A Safe and Sensible Approach to Correcting Acne Scars

Once your acne is under control and your skin is no longer inflamed, you can address the acne scars which remain.  The effectiveness of treatments tends to be better on people who are younger, healthier, and have fresh scars.   However, if you have decades old scarring, you can still diminish scarring.  My scars were 30 years old and I still got excellent results.  It will just take longer and require patience.   My suggestion is that you approach scar remodeling on a risk/benefit basis.  That is, try the least risky options first before embarking on more invasive and, potentially, damaging procedures.   Many people immediately go for the big guns, paying thousands of dollars on the latest laser treatments in hopes of instant scar repair.  “Instant” scar repair usually does not happen without some risk attached to it.  If there was a miracle treatment, we would have heard of it by now.  Though I have heard of some success stories with lasers, dermabrasion, and peels, I have also heard the flip side, of people who have become disfigured or damaged their skin permanently from botched laser procedures, dermabrasions, and deep chemical peels.  The damage may not show until months later, but it is devastating when it happens.  Remember, your results are totally dependent on the skill and knowledge of the doctor, nurse, or assistant doing the procedure.  If you sustain damage to the dermis or subcutaneous layer, you will have few options to repair it without risking further damage.   So, my recommendation is to eliminate or reduce the risk of damage by trying the less invasive treatments first, treatments which have little or no risk.     

Scar Remodeling – What I Found to Work  

I have been searching for acne repair solutions for the last 3 decades, so I’ve done many things and used many skincare lines.  Some have helped and some made things worse.  Most did nothing.  I believe I got some improvement from TCA peels in the doctor’s office, acids with Copper Peptides, and a line called Epicuren.  The problem was, with long-term use, they eventually led to my skin becoming sensitive, thinned, blotchy, and the results eventually stopped.   

Of the many treatments I have tried over the years, I find the following to be the most effective, safe, inexpensive, and without down-time.  Results are cumulative.  It can always get better, not worse.  Try these first before signing up for deep chemical peels, dermabrasion, or laser treatments:

1.   My Holy Grail of scar repair has to be this:   302 products with Avogen in conjunction with ultrasound and needling techniques.  The Avogen is a safe and effective ingredient that softens the skin and increases cell renewal.  I can honestly say that this has been the only thing which I could use long-term and see dramatically visible results.  I had 80% improvement in the first year, and now I would estimate it is 95% improvement after 5 years.  Avogen is very good at breaking up the gristly, cross-linked protein which presents as hardened scar tissue in the dermis.  It softens skin.   It also increases glucose utilization, which improves cell energy, and promotes the collagen and protein synthesis necessary to fill in the scar.  Ultrasound and needling are not required with Avogen, but I find it accelerates the process by breaking up the scar faster and pushing the Avogen deeper into the dermis.   The actual entire process is explained below in more detail. 

2.  Heating your skin to 115 degrees Fahrenheit for 8-10 seconds will denature the scar and help promote collagen formation.  You can use a number of gadgets to accomplish this.  In fact, that is how lasers seem to promote collagen, by the heat it generates, not the light.  See the study below.  You can safely use a 2 MHz ultrasound probe to generate the heat, a heating pad set on a low setting, or even hair dryer on low.  But the ultrasound probe is best because it will not dry out your skin or get too hot. 

3.  Take supplements which help break up scar tissue.  The two I use are serrapeptase and nattokinase.  These are fibrinolytic enzymes which dissolve excess fibrin which causes scar tissue, adhesions, and growths on organs, vessels, and arteries.  Once broken down by these enzymes, the cell debris is more capable of being excreted as waste.  These enzymes also have anti-inflammatory, immune system, and circulatory benefits.

