completely get rid of this most unpleasant problem. This article describes various methods for treating skin defects.

Nature of scars

A scar is a compaction of a certain area of ​​the body, formed as a result of regeneration after its rejection in the process of mechanical damage. The neoplasm consists of connective tissue, the quantity of which determines the classification of scars. There are 4 types of skin defects: normotrophic, keloid, hypertrophic and atrophic.

What is an atrophic scar?

A type of such pathological scarring is characterized by softness, mobility and sagging skin. Vessels are clearly visible through the scar layer consisting of connective tissue. Scars can be both light and dark, in particular, it depends on pigmentation. It is either absent altogether or pronounced.

Externally, scars appear in the form of depressions of uncertain shape. For this reason, too small formations are sometimes confused with enlarged pores. Basically, such manifestations are localized in places where there is no subcutaneous fat, under the outer layer of the skin. These are body parts such as the face, the front of the legs, the upper chest, and the back of the feet and hands.

Causes

The main cause of abnormal scarring is collagen deficiency. When there is enough of this substance, after damage to the skin, substances necessary for regeneration - cytokines and mediators - begin to be actively produced. During cell inflammation, fibroblasts produce collagen. Such natural processes contribute to the formation of a normal scar. During the renewal process, granulation (connective) tissue with new collagen fibers forms a healthy ligament consisting of hair follicles. Various disorders interfere with the production of collagen, which in turn leads to improper scarring of the subcutaneous tissue. Factors that provoke atrophic scars include:

1. sudden weight gain;
2. pregnancy;
3. certain medical procedures;
4. minor injuries;
5. acne and ulcers;
6. inflammatory processes;
7. burns;
8. chicken pox.

Treatment methods

It is immediately worth noting that atrophic scars do not go away on their own; even after many years, their traces remain forever. Those who want to restore their skin to its former attractiveness need to consider proper treatment.

First of all, you should consult a specialist. This is due to the fact that there are no universal remedies for atrophic scars, so the choice of medication directly depends on the degree of deformation of the affected area. There are plenty of ways to get rid of such unwanted lesions.

Sometimes this may be limited to local treatment using external agents and following a certain diet. Such recommendations are most often received by women who want to get rid of stretch marks after childbirth, as well as during pregnancy, in order to avoid such manifestations. Silicone-based gels and scar creams significantly reduce scarring. A therapeutic course using external agents is convenient in that it can be carried out at home. Scar ointments that are formulated with a herbal base may be helpful in such circumstances.

It happens that surgery is required to treat more serious injuries and burns. Carrying out such operations significantly changes the appearance of the epidermis.

Removal of acne scars is carried out using chemical peels, dermabrasion (resurfacing) and physical methods such as laser correction and cryotherapy.

Effective methods for treating atrophic scars are injections. The introduction of hyaluronic acid, collagen and fat allows you to remove unsightly depressions for a certain period of time. But this method of treatment requires repeated procedures.

Laser beams are a common way to get rid of scars. The description of each of these methods separately, provided below, will provide informational information.

Scar excision

The surgical method is used if the doctor does not see other potentially effective treatment methods. The scar is completely removed to allow the skin to regenerate. After physiological regeneration, scars after surgery become more neat, smooth and barely noticeable. This is the only method that can minimize the width of the scar. To carry out the manipulation, a laser or surgical scalpel is used.

Hardware methods

1. Peeling. By exposing the atrophied area to chemical elements, the surface layer of the skin is peeled off. Based on the specifics and degree of scarring, the specialist decides at what depth such a procedure will be performed. Chemical peeling promotes cell renewal.
2. Subcision. This method involves cutting the fibers that connect the tissue resulting from pathological scarring to the deeper layers of the skin. This therapy is carried out using a special needle. The sunken part of the dermis rises and is almost equal to the main surface of the skin and, thus, the effect of smoothing the skin occurs.
3. Microdermabrasion. This method involves grinding the dermis using microscopic solid crystals. The accumulated vacuum energy knocks out small areas of the skin. Over time, the affected areas of the epidermis are replaced by healthy tissue.

Laser resurfacing is the most popular method

Using the device, scar tissue is delicately and gently evaporated. The process is aimed at stimulating new cells - fibrocytes and fibroblasts, which, in turn, produce collagen fibers.

According to medical professionals, laser resurfacing of atrophic scars is considered the best effective method. Other existing methods, such as injections, dermabrasion and chemical peels, should serve as additional treatments to this primary method.

