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Transcript
DERMAROLLERS IN ACNE SCARS
Scar treatment is done by Dermatologists. Acne scars may be cosmetically disfiguring
and aesthetically unpleasant. They may lead to a loss of self-esteem, career options and
other psychosocial sequelae. Acne scars may be broadly classified into 2 main groups:
1. Acne scars involving tissue loss
2. Acne scar involving tissue excess.
Usually the scars are atrophic or depressed. This means the scar base is below skin level.
Due to the edges of the scar, the tissue in and around the scar is less pigmented and looks
pale. In darker skinned individuals the acne scars are often associated with pigment spots.
Rolling scars, box scars, dystrophic scars, distensible retractile scars, non-distensible
superficial. medium or deep scars can be ameliorated or even healed by using Derma
roller. Regardless of the classification almost all types of acne scars can be successfully
treated with a device called derma roller (except keloid scars).
The derma roller is a device, which has both cosmetic and medical applications. Its
mechanism of action is through collagen induction in the deeper layers of the skin.
Collagen is a fibrous protein found in deeper layer of skin, and contributes to the
thickness and mechanical strength of the skin, it is more in youth, less in old age and
reduced or lost in depressed scars. Percutaneous collagen induction is the process during
which we initiate the physiological collagen production of the dermis (deeper layer of
skin) without causing any permanent damage to the epidermis of the skin. The epidermis
is the upper visible layer of the skin . The best way to achieve this is by using a derma
roller (which contains 192 needles of 0.5mm length). This process has been formerly
described as skin needling.
Before the acne scar treatment with derma roller, 1 principle has to be followed- acne
must be completely healed. The fine but extreme sharp surgical needles perforate the scar
bed and scar edges.
After cleansing the area to be treated, local anesthetic is applied and left for
45min-1hour. Each skin part is dermarollered about 15-20times in order to achieve an
intensive perforation, without any pain. This takes off the tissue tension and softens it.
The needle only penetrates through the epidermis and does not remove it, so the
epidermis is only pierced and will rapidly heal in a matter of hours, since the
keratinocytes are highly elastic and flexible.. Keratinocytes are the cells that make up the
epidermis. This procedure causes micro- bleeding which usually stops within a few
minutes. This procedure also perforates and breaks down the fibrotic fibres that often
connect the scar base to the deeper layers, keeping the skin tethered down. Soon after
scar perforation new capillaries and fibroblasts migrate in the scar crater. Fibroblasts are
the cells that produce collagen. This results in re-vascularization. and a normalization of
the previously pale colored surrounding tissue. Revascularization means formation of
new blood pipes in the skin. After several treatments the former ‘acne scar crater’ is filled
with new collagen layers, this brings the previous depressed scar to normal skin level.
Even the brown spots associated with acne to an extent are cleared.
The appearance of the face immediately after a derma roller session is pinkish to
red. A special sticker type dressing that is skin colored is advised. Depending upon the
skin type, the redness will disappear in 1-2 days. After 1-2 days patients can resume their
work, following application of a camouflage cosmetic, if required. Follow up is required
after 3weeks. Depending on the skin response to derma roller repeat treatments may be
advised by the Dermatologist, taking into account the severity and depth of scarring.
Advantages of derma roller
- complete preservation of epidermis during procedure
- no permanent damage to the skin, no pain during procedure
- no bleeding, infection, discoloration or other complications on the treated area
(response varies with each individual)
- Only 24- 48hrs healing period , next day patient can go to work or study.(
response varies in different individuals)
- Only 3- 5 days of protection from Ultraviolet light required
- Leads to softening of the scars
The derma rollers can not be used on pustular acne lesions, keloid acne scar tissues,
Active herpes outbreaks or any acute infection or inflammation of the skin.
The derma roller is a breakthrough device, simple in concept but yielding gratifying
results.