Acne is an inflammatory condition in which cytokines release occurs. This destroys the collagen under the skin leading to scary acne has prevalence of over 90% in adolescence, and the incidence of scaring due to acne is 39.5%. Factors that contribute to acne caring are under treatment, not treatment, wrong treatment, delayed starting of acne treatment, steroid use, insulin resistance, or PCOD. Indians have more incidence of scar due to delayed concentration and subsequent treatment.
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Types of acne scar
Atrophic scars
These scars show themselves as tiny skin indentations.
- Tiny scars that resemble pinpricks are known as “icepick scars.”
- Boxcar scars are more noticeable dents with distinct borders.
- Rolling scars resemble rolling or undulating skin and have hazy edges.
Recent advance in the management of acne scars
Laser and energy based devices are widely used in the Managing acne scars. These includes
- Micro-needling radio frequency (MNRF): it exhibit a beneficial effect on scars, Is equally effective as that of fractional CO2, and pose up to 60% to 70% of his car reduction.
- Ablative lasers- frictional CO2,
- Non-ablative lasers
Level A evidence exist for the following modalities in the management of Acne scar. as a result these agents can be used as a first-line agent for the management of Acne scars.
- MNRF, fractional CO2,
- Combination treatments: Subcision with MNRF or Fractional CO2, Fractional ablative with MNRF, PRP with Derma Roller fraction lasers, micro needling with GA Peel.
Treatment as per the severity of the scars mild scars:
Derma Roller moderate scars : CO2 fractional laser, microneedling and subcision severe scars: Panch elevation techniques
Derma Roller: Derma roller, also known as a microneedle roller, is a hand-held a device used in skincare treatments like scars, acne etc. It consists of a handle and a roller head studded with hundreds of tiny needles, and typically made of surgical-grade stainless steel or titanium. The needles can vary in length, usually ranging from 0.25 to 1.5 millimeters.
Micro-needling: Micro-needling, known as collagen induction therapy or percutaneous collagen induction, this is a minimally invasive cosmetic procedure used to rejuvenate the skin condition. It involves the use of a device containing fine needles to create tiny punctures or micro-injuries on the skin’s surface.
Role of topical agents like peptides in the management of Acne scars:
Peptides have protective effects on wound healing and reduce car formation. mechanism of action of peptides in acne scar management include-
- Promote scar maturation
- Speed up re-epithelization
- Decrease is scar growth
- Reduce scar progenitors
- Prevent excessive scarring
- Targets multiple-pathway like TGF-beta-mediated fibrosis, renin-angiotensin pathway or inflammatory cascade.
Topical tripeptides can be used as a standalone therapy or Adjuent therapy along with lasers.
Peptides can be used in combination with IL injections, Botox, electroporation PRPs, peptides or hyaluronic Acid.
Botox:
Botox, referred to as botulinum toxin, is a widely-used cosmetic procedure often combined with other skincare treatments to minimize facial wrinkles and fine lines. It originates from a bacterium called “Clostridium botulinum”, which produces a toxin leading to temporary muscle paralysis. During a Botox session medical professional precisely administers small doses of the toxin into the facial muscles. These injections are temporarily inhibits muscle contraction by blocking nerve signals, resulting in diminished wrinkles and fine lines in the treated areas. This creates the illusion of smoother, more youthful-looking and young skin.
Topical peptides as an adjuvant with lasers
A study was conducted in which it tri and hexa-pepetide combination was applied before and after treatment with a fractional laser.
the treatment showed improvement in the trans-epidermal water loss over a long period i.e, up to 40 days. there was a reduction in the erythema and a batter reduction in the Acne scars.
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