Laser correction is a method of precise dosed impact on compacted scar tissue, which does not have a negative effect on the surrounding areas of the skin. A carbon dioxide laser is used for evaporation. This is a bloodless procedure that is well tolerated by patients. Using this type of treatment, specialists try to achieve skin renewal and healing.

There is another method of similar therapy - the use of a vascular laser. It ensures the gluing of blood vessels on an atrophic scar. Unlike carbon dioxide laser, which is characterized by skin pigmentation and redness, vascular laser does not leave such consequences.

In this case, correction of atrophic scars is carried out under anesthesia.

Mesotherapy

Atrophic scars on the face are corrected by introducing medications under the skin. The medicine has a positive effect on the condition of the pathological compaction and its appearance. This method is based on the principle of stimulating the production of fibroblasts, which contribute to the normalization of collagen synthesis.

Contour plastic

Correction of atrophic scars using contour plastic surgery is considered the fastest method. The result is achieved by injecting a gel filler under the skin. Many patients noted that such injections are the most effective and convenient. Due to the gel-like mass, the skin is instantly smoothed. The downside is that after 6 months the gel gradually dissolves and the compacted depression appears again.

Ointments and creams

The use of external agents can accelerate or slow down collagen synthesis, improve blood circulation and promote tissue smoothing. Scar creams have antibacterial and immunostimulating properties and act directly on the scarred area. The most popular products include the following: Dermatix, Kelofibraza, Contractubex, Cordran, Medgel and Skarguard. Details of some of them are provided below:

1. "Kelofibrase." The product has a moisturizing and softening effect. After its use, the skin becomes elastic and elastic. Thanks to urea, which is part of the ointment for scars, an optimal level of moisture in the skin is maintained. Heparin sodium contained in the drug stimulates blood supply to the scar area and adjacent tissues. The ointment is an antibacterial and anti-inflammatory agent and stimulates the process of cell renewal.
2. "Kontraktubeks". The external remedy helps smooth out the damaged surface and significantly reduces skin deformation. In addition, it eliminates the tightening effect and reduces discomfort.
3. "Dermatix". Silicone-based cream, in particular, is used to correct hardened and long-formed scars. It does not have a negative effect on other areas of the skin or on the body as a whole. The drug can be used for preventive purposes.

Enzyme therapy and hydration

Enzymatic action helps soften connective tissue. The procedure is carried out using applications of ointments and gels, which contain enzymes. Electrophoresis and iontophoresis are also used to soften rough areas. Enzyme therapy cleans wounds and creates a favorable environment for normal scarring. Healing of damage after such treatment occurs much faster.

If there is a need to increase the number of collagen cells, then there is a need to extend the period of tissue renewal. For this purpose, using semi-synthetic products, maximum hydration of the affected area is achieved.

Finally

It can be seen that scientists specializing in the field of medicine have taken care of people suffering due to the presence of an atrophic scar. But treatment of such a serious pathology should be under the strict supervision of a specialist. You should be aware that some gels and ointments may have the opposite effect. Treatment with external means will bring the expected result if they are used along with hardware methods.

Every girl wants to have perfect facial skin. But sometimes this dream cannot be realized. The reason for this is scars and scars that occur as a result of mechanical damage, burns, surgeries and much more. Will I really have to live with these defects my whole life? How to get rid of atrophic scars is the topic of today’s article. We will look at how to properly deal with scars using cosmetic procedures, folk remedies, and medications. Let’s find out whether it’s worth visiting a specialist or whether you can deal with scars yourself at home.

Atrophic scars are very dense formations that consist entirely of connective tissue. They occur mainly after mechanical damage, burns, and operations. Dealing with defects is not easy. But still there are methods and there are quite a lot of them. In first place in popularity are injection and hardware methods. What is their advantage, we will find out below.

Types of scars

Speaking about scars, first of all, you need to find out their classification, treatment will depend on this:

1. Normotrophic scars. Cosmetologists consider them the most harmless. They are formed almost flush with healthy skin, there are no depressions or other deformations. Over time, such scars acquire a natural color, become quite thin and practically invisible. To completely get rid of the defect, it is enough to perform simple cosmetic procedures, for example, peeling or use medications;

2. Atrophic scars. They appear due to mechanical damage to the skin. Very often the problem occurs after squeezing out pimples. Depressions and pits appear on the skin. In addition, obvious pigmentation is noticeable, the scars acquire a reddish or pink tint. Treatment is best done at an early stage of scar formation. Folk remedies, cosmetic procedures, and the use of medicinal ointments can help. In advanced cases, you cannot do without the help of a plastic surgeon;

3. Keloid and hypertrophic scars. As a rule, they occur after operations. The scars are quite noticeable, dense, pigmented. To remove them, in most cases, the help of a surgeon is required.

