Treatment of atrophic scars
Last reviewed: 20.11.2021
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Strictly speaking, atrophic scars are a variant of normotrophic scars. These scars, as well as normotrophic ones, are flush with the surrounding skin, but they are formed where there is practically no subcutaneous fat. The most frequent localization of atrophic scars is the anterior surface of the upper part of the thorax, the shoulder girdle, the front surface of the lower leg, the rear of the feet, and the brushes.
In these areas, scars with (-) tissue are never formed. They simply can not be formed here because of the very thin layer of the hypodermis. The peculiarity of these structures is also that they consist of a thin layer of scar tissue through which the vessels are sometimes seen through the vessels. In connection with this, the main therapeutic direction in dealing with these scars as well as with normotrophic ones are all technologies that help leveling their surface. But in connection with the fineness of the structure of such scars (by analogy with atrophic skin), in addition to alignment, they also need to increase the thickness of the scar to reduce the visibility of the vessels to be treated.
Thus, the recommended technologies and tools for working with atrophic scars are the following:
- Cryomassage.
- Vacuum massage.
- Electrophoresis.
- (iontophoresis of the cosmetology rack) with vasoactive, biostimulating, vitamin preparations, microelements (theonikol, organic silicon, ascorbic acid, aflutop, oligosol zinc, retinoic acid, etc.).
- laser phoresis with the same drugs,
- introduction of similar drugs with microcurrents.
- Phonophoresis with madecasol, solcoseryl ointment, mederma.
- Laser therapy (see treatment of normotrophic scars ).
- Microcurrent therapy.
- Magneto-thermal therapy.
Stimulates blood circulation, improves trophism, stimulates the sitetic and proliferative activity of fibroblasts.
- Mesotherapy.
The procedures are carried out with biologically active, vitamin, microcirculation-improving, cell metabolism drugs (aloe extract, placenta extract, nicotinic acid, retinoic acid, vitamin C, etc.). In addition, good results can be obtained by working with homeopathic preparations - placenta compositum, kutis compositum, echinacea compositum, ubiquinone compositum, coenzyme compositum.
- Peelings with AHA (alpha fruit acids).
The preferability of these particular peelings is explained by their mechanism of action. Due to the small molecular weight of the acids that make up these complexes, they easily penetrate the basal membrane of the epidermis and stimulate the synthetic and proliferative activity of keratinocytes and fibroblasts. As a result, not only the leveling of the scar surface, but also the improvement of its trophism occurs.
- All kinds of therapeutic dermabrasion.
It is necessary to work with these scars superficially. The number of sessions and the frequency of exposure - 2 times a week № 10-15.
- Operative dermabrasion with erbium laser.
AHA peels are a much more preferred technology than laser dermabrasion, since in addition to the peeling action they also stimulate microcirculation and trophism in the rumen.
Note: Atrophic scars, in the absence of a noticeable vascular pattern under the scar, are the least noticeable among other scars. In this regard, the results of treatment may be subtle, at the level of nuances, especially on old scars, which patients should be warned about.
- Application of external cream and gel forms.
Gel Medrema, production of the company Merz (Germany).
The main active substances of the gel Mederma - tsepalin and allantoin. Tsepalin - a component of onion extract, which has anti-inflammatory, bactericidal, regenerating and stimulating the production of collagen action. Alantoin has a moisturizing, anti-inflammatory, bactericidal, regenerating and keratolytic effect.
Indications. Treatment of atrophic and hypotrophic scars, striae.
Cream-balm "Kapilar".
Ingredients: dehydroquercetin, turpentine turpentine, camphor, menthol, mint and fir oil.
Mechanism of action: The therapeutic effect of cream-balm is primarily due to capillaroprotective and antioxidant properties. "Kapilar" has a stimulating effect on tissue blood flow, somewhat reduces the permeability of capillary walls, stabilizes the barrier function of microvessels, activates metabolic processes in tissues.
The use of cream-balsam "Kapilar" under the film gives some strengthening of the effect of stimulation of microcirculation. This increase is due to the so-called greenhouse effect, which is typical for any compresses. Possible introduction into the skin with phonophoresis.
It is indicated for the treatment of atrophic, hypotrophic, scars and striae, as well as preoperative preparation of the skin and scars.
- The use of cosmeceutical agents with a stimulating effect on fibroblasts.
As an example, you can bring the cream NUCLEA cosmeceuticals Zhernetik (France). The cream has, by definition of the firm's specialists, a super-regenerating effect.
Ingredients: B vitamins, Vitamins A, C, E, H, allantoin, micropeptides, trace elements (K 65%, Mg 29%, Ca 16% Iron 29%, Copper 1%, Zinc 1%, Mn 0.5% , amino acids - proline (16%) and glycine (21%), glutamic acid (5.3%), alanine (21%), methionine (2.7%), valine (10%), cystine (3, 8%), phenylalanine (1.7%), histidine (0.6%), leucine (5.3%), lysine (5.3%), arginine (2.4%).
Has anti-inflammatory, wound-healing, regenerating, antiseptic, antioxidant action. The drug enhances the regeneration of tissues, promotes the deposition of melanin in those places where the drug is applied 2 times a day. It is shown not only for the treatment of atrophic, but also hypotrophic scars and striae. In addition, SYNCHRO + IMMUNO creams are used for treatment - in a ratio of 1/1, preferably 2 times a day.
CELLS LIFE is a restoring serum that acts synergistically with previous drugs. Serum is recommended to be used once a day, after applying all the drugs at night.
The course of treatment of old atrophic scars and striae is no less than 1-1.5 years.
The optimal measures for working with atrophic scars are:
- AHA peels;
- various types of vacuum massage;
- mesotherapy and electrophoresis with drugs that stimulate fibrogenesis (retinoids, Centella Asiatics, placenta, embryoblasts, etc.);
- phonophoresis with preparations: madecasol, mederma. Capillar;
- ointment forms for home care - the same as for phonophoresis.