Treatment of atrophic scars

Strictly speaking, atrophic scars are a variant of normotrophic scars. These scars, like normotrophic ones, are located flush with the surrounding skin, but they form where there is virtually no subcutaneous fat. The most common localization of atrophic scars is the anterior surface of the upper chest, shoulder girdle, anterior surface of the shin, dorsum of the feet and hands.

Scars with (-) tissue never form in these areas. They simply cannot form here due to the very thin hypodermis layer. Another feature of these structures is that they consist of a thin layer of scar tissue, through which vessels sometimes show through. In this regard, the main treatment direction when working with these scars, as well as with normotrophic ones, are all technologies that help smooth out their surface. But due to the thinness of the structure of such scars (similar to atrophic skin), in addition to smoothing, they also need to increase the thickness of the scar to reduce the visibility of the underlying vessels.

Thus, the recommended technologies and means for working with atrophic scars are the following:

1. Cryomassage.
2. Vacuum massage.
3. Electrophoresis.
   • (iontophoresis of a cosmetology stand) with vasoactive, biostimulating, vitamin preparations, microelements (theonikol, organic silicon, ascorbic acid, aflutop, oligosol zinc, retinoic acid, etc.).
   • laserphoresis with the same drugs,
   • introduction of similar drugs using microcurrents.
4. Phonophoresis with madecassol, solcoseryl ointment, mederma.
5. Laser therapy (see treatment of normotrophic scars ).
6. Microcurrent therapy.
7. Magnetic thermal therapy.

Stimulates blood circulation, improves trophism, stimulates the sthetic and proliferative activity of fibroblasts.

8. Mesotherapy.

The procedures are carried out with biologically active, vitamin, microcirculation and cell metabolism improving preparations (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, cutis compositum, echinacea compositum, ubiquinone compositum, coenzyme compositum.

9. Peelings with AHA (alpha fruit acids).

The preference for these peelings is explained by their mechanism of action. Due to the small molecular weight of the acids included in these complexes, they easily penetrate the basement membrane of the epidermis and stimulate the synthetic and proliferative activity of keratinocytes and fibroblasts. As a result, not only the scar surface is leveled, but also its trophism is improved.

10. All types of therapeutic dermabrasion.

These scars need to be treated superficially. The number of sessions and frequency of exposure is 2 times a week No. 10-15.

11. Surgical dermabrasion with erbium laser.

AHA peels are a much more preferable technology than laser dermabrasion, since in addition to the peeling effect, they also stimulate microcirculation and trophism in the scar.

Note: Atrophic scars, in the absence of a noticeable vascular pattern under the scar, are the least noticeable among other types of scars. In this regard, the results of treatment may be barely noticeable, at the level of nuances, especially on old scars, which patients should be warned about.

12. Application of external cream and gel forms.

Mederma gel, manufactured by Merz (Germany).

The main active ingredients of Mederma gel are cepalin and allantoin. Cepalin is a component of onion extract, which has anti-inflammatory, bactericidal, regenerating and collagen production stimulating effects. Allantoin has a moisturizing, anti-inflammatory, bactericidal, regenerating and keratolytic effect.

Indications: Treatment of atrophic and hypotrophic scars, striae.

Cream-balm "Kapilar".

Ingredients: dehydroquercetin, gum turpentine, camphor, menthol, mint and fir oils.

Mechanism of action: The therapeutic effect of the cream-balm is primarily due to its capillary-protective and antioxidant properties. "Kapilar" has a stimulating effect on tissue blood flow, slightly reduces the permeability of capillary walls, stabilizes the barrier function of microvessels, and activates metabolic processes in tissues.

The use of the cream-balm "Kapilar" under the film gives some enhancement of the effect of microcirculation stimulation. This enhancement is due to the so-called greenhouse effect, characteristic of any compresses. It is possible to introduce into the skin using phonophoresis.

Indicated for the treatment of atrophic, hypotrophic scars and stretch marks, as well as preoperative preparation of skin and scars.

13. The use of cosmeceuticals with a stimulating effect on fibroblasts.

An example is the NUCLEA cream from Gernetik (France). The cream has, according to the company'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%).

It has anti-inflammatory, wound-healing, regenerating, antiseptic, antioxidant effects. The preparation enhances tissue regeneration, promotes melanin deposition in the areas where the preparation is applied 2 times a day. It is indicated not only for the treatment of atrophic, but also hypotrophic scars and stretch marks. In addition, SYNCHRO + IMMUNO creams are used for treatment - in a ratio of 1 / 1, preferably used 2 times a day.

CELLS LIFE - a restorative serum that acts synergistically with the previous preparations. It is recommended to use the serum once a day, after applying all preparations at night.

The course of treatment for old atrophic scars and stretch marks is at least 1-1.5 years.

The optimal measures for working with atrophic scars are:

• AHA peelings;
• various types of vacuum massage;
• mesotherapy and electrophoresis with drugs that stimulate fibrogenesis (retinoids, centella asiatica, placenta, embryoblasts, etc.);
• phonophoresis with drugs: madekasol, mederma, capilar;
• ointment forms for home care are the same as for phonophoresis.