Microdermabrasion is when surface skin cells (Epidermis) are “sanded” down so that, new cells which replace them, are smoother and give a flatter surface to skin.
Unfortunately, the problem with Acne scarring is not in the Epidermis.
The scarring process begins in the deeper Dermal layer of skin, extending deeper into the hypodermis.
A basic understanding of the scarring process is necessary to see, if Microdermabrasion for acne scars makes sense.
Scarring has traditionally been defined as a process of three steps:
Step 1:
Inflammation:
This is the acute stage of injury to the dermis lasting up to 2 weeks. Its seen as redness, swelling, pain, heat &loss of function. The longer this inflammation stage ,the worse the scarring. Unfortunately, in acne the infection can keep this inflammation phase for a long time giving the typical sunken scars seen in acne.
Step 2:
Proliferation:
This process begins about 10 days after the injury when cells called fibroblasts lay down a matrix in which, new collagen fibres begin to grow.
In acne this causes a raised red mark on skin.
This proliferation phase can last a long time, but infection in acne makes it very difficult to control. Now collagen is being laid without check.
Step 3
Maturation:
Now this ball of collagen & ground substance begins to shrink, because the type of collagen present does not heal the skin normally.
This shrinking occurs with tight bands of collagen, that stick the skin to the deeper hypodermis & fat layer.
Therefore, it is obvious that rubbing a few cells from the skin surface is not going to remove these deep fibrous bands that tether the skin & pull it into shapes, called “box scars” & “icepick scars” seen in post acne faces (craters).
In addition, Microdermabrasion for Acne scars is not recommended if there is any infected acne present.
There is no evidence and no clinical study that substantiates the claim that Microdermabrasion can do anything for acne scarring.
The only physical treatment proven to be useful in acne scars is Micro-needling. Unfortunately, bleeding is essential & there is a downtime with it.
In addition, active acne is a contraindication to micro-needling.
A well proven & a reasonable resurfacing approach is to Chemically peel off layers of skin while treating any active acne present.
This Chemical peel must dissolve skin protein & control infection as well as be anti-inflammatory.
Therefore, a combination of Fruit acid such as Glycolic acid, along with Azelaic acid, Phytic acid & Salicylic acid is ideal to remove skin layers as well as prevent any new acne lesions from developing.
Acnex® Peeling mask is designed for this purpose.
In addition, post-peel care is critical using a purpose made scar healing cream.
This is essential because a controlled micro-injury has been induced & a scar revision is being attempted. Any complacency or neglect of this wound can worsen the situation.
A logical scar healing cream must have the following components:
- Silicone: To seal, occlude & heal the skin.
- Healing promoters:10 %Vitamin C, Vitamin A&E, & Hyaluronic acid.
- Anti-inflammatories: Salicylic acid 2%& Rutin anti-histamine.
- Anti-oxidants: Ferulic acid 2%
Scar Repairex® Ultra is such a cream designed to promote rapid healing & prevent scar collagen from being laid. This is recommended by all the leading Dermatologists.
Microdermabrasion for Acne Scars is not recommended by Dermatologists.
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