Tag Archives: scar

Collagen Induction Therapy

18 Sep

 Although not a new technique, this skin care treatment is certainly the hottest trend right now.  This procedure, also known as Micro-Needling, is clinically-proven for treating aging, pigmentation, and scar tissue, and recently, stretch marks.
This minimally invasive procedure uses a sterile, automated, micro-sized needle device system to build up the connective tissue in the lower skin layers (dermal layers) while keeping intact the protective layers of the skin (epidermal layers).  In fact, CIT is the only skin rejuvenation treatment to target and regulate all 3 skin cells (keratinocyte, melanocyte and fibroblast) without compromising the integrity of the epidermis.
Controlling the depth, angle, pressure, and speed of the needle is imperative to the safety and outcome of the treatment, and cannot be done effectively with manual rollers (dermal rollers).

How Does It Work?
Collagen Induction Therapy works by creating a controlled “injury” to the skin, resulting in a systematic interaction of complex cellular events.  In order to work effectively, the mechanical stimulation of the dermis must activate a wound healing response, but the wound must close quickly or scar tissue will form.
 CIT can penetrate the skin anywhere from 0.5 mm to  2mm depending on the depth of the skin condition needing remediation.  The skin bleeds slightly but for only a short period (seconds).  When the dermis is penetrated by the needle, the skin activates the complex cascade of growth factors that eventually result in collagen production.

By inducing the healing response system in a controlled manor, scarless healing and normalized collagen structures result.  The growth factors released stimulate regenerative healing (collagen forms from the base upwards) resulting in type III collagen or healthy collagen as opposed to the growth factors released when the epidermis is damaged by ablative or heat methods, which result in cicatricial healing (collagen forms from the top down) and is type I collagen or scar collagen.
As the collagen matures and remodels, it tightens the skin.  A thickening of the epidermis by as much as 40% has been observed.
Because there is no heat involved in the process, there is a low risk of post-inflammatory hyper-pigmentation, making it safe for all skin types.

Enhanced Product Penetration
The “wounds” created by the needles also act as channels through the skin layers, and therefore a product will penetrate deeper into the skin when applied topically.  Large molecules that cannot typically pass through the epidermis alone, such as hyaluronic acid, will penetrate very effectively through the channels.
Although channels should close 15-20 minutes post-treatment, it is imperative post-care involves using ONLY the topical products instructed by the provider to avoid any reactions.
This makes a great treatment with Platelet Rich Plasma…. Blog coming soon!

Micro-Needling VS. Alternative Treatments

This system has many benefits compared to other more invasive and painful treatment options.

  • Reduced risk of hyper-pigmentation and scarring therefore safe on ethnic or dark skin.
  • Suitable for thin and sensitive skin.
  • Can be done on areas of skin not suitable for laser or peels.
  • No line of demarcation between treated and untreated skin, as usually occurs with other resurfacing procedures.
  • Regular activities can be resumed within a few days, depending on the depth of penetration of the needles.

Basically, it was so impressive that after reading about it and seeing it done on a surgical scar, I tried to buy it an hour later.  It’s been the longest three weeks of my life.  😒.  But my new employee HAS a micro-needling system.  So for your viewing pleasure…. I had it done (and I skipped out on Pure Barre I wanted to do it so bad!).  (Also… I was planning on going to the Container Store… As I mention in the video–totally worth it!).


Although I am very red in the video, by the time I left the office it only looked like a slight sunburn.

A few hours later my face peeled like crazy.  I was sloughing off layers of skin while I applied hyaluronic acid.  I thought I eould continue to peel, and didn’t immediately take a picture.  By the time I woke up the peeling had subsided.

Not everyone will experience peeling, but if you do, don’t pick at it!

Post-procedure care 
It is imperative patients follow post-care instructions after professional Collagen Induction Therapy.

  • You cannot go in the sun for 24 hours and you have to wear sunscreen.
  • In the case of acne scars, after the skin needling procedure, the face should be cleaned with a gentle cleanser before bed. The next day, the face may be cleansed and makeup, lotions and other topical products applied as instructed.
  • Rejuvenation of skin may be seen as soon as 2 weeks and as long as 6-8 months after the medical procedure.
  • Burn scars are slow to respond. It can take up to 6 months to 1 year to see the final results from a single treatment.

For more information…. Stay tuned!

Post Treatment Day 1


  

Patients have been thrilled with this treatment.  For more information, A Girlfriends Guide to Vampire Facelifts a first hand account from Kim as she describes her treatment with me.

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What To Do With A Scar

2 Nov

My friend Nicole had a thyroidectomy and she was asking me about what to do with the scar to help it heal. The neck is a tough area, so I directed her to ask a dermatologist, but I told her I’d research it a little. Scars can be very bothersome to people, especially when they can’t hide them. My friend Amy’s son just required a couple of stitches from a hockey accident. I told him not to worry though. Chicks dig scars. Fact.


Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

I assisted in a scar revision surgery from a tummy tuck done in New Jersey that did not heal well. This woman went in to have the abdominal muscles repaired from her pregnancy, and left with a whole new embarrassing problem that still kept her out of a bikini.

What Causes Scar Tissue

One word: Trauma. Whether you fell of your bike or barstool, had surgery, were in a car accident, decided to take the brakes off your rollerblades even though you didn’t know how to rollerblade and you decided to start with going downhill (I like to live dangerously… what can I say… I was 13). I have a few scars that particularly bother me.