4.  Even without 302 Avogen, you can try individual needling, dermarolling, or dermastamping.  This involves puncturing the skin with tiny holes, which can break up scar tissue and allow topicals to permeate the dermis better.  Vitamin A and C topicals are recommended prior, during, and after these treatments to promote collagen regeneration.  Just make sure not to apply Retin-A or L-ascorbic C forms, as these are highly irritating and will sting.  Instead, use lipid soluble vitamin A in the form of Retinyl Palmitate and vitamin C in the form of tetrahexydecyl-ascorbate (THDCA).  These forms are gentler, yet still provide the same benefits as Retin-A and L-ascorbic C.  These are the forms used in the 302 A Boost and Lightening Drops.  You can buy microneedling devices from the Internet or Ebay, but you have to be extremely careful.  There are many dangerous and shoddy devices out there.  I would never go any longer than 2.0 mm in length, because the possibility of going all the way to the subcutaneous fat layer is too risky.  You can permanently damage your fat cells by using extremely long needles and cause them to die or atrophy, leaving your face gaunt looking.  I buy my supplies from www.owndoc.com.  I find them honest and reasonable in cost.  You can also try finding a physician who does these procedures in an office setting under sterile conditions, which would be the safest option.             

My 302 Protocol for Scar Remodeling

First, a disclaimer.  This is my personal protocol.  The 302 company does not endorse self-needling, dermarolling, or dermastamping.  Obviously, there is a risk of infection if the tools are not sterile or you do not do it correctly.  Before embarking on this, read about dermarolling, needling, and stamping in the www.owndoc.com website.  There are several very informative articles in their forum. 

The one important prerequisite is that you have used the 302 skincare protocol suggested by your esthetician and have come to a point where your skin is calmed, healthy, and functioning well.  If you are not at this point, don’t attempt this yet.  You want your skin to be in optimal health before doing this.  Select your tools correctly.  If you have numerous scars on the face, you will want to use a 1.5 mm dermaroller.  If you only have a few isolated scars, a single needle (for ice picks) or a dermastamp (for small scars) is a better option.  You will need some anesthetic if using the roller, but is not necessary or desirable for the individual needles or dermastamps.  Anesthetic seems to exacerbate redness, and it takes longer to go away in my experience. 

So, in a nutshell this is what I did for my acne scars.  This should also work for chemical burns and other general scarring: 

1.   Take a 2- or 3-week holiday from Avogen-containing topicals, also A and C actives.  You may continue using all other 302 products as usual if you want.  The reason for the break is to reset your skin to baseline again.  Nothing bad will happen, and when you resume the actives, the improvements seem to jump to another level.

2.  At the end of the holiday, use the appropriate tool to roll, needle, or stamp your scars.  Below, from left to right, is a 2 mm single needle, 1.75 mm dermastamp, and 1.5 mm dermaroller.It’s very important to use sterile technique and instruments.  You don’t need to excessively roll, needle or stamp.  Four passes on the roller in 4 directions, 15 stamps or 15 needle punctures is all you want.  You want to see pinprick bleeding, this is an indication you are reaching the dermis, where the scar resides.  But don’t make your skin a bloody pulpy mess, or you will cause more scarring.  With proper technique, you should have some redness or red spots, but they will be totally gone in a matter of 5-7 days.  Use appropriate sunscreen or better yet, stay inside while you are in this stage of healing; otherwise, hyperpigmentation may result. 

3.  Immediately after the rolling, needling, stamping, apply equal parts of 302 Drops OR 302 Serum (or Hi Potency Drops or Hi Potency Serum if available) + A Boost + Lightening Drops.  This is the only time you should combine 302 actives.  This is what I call my 302 Triple Threat, and I only use this when needling.  Mist with water or Calming Mist afterwards to spread it out.

4.  Let your skin rest.  Don’t apply any more actives until your redness go away.   You can use the 302 cleansers, mists in the interim. 

5.  After your skin is back to normal, resume your 302 actives as usual. 

6.  In between treatments, use your 2 MHz ultrasound probe after applying your 302 Avogen topical at night to heat up the skin and push the Avogen even further. 

