Title : Atrophic scarring
Abstract:
Atrophic scarring is a permanent complication of acne vulgaris, which may be associated with significant psychological distress. The severity and duration of the inflammatory response have been demonstrated to correlate with the development of atrophic scars, as the inflammatory process and the associated MMP/TIMP imbalance are responsible for the degradation of collagen in the extracellular matrix (ECM). Therefore, the treatment modalities for improving atrophic scarring should be aimed to stimulate neocollagenesis and skin matrix remodeling. In recent years, injectable treatments have gained considerable recognition as a highly effective treatment option for patients with atrophic acne scars. Dermal fillers have been shown to be effective, with hyaluronic acid (HA) being the most commonly used. HA has been specifically developed for soft-tissue augmentation. Furthermore, it stimulates collagen synthesis and restores dermal matrix components. Semi-permanent bio stimulatory fillers (e.g., poly-L-lactic acid and calcium hydroxyapatite) have been demonstrated to promote collagen production by directly stimulating dermal fibroblasts. Furthermore, platelet-rich blood plasma containing significant amounts of growth factors, chemokine, cytokines, and other physiologically active molecules is successfully used for the treatment of atrophic scars. Many studies demonstrate that autologous fat or stem cell transplants effectively promote the expression of bioactive substances, the formation of native collagen fibers and other ECM proteins. In summary, injectable treatments either alone or in combination with other treatment options (e.g., laser resurfacing, chemical peeling, subcision, or micro needling) have demonstrated highly favorable efficacy and safety profiles.