So you fall and you bleed. What happens? In the LK abridged version (for all intensive purposes):

Treatment can depend on what type of scar you have. These are several different types of scars including:

  • Hypertophic: Raised and red scars that cover the site of the original injury. Just your basic run of the mill scar.
  • Keloid: result of overly aggressive healing process, extending beyond the site of the original injury. (Interesting fact from Dr. Russo: 50% of people with Japanese heritage form keloid scars.)
  • Contracture: results from a burn when the skin tightens and can impair muscle and nervous tissue.
  • Acne: result from severe acne.

Treatment Options

As you are healing from a wound… proper nutrition is very important!
The healing process places extra demands upon the body. Adequate protein intake and vitamins are essential for wound healing.

  • Vitamin A is essential for replacement and healing of epithelial tissues
  • B-vitamins are needed by cellular enzyme systems
  • Vitamin C is essential for production and maintenance of collagen and development of new blood vessels
  • Vitamin D is needed for bone healing and formation
  • Vitamin E may help prevent some types of tissue scar
  • F, G, H, I, J are nonessential. There are no such vitamins. Interesting that they skipped out on these letters. I wonder why. (I digress).
  • Vitamin K is essential in the blood clotting process.

Topical Treatments

  • Creams/Ointments/Gels
    • Topical Vitamin E while the wound is healing. The process of massaging the cream during application is also good for the scar. I think it’s the main ingredient in Mederma. Which according to the box (see picture below) it is the #1 recommended product for scars. I’m not sure if this is true or not. I’m just saying that’s what the box says.


    • Corticosteroid or Antihistamine creams if scars are itchy or sensitive.
    • Retinol (More on Retinoic Acid (my fav!) can minimize post-scar formation pigmentation. Use 30 days after the scar has formed.
    • Silicone gel sheets can be placed over a wound when it has healed. I am using these right now on my breast augmentation incision. I will let you know how it turns out!

  • Tension and Pressure
    • Bandaging a wound applies pressure to the area.
    • Steri-strips applied to keep the wound closed as it heals.


Minimally Invasive Procedures

  • Stitches and Staples:
    • For wounds that require a visit to the ER, you may get stitches or staples. Follow your home care instructions if you do wind up in an ER (or if instructed to do so by a doctor or nurse). Not only will it decrease the likelihood of a scar, but it will also decrease the likelihood of things like infection. Yup. It’s true.
    • I highly suggest requesting a plastic surgeon stitch a facial wound. I know it’s the last thing you think about when bleeding profusely from a head wound, but they really do the best work, at the very least, much better than the ER intern who has never done it before. It’s your face. They can practice elsewhere.



  • Injections:
    • Steroid injections can be used for protruding scars. I actually had a scar on my back injected. The area was numbed with lidocaine and then injected with a corticosteroid. It took about 6 weeks to see a difference (sorry no pictures of before and after!). It can take several treatments to work. Which reminds me I should probably have it injected again.
  • Laser:
    • Vascular lasers may be used to lighten scars that are pink to purple in color. It may also facilitate the flattening of raised, red scars.

Surgical Revision

There are many options under this category including skin grafts, excision or laser surgery.

The tummy-tuck scar surgery I assisted in was an excision. The scar tissue was numbed with local anesthesia, which was difficult due to the fact that the tissue is fibrous, making it hard for the anesthesia to localize through the area. After the patient was numbed, a cauterizing tool was used to remove the scar tissue. The wound was re-stitched and a steroid impregnated tape was applied with a pressure dressing over it. The whole procedure took about 30 minutes.

I have also seen CO2 laser scar revision for acne. There is a lot of down time with this, but the end result is really nice.

Treating Acne Scars

I think it’s something like 3 out of 4 people suffer from acne some form of acne some time in their life, so acne scars are an issue for SO many people. Acne marks that are left behind after a breakout heals (usually reddish or brownish in color) will eventually fade without any intervention. But… most people will pick at acne with their fingernails, which causes a lot of damage to the skin and can also introduce bacteria to the site. Don’t do it. You will make it worse and increase the likelihood of scarring. A person’s acne needs to be under control before scars can be treated. Retinol. Cough.

Depending on the severity of the scarring, there are several possible avenues of treatment. I’d stay away from over the counter products when it comes to acne scars. First, they’re not going to help any, and second they can irritate the skin making a scar even more noticeable.

  • Mild scars: Microdermabrasion. and chemical peels (‘Tis the Season for Chemical Peels!.) will help with mild issues of the texture and tone of the skin.
  • Moderate scars: Laser skin resurfacing is recommended. I had this done at the office. It HURT. It usually takes between 3 and 10 days for the skin to heal completely.

I get asked all the time to put filler into a scar. Personally, I think there are better options. In order to inject filler, the scar tissue needs to be excised (yes, it is as uncomfortable as it sounds). It’s the same idea as numbing a scar with an anesthesia, the tissue just does not allow liquids (or gel’s like fillers) to penetrate evenly. This is my personal experience, but I know it is very common so I guess maybe some people have a better technique? I’m not sure.

  • Severe scars: CO2 laser can only be done by a doctor, under anesthesia. There is a lot of downtime with this procedure, unfortunately, but it yields fantastic results (I’ve seen it done a few times). I have never seen or heard of grafts for acne scarring.

XOXO, LK

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