Do this 3x/week, 10 minutes for your face.   This is going to promote even more collagen regeneration and help tighten the skin.  Keep your skin slightly wet when using the probe, keep moving it in little circles, concentrating on scars.  I use the Calming mist, but misting water is okay too.  You should feel a little heat, but it should never be hot.   

7.  Do not roll, needle, or stamp again for at least another 4 weeks.  Six weeks, even better.  The skin is actively producing collagen during this period of time and you don’t want to disrupt the process.  Also, you don’t want chronic inflammation, so limit your treatments.

7.  Give yourself at least 6 months before assessing progress.  Scar remodeling is one of the longest processes you will encounter, especially the older you are.  Be patient.  Don’t expect overnight results.  Take before and after shots.  Your friends and spouse will probably notice before you do, which is exactly what happened to me. 

So, stop constantly monitoring your skin on a daily or hourly basis, and keep a positive attitude!  Scar repair can be done safely and cheaply if you educate yourself, use the right tools, and have patience.  

Resources:

http://www.healthiertalk.com/enzymes-fibrosis-scars-keloids-lung-disease-and-cancer-2118 

http://www.taoofherbs.com/articles/88/NeprinolEnzyme.htm

http://dermaroller.com/en/scar-treatment/derma-stamp

http://www.sciencedaily.com/releases/2010/10/101021141000.htm

http://www.asds.net/UltrasoundUsefulinSkinTightening.aspx

 

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15 responses to “A Safe and Sensible Approach to Correcting Acne Scars

  1. Really enjoying reading your blog ladies. Interested to know what you think about dermarolling in general? Do you think it is a good idea to use a dermaroller regularly (or at all) to help fight aging?

    • Hi Emily!

      Thanks for reading the blog. I’ve been using dermarollers, needles, and dermastamps occasionally for several years now. I think the best use of dermarollers is for breaking up scar tissue or deep wrinkles. Though it helps topicals to penetrate deeper into the dermis and generates a wound response which triggers some collagen production, there are other safer methods that do the same thing. Although minimal, it’s still an invasive treatment. You are creating a bunch of tiny puncture wounds in your skin.

      I personally wouldn’t use it for anti-aging on a regular basis. At most, I’d use it for scars, stretch marks, or deep wrinkles, like the 11s on the forehead or nasolabial lines. And even then, I would only needle or roll once every 4-6 weeks. You don’t want the skin in a constant state of inflammation. Chronic inflammation actually ages the skin (see my article on causes of aging). When you use the dermaroller on a regular basis, you put your skin in a state of constant micro inflammation with sweling which make wrinkles “appear” smoother temporarily. This is probably why people think rolling is good for anti-aging, because lines and shallow wrinkles seem to improve almost immediately. But for the most part, these are temporary “results”. There are plenty other ways to promote collagen and elastin without inflicting damage to the epidermis. I’ve discussed these anti-aging tools in my various articles, so I won’t repeat them here. But consider these other “cons” of regular dermaroller use. 1) The quality of the roller affects your results. If you use a shoddy roller with bent needles or not very sharp tips, you could damage your skin. 2) With increased use comes increased risk of infection. 3) And finally, but most obvious, is that it HURTs to roll properly. I don’t roll anymore. I don’t need to, most of my scars are gone. I can’t tolerate the pain and I hate applying numbing gel.

      So, that’s my take on dermarolling for anti-aging. Love it for scars, stretch marks and deep wrinkles, but I don’t think it’s a good anti-aging tool on a regular basis.

  2. Hi Nancy,

    Thanks so much for your reply. It has been very helpful. I was planning on buying a dermaroller but after reading your answer I have changed my mind. Will be looking in to investing in some of the other products you recommend now.

    Thanks again 🙂

  3. Nancy,

    What do you think of LEDs in conjunction with this?