Before starting treatment for any type of scar, you must consult a cosmetologist or surgeon. Only a specialist can choose the right method.

We use surgical methods to treat scars

To cope with scars, many turn to surgeons for help. This method is quite traumatic; as a rule, it is used to remove large atrophic scars on the body.

Surgical excision is a complex operation. The doctor cuts off the old scar and makes a cosmetic, neat cosmetic scar. The procedure is painful and is performed under general anesthesia. The operation may take several hours. The result can be assessed only after 8-10 months. The rehabilitation period is quite long.

It is worth being prepared for the fact that after excision you will need the help of a cosmetologist or the use of special ointments.

If the atrophic scar on the face is very deep, the doctor may suggest a cutting method (subcision). The operation is performed using a special needle, which pries out the sunken connective tissues and lifts them upward. Visually, the skin is significantly smoothed out. But, as in the previous case, after the operation you will need to use additional methods that will completely get rid of atrophic scars.

Hardware methods: all the pros and cons

Treatment of atrophic scars can be carried out using special devices. Let's look at the most effective ways:

1. Microdermabrasion. A grinding device is used. Select a nozzle with a hard coating. Mostly small crystals are used. Using vacuum energy, they pass into the epidermis and select affected skin particles. In their place, regeneration occurs, replacing skin areas with new tissues. The method is painless and is performed without anesthesia. But to achieve a positive result, at least 10 procedures are needed;

2. Laser Application. Quite an effective way. Cosmetologists advise using this method to remove atrophic scars after acne.

There are several types of laser. The most popular is vascular. In this case, gluing of blood vessels in the scars occurs. The carbon dioxide laser vaporizes the upper layers of the skin. Complications in the form of keloid scars are often observed.

Cosmetologists consider laser resurfacing the most effective method of getting rid of atrophic scars. To achieve the desired results, you must complete a course consisting of 3-6 procedures. A very important note: resurfacing is not carried out on dark, tanned skin. It is better to do the procedure in autumn or winter, when there is no scorching sun. But even at this time of year you will have to use sunscreen.

Injection methods for treating atrophic scars: quickly, reliably, effectively

Atrophic scars on the face are best treated with injections:

1. Mesotherapy. The cosmetologist injects a special preparation under the skin that nourishes the epidermis, starts the process of cell regeneration, and collagen synthesis begins. The result can be seen almost immediately. Deep atrophic scars are leveled out, skin pigmentation goes away;

2. Biorevitalization. The cosmetologist injects a drug containing hyaluronic acid into the scar. As a result, the process of cell and tissue regeneration starts. Experts say that it is better to carry out the procedure after laser resurfacing;

3. Contour plastic. It will quickly help remove an atrophic scar on the nose. The essence of the procedure is that the patient is injected with a gel filler, which smoothes the skin and removes defects. The result is immediate. The downside is that after 6 months the procedure will have to be repeated, and it is quite expensive.

Injection methods for getting rid of atrophic scars are quite effective. This is evidenced by photos before and after the procedures.

Patients note that contour plastic surgery gives the best result, which is immediately noticeable. But after 5-6 months the gel completely dissolves, and the problem returns again.

What medications will help get rid of scars?

If the atrophic scar is quite fresh and shallow, you can get rid of it with the help of medicinal ointments and creams. The list of drugs that have a good effect is as follows:

• Kelofibrase. Available in the form of a cream. The main component is urea, which can well moisturize and soften the skin. In addition, the composition contains heparin.

It is responsible for improving blood flow in tissues. Thanks to the cream, the scar is gradually smoothed out, there is no tightening effect. Kelofibrase relieves inflammation and evens out the color of the scar;

• Contractubex. Perhaps the most popular remedy. The ointment has a rather dense structure. Well moisturizes the skin, starts the process of cell regeneration, smoothes out the scar. The cost ranges from 1000 rubles;

• Dermatix. New generation drug. Available in gel form. Works great on scars and blemishes. You need to use it at least 2 times a day for several months. Can be used to treat scars in children. The disadvantages include a rather high price (about 2000-2500 rubles);

• Badyaga. One of the most cost-effective drugs for the treatment of scars. The average price is about 150 rubles. It has a completely natural composition. It is made from algae that grows in fresh water bodies or rivers. It helps only in the case of small and shallow atrophic scars, for example, from acne.

