Title : Chemabrasion: Treatment of difficult acne and acne scarring
Background: This paper includes a new combination treatment of difficult acne and acne scarring. It’s an original work with a new idea where microdermabrasion is combined with immediate chemical peeling (called CHEMABRASION). The microdermabrasion produces controlled removal of skin layers in successive sessions and the chemical peeler (Jessner’s solution) absorbed selectively through abraded follicular openings causes partial destruction of sebaceous glands.
Objects: Our hypothesis is that the target organ (i.e. sebaceous gland) is attacked directly and selectively in this procedure to cause permanent partial destruction or shrinkage of sebaceous glands. As in acne the sebaceous glands are larger and sebum excretion rate (SER) is increased due to end organ hypersensitivity mostly at normal levels of circulating androgens, a decrease in no. and size of sebaceous glands due to chemabrasion may be a break through towards cure of acne.
Methods: A study of chemabrasion was done over 100 patients, 13 males and 87 females. Inclusion and exclusion criteria, a result criteria and a study Performa with follow-up details was decided. Photos of patients taken before and after the treatment. All patients had 3-4 Chemabrasion sessions for active acne and 6-7 sessions for acne scarring. The interval between the sessions was 10-14 days. Before each session the skin of face was intensely dried. During each session microdermabrasion was done with aluminium oxide crystals, immediately followed by Chemical Peeling. Burning was well controlled with ice cooling. Treated area covered with topical antibiotic dressing for 12-24 Hrs. Most pts healed in 5-7 days.
Results:All Patients had remarkable improvement, number of new lesions decreased, Greasiness of skin (SER) decreased (measured by casual level method), Open Pores and scars improved much. Our results were: Complete response in 77%, Partial response in 23% and No response in 0%. Chemabrasion has proved very safe and effective treatment for acne and acne scarring.