    • If you already have an LED unit, you can certainly use it in conjunction with the above regimen. The main benefit is that LEDs reduce inflammation and keeps active acne under control (depending on the wavelength you have). But as far as “needing” LED for scar repair, it’s not critical. I would focus more on the weekly ultrasound with 302 topicals (Avogen drops or serum alternating with a C active) AND dermarolling or stamping on an 4-6 week basis. The ultrasound works two ways, it gently heats the skin which denatures (or loosens) the fibrous scar tissue and it drives the Avogen down into the dermis where it further softens the scar tissue and lays the groundwork/matrix for new collagen to fill in the scar. The 302 company did do some clinical studies on LED for scar repair way back around 2005-2006, but they just didn’t see any substantial scar repair with using LED alone, plus you have to devote more time to using it than the ultrasound. But it could help to speed up results, since it does reduce inflammation and also heats up the skin a bit. So, if you have one already, go ahead and use it. It won’t hurt anything. In fact, I used to use a Quasar SP LED way back when I first started, along with my ultrasound on alternate days. But now, my LED unit is just gathering dust. I really have no need for it. I find the ultrasound and 302 topicals adequate for maintenance.

  4. Thanks for the reply Nancy. Thanks for the great post and positive outlook.

    Do you happen to know the wavelength and “color” that the 302 company used when they did those studies? Also, what is the wavelength and color of the LED unit that you have (that is gathering dust)?

    What form of vitamin c do the people at 302 use? I can’t seem to find it anywhere.

    Do you happen to have any studies regarding ultrasound and topical penetration?

    Thanks!

    • Hi Jordon,

      Will need to check on the wavelengths. I have old notes about the frequencies but don’t remember exactly what range they used. As far as C actives, 302 skincare offers the C Boost, C Boost RX (no essential oils) or Lightening Drops, Lightening Drops RX. The percentage of the tetrahexyldecylascorbate C or THDCA is much higher in the Lightening Drops Versions. Can’t remember off the top of my head how much. All the C products are described in detail on the 302 skincare site. I would start with the lower level C and work up to the Lightening Drops. Also use as directed, which is sparingly. If you use C everyday, the effectiveness is reduced. 3x/wk, alternating with the 302 Drops or serum on the other nights is adequate. This is one skincare line where more is NOT better.

      To get you started here is a link to some of the scientific studies on ultrasound as used in medical and drug delivery applications. It works the same way for all topicals. http://www.skinspatula.com/Pubmed.htm

      You can also go to PubMed directly and get even more current studies. Search on the terms ultrasound, sonophoresis, transdermal, drug delivery.

      I will get back on the wavelengths later. HTH

  5. Nancy,

    Thank you for the reply.

    Do you happen to know if that form of vitamin c is the same thing as ascorbyl tetraisopalmitate (hexyl decyl ascorbyl palmitate)?

    Thank you for the studies on the ultrasound. I had stumbled across that at one point, but I forgot it.

    Yes, please let me know if you find out more about the wavelengths that they used as well as the wavelengths to the unit that you have.

    • Yes, they are the same form of C. I use the spelling that 302 uses in their ingredient list. I can never remember how to spell it. It’s a more stable form of C than LAA, and is just as effective as LAA without the irritation. I found out the C Boost has 8% and the Lightening Drops 16% of that form of C. The 16% is really designed for difficult pigmentation problems.

      I found a link about the Quasar SP that has the specs: http://www.makemeheal.com/mmh/product.do?id=48247 This model is no longer available, though.

      I can’t find the old emails about the wavelengths 302 company tested, but I believe it was in that 650 to 680 range, which seems to be the optimal range for skin rejuvenation.

  6. Here is an 2011 article that explains how sonophoresis (ultrasound) works to penetrate topicals (in more layman’s terms). It’s been used in the medical field for decades, but few people know of its use in skincare, so it is rather cutting edge in that sense.

    http://www.ijcpr.org/Issues/Vol3Issue3/367.pdf

    The unfortunate thing about ultrasound is that it’s rather boring to use….barely detectable except for a slight warming of the skin. It doesn’t buzz or tingle or make your skin all red, so you don’t think anything is happening. But there is plenty going on underneath the surface. You just have to be patient and consistent with it. Skin takes time to rebuild properly

    Hope this is helpful.