Cosmetologists tend to believe that medications cannot completely get rid of defects. It makes more sense to use them in combination with other methods.

Cosmetic procedures at home: can they help get rid of scars?

Treatment at home can be carried out only if the atrophic scars are shallow and fresh. But even in this case, the chances of a positive result are quite small.

Below are recipes for popular masks that will help smooth out scars a little:

• Mix 30 g of cosmetic clay with water until a thick mass is formed. Add 40 g of freshly squeezed lemon juice. Do not use bagged product. Mix the mixture thoroughly and apply to the problem area of ​​the skin. Leave for 30 minutes;

• Take a few grams of mumiyo, mix with 100 g of regular baby cream (for example, Antoshka). Apply to the scar for 30-40 minutes. Perform the procedure daily;

• Melt 50 g of beeswax, add 100 g of olive or vegetable oil. Apply the mixture to gauze and apply to the scar. Monitor the temperature. The skin of scars is delicate and you can get burned.

Treatment with folk remedies is not always effective. It is better to use them in extreme cases, when there is no money or time to go to specialists.

Atrophic scars can occur for many reasons. Quite often they appear due to improper skin care, for example, squeezing pimples or unsuccessfully cleansing the face. How to get rid of such defects was described above. The most correct way is to go for a consultation with a cosmetologist. A specialist will be able to choose the right method based on the condition of the skin. Remember, treatment at home does not always bring the desired results. In most cases, the condition of the scars only worsens.

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Comments

1. Lisa | 2018-10-02 11:25:50

I used Dermatix gel to smooth out a scar after a burn. It was so loose, not beautiful! And on the wrist too! Horror! Now it is almost the same color as the skin and more even

Natasha | 2018-09-04 12:49:21

After plastic surgery, the seam was treated with Dermatix gel. The doctor explained to me when to apply it and how. Now the seam looks very presentable)

Ruslan | 2018-09-03 20:03:09

Of the products presented, I used Dermatix gel. There was a scar after a deep cut, in a visible place, unfortunately. Now there is a thin strip of pink color. Anything is better than terrible tripe!

Atrophic scars are a common complication after acne. They are common not only among adolescents, but also among adults.

Atrophic scars significantly impair the quality of life, reduce self-esteem, cause depression, anxiety, embarrassment, anger, and change social norms of behavior, so they are a modern problem for all treating dermatologists.

Dermatologists are often faced with the problem of assessing the overall condition of tissue scarring, which is why the provided treatment algorithm does not produce the expected results.

Treatment for atrophic scars varies depending on the type of acne scar and the limited treatments available.

Many scar treatment methods are now available: chemical peels, dermabrasion, laser treatment, mesotherapy, subcision, etc., but sometimes it is combination therapy that gives long-term positive results.

Before starting treatment, cosmetologists and dermatologists must evaluate not only the condition of scars on the body, but also discuss treatment methods and expected results with the patient. It is necessary to decide which procedures will be most effective for the patient.

This last point is the most problematic because each dermatologist has a different skill set and procedural experience, education, and access to surgical instruments and machines.

We will try to describe all possible methods of treating atrophic scars and what can be expected after their treatment.

What are atrophic scars?

Acne appears on average in up to 80% of people, starting in adolescence. Moreover, with stages 3 and 4 acne, scarring occurs in almost 95% of patients.

Post-acne scars are divided into 4 different types: atrophic, normotrophic, hypertrophic or keloid. Atrophic scars are the most common type.

Atrophic scars are a scar in which all its boundaries are below the normal tissue level, that is, the scar sinks into the skin. The pathogenesis of atrophic scars is most likely associated with the occurrence of inflammation and changes in subcutaneous fat and collagen fibers.

Various methods are used to correct such scars, but they all have their limitations, effectiveness and side effects, which limits their use.

In order to optimally correct or treat a patient's scar, it is necessary to consider which method produces the most satisfactory result. For each patient, this may be a different method or combination therapy.

Many dermatologists are confident from their experience that fresh scars up to 6 months old can be cured 100%, but old ones can only be made less noticeable, at best corrected by 70 - 90%.

Methods for correcting atrophic scars

1) Chemical peels

Chemical peeling is a procedure of applying chemical solutions to the skin to peel off the damaged outer layers. All chemical agents have different depths of penetration, and therefore the skin either flakes off or peels off.

This is why there are superficial, medium and deep peels. Below is a classification of chemical agents for peeling.

Glycolic acid

It is the most commonly used alpha hydroxyl acid as a peeling agent. Glycolic acid in low concentrations of 5 to 15% can be used in daily skin care products.

High concentrations from 30 to 70% are used for chemical peeling. The higher the concentration, the deeper the acid penetrates the skin.

Glycolic acid peels are relatively safe and non-toxic. Quite well tolerated by patients. The best results from post-acne scars are achieved after several consecutive treatments with 70% glycolic acid with an interval of 2 weeks.

The advantages of glycolic peeling include: mild redness, mild peeling and a short recovery period. Main disadvantages: non-uniform penetration, mandatory neutralization and high risk of burns if left on the skin for too long.

Trichloroacetic acid (TCA)

It is used in various concentrations: from 10% to 20% TCA for superficial peeling, 30 - 35% for medium peeling.

Concentrations higher than 35% are not recommended because the results are less predictable and the possibility of re-scarring is higher.

This acid causes protein coagulation, resulting in a white coating on the skin, the uniform distribution of which indicates the depth of penetration of the acid.

After superficial peeling, slight redness appears, and peeling appears on days 2–4. Medium peeling is characterized by the appearance of a more even white coating, while the depth of acid action reaches the epidermis. The crust comes off in about 5 days.

After deep peeling, a hard white opaque coating appears with significant redness of the skin. The depth of exposure expands to the papillary layer of the dermis.

Advantages of trichloroacetic acid peeling: relatively low cost and ease of assessing penetration by plaque formation on the skin. Disadvantages include tingling, burning and the possibility of hyperpigmentation in people with skin types 5 and 6.

Jessner Peel

Jessner's solution is used to remove small scars or in preparation for a TCA peel. The drug is made from salicylic acid (14 g); resorcinol (14 g), lactic acid 85% (14 g) in an ethanol solution of 100 ml.

The depth of peeling depends on the number of layers of solution applied. Penetration of Jessner's solution is observed in very slight superficial erythema, sometimes a slight white coating is visible.

Superficial peeling is observed when applying 1 to 3 layers of solution. Light peeling is observed within 1-2 days or is absent altogether.

From 4 to 10 layers of solution, increased redness and a clearly visible white coating appear. The burning and tingling sensation lasts for 15 to 30 minutes. In the first 3 days, a soft red-brown color develops and the skin becomes tougher. This is followed by peeling for 2 to 4 days.

The next level of Jessner peel application is more than 10 layers, when severe redness, severe burning and a hard crust are clearly observed. Exfoliation usually lasts 8 to 10 days.

Different patients may need different numbers of layers to achieve the same result. This is because penetration of the solution depends on a number of factors, including skin preparation, skin thickness and sensitivity.

The main advantages of Jessner peeling are safety, because mostly superficial peels are done and the acid rarely goes deeper than the expected level. Disadvantages include severe redness and discoloration of the skin.

Pyruvic acid

Atrophic scars are often treated with pyruvic acid. It has sebum-regulating, antibacterial and keratolytic properties, and increases collagen synthesis.

Moderate atrophic scars are corrected at concentrations of 40 to 70% pyruvic acid.

The advantages of this peeling: uniform penetration with uniform redness, mild peeling, can be used on all skin types. Disadvantages include severe tingling and burning, mandatory neutralization, and caustic vapors for inhalation.

Salicylic acid

Almost all atrophic scars are tested for salicylic acid. This substance is called beta-hydroxy acid, because it removes intercellular lipids around the stratum corneum of the scar.

The best concentration of salicylic acid for post-acne is 30% when carrying out several procedures with a break of 3 weeks.

Side effects of peeling are short-term. These include redness and dryness. The occurrence of hyperpigmentation is very rare.

Advantages: safe for any skin, formation of a white coating, which signals the depth and uniformity of penetration.

Phenol peeling

Most often, phenol peeling is called deep peeling. This option is rarely used due to the risk of complications and prolonged skin healing.

But only this kind of peeling penetrates the dermis and maximally stimulates the production of new collagen.

Deep peeling solutions consist of a combination of croton oil and phenol in different concentrations.