  7. Nancy,

    I also can never remember how to spell it. I had to copy and paste. 🙂
    Thanks for the info. Thanks for the info regarding the percentage of C in the products.

    Is it possible to use the vitamin a and the vitamin c at the same time?

    Thanks for the link to the Quasar that you have. It looks like they use a 660nm red light. I was not able to find what type of infra-red that they use. Do you happen to know (or know how to contact them)?

    That sounds about right for the wavelengths that 302 used. Thanks.

    Thanks so much for the ultrasound article. That is a good one.

    • You could possibly use A Boost and C Boost on alternate nights. Never apply 2 actives the same day (except when rolling or stamping). If you are new to 302, it’s really important to get your skin into good shape before attempting the rolling/stamping, as you don’t want to inflame already inflamed and sensitive skin even more. When I started 7 years ago, I only had the 302 serum avail to me, so I was forced to add actives (C and A) slowly, step by step. Don’t try to do everything all at once because then you won’t know what is causing problems (if you do have problems). Start with the 302 drops/serum every other day for a couple weeks. If doing well, then add the C boost on alternates days, rest 1 day of the week. If you still doing okay after a couple weeks, introduce the A boost once a week. After you use up the C and A boost, if you feel it’s necessary, you could bump up to Lightening Drops and Clarity. That’s kinda how I did it because I had no choice… the more potent actives came later. Pay attention to how your skin reacts if you are doing this yourself. Scale back if necessary. Some people will be more responsive than others. For example, I can only use Clarity as a wash-off one time a week. Any more than that makes my skin dry and irritated because my skin responds so well to it. Sluggish skins, older skins may be able to handle the Clarity as a leave on twice a week. But I would not use it more than that. It’s very photosensitizing. It would be best if an 302 esthy could see and guide you, but that’s not possible all the time. You seem to be researching things first, so that’s a good sign you will do well. I will try to help if you encounter any problems.

      Found the specs for Quasar SP in this EDS thread from 2007. Look for Advanced Therapeutics post 2nd from the bottom

      http://www.essentialdayspa.com/forum/viewthread.php?tid=20730

  8. Thank you Nancy.

    Let me make sure I understand you correctly. Are you saying that I can apply A Boost and C Boost at the same time only on the days that I roll (I assume afterwards)? – If so, why is that? – What is the reason for not applying two actives at the same time? Do they compete or something like that?

    Thanks so much for the regimen and the willingness to help.

    Also, thanks for the specs regarding the Quasar SP.

    • The reasoning for alternating actives and cleansers is one of the biggest differences between 302 and other skincare lines. It’s based on the concept of avoiding “receptor fatique”, a term coined by Richard Huber, the lead scientist and formulator for 302. Basically, it prompts the skin into action instead of forcing it. It is a much more tolerable dosing schedule (and less expensive too) that prevents skin from getting irritated and sensitized in the long-run. Its the basis for sustainable results that last even after you stop the actives. My reasoning (and it is just mine, not 302’s) for combining the 3 actives (A, C, 302) for post procedure application after rolling or stamping is that you don’t do it often (every 4-6 weeks) and its a huge jolt of actives that will reach the dermis where the scar is and jumpstart it into action. That’s why I recommend stopping actives 2 weeks prior to rolling/stamping too. The skin seems to react better after short rest periods of 2-3 weeks from all actives. If you haven’t read the EDS forum thread on 302 Skincare Part 1 in the Products Review section, I think you should go over there and read all of Richard Huber notes (they are highlighted in blue). They explain much of the reasoning (including receptor fatique) behind the dosing and ingredients used in 302 products. I have the email from Richard explaining receptor fatique and I will email it to you, so you don’t have to dig around for it. That thread was 146 pages long I believe. It’s alot of material to digest, but really worth the effort if you are serious about using 302 skincare

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