Deep peeling can significantly improve atrophic acne scars, but the patient requires constant monitoring because the procedure can cause arrhythmia. In addition, it is not recommended for skin types 4-6 and can lead to cardiotoxicity, hypoglycemia and hyperpigmentation.

2) Dermabrasion and microdermabrasion

The next serious procedure we will consider is dermabrasion. At one time, it became a major achievement for the treatment of post-acne.

The essence of the method is that special attachments are used to mechanically polish the skin for subsequent tissue regeneration. Although the method of physically resurfacing the skin is common to both procedures, dermabrasion and microdermabrasion use different instruments with different techniques.

Dermabrasion completely removes the epidermis and penetrates to the level of the papillary dermis. Microdermabrasion is a more superficial modification of the skin to remove the outer layer of the epidermis, which speeds up the skin's natural exfoliation process.

Both techniques are quite effective in treating scars and provide clinically significant improvements in the appearance of the skin.

Microdermabrasion can be repeated at short intervals, is painless, does not require anesthesia, and therefore has fewer serious complications. The only thing is that it does not immediately give such a good result as after deep dermabrasion.

You must understand that dermabrasion will not completely remove deep atrophic scars.

3) Laser resurfacing

Atrophic scars are removed using another popular procedure - laser resurfacing, which is slightly easier to use compared to other treatment methods.

Ablative lasers (CO2 or erbium)

CO2 laser evaporates tissue at a wavelength of 10,600 nm, which causes rapid heating and evaporation of tissue. Thermal heating below the ablation zone induces a wound healing response, which enhances collagen production.

Epithelization lasts from 5 to 10 days, especially during severe redness of the skin. Hyperpigmentation and hypopigmentation may occur, there is a risk of infection and there is a clear demarcation line between the treated areas.

Erbium laser : Yttrium aluminum garnet, which emits a wavelength of 2940 nm. It is 10 times more selective for water than a CO2 laser due to its shorter wavelength.

The main difference between an erbium laser and a CO2 laser is that the energy from it more closely approaches the absorption peak of water (3000 nm), so almost all the energy is absorbed in the epidermis and in the papillary layer.

Therefore, this laser does not cause as much thermal damage under the layer of abraded skin, which significantly reduces healing time and side effects.

Plasma skin resurfacing

A new and relatively very expensive procedure that uses a plasma device to generate a cloud of electrons through separation from atoms, releasing ionized gas.

This technology allows you to deliver thermal energy directly to problem areas of the skin. Initially, the epidermis remains intact, only later, about 10 days after treatment, fibroblasts of fallen elastin and collagen fibers will be visible.

Sometimes there is temporary hyperpigmentation, severe redness, swelling, scarring, or infection.

Non-ablative lasers

Atrophic scars are often corrected using less dangerous non-ablative lasers, because they reduce the risk of negative effects and the healing period of the skin. They are designed to polish the epidermis and stimulate the synthesis of new collagen.

Neodymium Yttrium Aluminum Garnet Laser

The name of this laser speaks for itself, because the main element of this laser is an yttrium aluminum garnet crystal. The laser is used for people with darker and more sensitive skin. It differs from an erbium laser in that the crystal is activated with neodymium.

It is able to cool the surface of the skin, and with the help of infrared waves it reaches the deep layers. The wavelength targets the underlying collagen in the skin without disturbing the epidermal layer.

For good results, it is necessary to conduct a large number of sessions (3 - 5 times a month for a couple of months), and the patient can expect an average improvement of 40 -50%.

The results are long-lasting and over time, collagen production continues even after the laser treatment ends. This is a good method for scar correction in terms of its short healing period and negligible risk of infection.

Diode laser

The laser targets the upper dermis, resulting in the formation of new collagen up to 6 months after laser treatment.

Fractional photothermolysis

A new concept in laser skin therapy is Fraxel. With the help of fractional photothermolysis, not only atrophic scars are removed, but also skin rejuvenation.

Fraxel creates micro-thermal wounds to achieve damage at the desired depth of the skin. This laser system selectively damages skin tissue to induce a healing response without directly damaging the epidermis.

The procedure is not as dangerous as chemical peels, laser resurfacing and dermabrasion, because damaged areas heal on average in 24 hours.

Point irradiation technique

This is as effective a method as fractional thermolysis. It often creates microscopic thermal wounds to reach the depths and clear up acne scars.

During irradiation, the treated areas of the skin are accurately determined, no complications are observed, and compared to conventional laser resurfacing, the healing time is reduced to 3–6 days.

All irradiated spots on the face are small dry spots of dead epithelium, which can be carefully removed with cream every other day. The color of the treated scar tissue returns to its normal pink shade within 2 to 4 days.

If you use sunscreen correctly, hyperpigmentation does not occur in the postoperative period.

4) Radio frequency grinding

The radio frequency method uses a bipolar device that emits non-ionizing electromagnetic radiation in the frequency range from 3 to 300 GHz. It generates fractional heat deep into the skin to cause skin damage and then a wound healing response by stimulating collagen. Atrophic scars respond well to treatment with this method.

5) Microneedling therapy

It is carried out using a special instrument - a dermaroller (mesoroller) or mesoinjector, and the procedure is also called transdermal collagen induction.

A dermaroller is a drum-shaped device with protruding thin stainless steel needles (from 0.25 to 3mm in length). When the needle penetrates the skin, there is localized damage at the site of injury and minor bleeding from ruptured blood vessels.

A completely different picture occurs when hundreds of small needles located close to each other penetrate the skin. Unlike lasers, needles penetrate the epidermis but do not remove it.

Therefore, microneedling therapy can be safely repeated as often as necessary and only in areas where there is atrophic scarring. It is believed that the needles break down the collagen ligaments in the superficial layer of the dermis, resulting in subsequent collagen synthesis.

Nowadays, the dermaroller is used in many beauty salons to treat several skin conditions, including pigmentation, wrinkles, acne, atrophic scars, large pores, and more.

The therapeutic possibilities of microneedling therapy are now widely discussed. The main problem is that clinical results often depend on the subjective assessment of doctors and patients. Some note positive improvements, while others talk about their complete absence.

It must be remembered that the first results after the procedure can be observed after 6 weeks, and the full effect after 3 months, since the deposition of new collagen is very slow. The skin may continue to improve for up to 12 months, and several treatments are needed to get the full picture.

6) Subcision

This method means excision of the scar at the subcutaneous level. Based on the results, its use is often justified on very deep atrophic scars.

Subcision is performed under local anesthesia. Needles are inserted into the skin next to the scar at an upward bevel parallel to the surface of the scar into the deep layers of the dermis.

They are moved back and forth under the scar in a fan-like motion to release the fibers. After such a procedure, nothing pulls the atrophic scars down, and they can easily rise.

After pulling the needle around the circumference of the scar, the exit points are compressed to stop the bleeding and prevent the formation of a large hematoma. But there will be a small hematoma in any case.

The only drawback of this method is that improvement occurs only on the treated scar; you will not get rid of pigmentation, enlarged pores and small scars. This will require sanding.

The advantages of this innovative method are: easy to apply, inexpensive treatment, short downtime, the procedure is applicable to different skin types (1 - 4), without any significant complications, and permanent improvement of atrophic scars in a short time without damaging the skin surface.

Disadvantages include pain during subcision, bruising, transient discoloration, hemorrhagic papules and pustules, hypertrophic scars, and the need for frequent suction sessions.

7) Filling scars with fillers

If resurfacing, peeling, and dermabrasion can easily cope with small scars, then only a dermaroller, subcision, or, in extreme cases, filling with fillers can work on deep atrophic scars.

This method is not a treatment; it is rather a cosmetic solution to skin defects for a certain period of time, since fillers dissolve over time and the procedures must be repeated again.

Hyaluronic acid, collagen and even your own fat (scar lipofilling) can be used as fillers.

The latter method is very close to the ideal filling material, because it is cheap, easily accessible, rarely rejected by the body, and does not cause allergies or other adverse reactions.

Fillers are used to correct acne scars in two ways. They are either directly injected under scars for immediate improvement, or delivered to areas where increased skin laxity or deep tissue atrophy accentuates the appearance of scars.

Among synthetic fillers, hyaluronic acid is considered the most popular; it reduces the risk of hypersensitivity and immunogenicity.

Combination therapy

The essence of combination therapy is the use of several methods. For example, this may first be peeling, then subcision for deep atrophic scars and targeted laser irradiation.

Today there is a huge variety of methods for treating atrophic scars. Each plays a different role in acne treatment, with some people benefiting from some methods better than others.

Therefore, the most important task of a dermatologist is to correctly assess the condition of the scar and select individual methods that will be the most effective for a particular patient.