Not All Collagen is Created Equal - Why Collagen Induction Therapy Produces Natural Collagen NOT Scar Collagen
In any anti-aging situation , growth factors need to be stimulated by some means. Typically this is accomplished through controlled wounding. Several different types of growth factors are released according to the type of wound incurred. Growth factors are responsible for orchestrating and regulating cellular function and repair after injury. An ideal skin rejuvenation wounding or treatment would both improve the penetration of any active ingredient and wake up the fibroblast.
Unfortunately most rejuvenation treatments rely on dramatically invasive chemical peels, light or radio frequency to burn the skin, which leads to the release of TGF-B1 and TGF-B2 (transforming growth factors), TIMP-1, and Heat Shock Protein 47. These generate a fibrotic response that promotes scar collagen (thick, parallel oriented bundles.)
By contrast collagen induction therapy or dermal needling results in increased TGF-B, FGF-7 (keratinocyte growth factor), and EGF (epidermal growth factor)which promotes natural collagen, with scarless wound healing.
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In the early stages of wound healing the fibroblasts produce hyaluronic acid which helps stimulate cell renewal. In fact, one of the reasons fetal wound healing is scar-less is there is an abundance of hyaluronic acid. Studies have shown that hyaluronic acid applied topically during a wound dressing are associated with quicker healing and reduce scarring. Oral Glucosamine taken in adequate amounts during the first few days of surgery or trauma enhance hyaluronic acid production in the wound thus also promoting swifter healing with fewer complications related to scarring.
Acne is a chronic inflammatory disease of the sebaceous gland and a condition commonly seen in teenagers. It usually resolves when patients reach their twenties. Unfortunately, there are a significant proportion of people who continue to suffer from acne well into their forties. Acne scars are more common in this persistent acne group, and are more likely to be on the face, a cosmetically sensitive area. Minor acne scarring may occur in up to 95% of patients, but to a significant degree in only 22%. For those patients with any degree of scarring, the scars go much deeper, affecting every facet of life. Repairing them can make life better and reveal an entirely new person.
Acne scars can be classified into three broad categories: ice pick, rolling, and boxcar. A palette approach to acne scarring yields the best results, because each individual technique is best suited for a particular type of scar. It is important to remember that improvement is the goal, and it is usually necessary to combine several techniques in each individual case. Various treatment modalities are used for reconstructing and improving the appearance of acne scars, including punch excision, punch elevation, subcutaneous incision (subcision), dermal fillers (liquid injectable silicone, hyaluronic acid), chemical skin resurfacing, and laser skin resurfacing. By combining these multiple modalities, it is possible to produce dramatic improvement in acne scars. It has proven difficult to repair deep rolling scars, especially in dark skin.
Trichloroacetic acid (TCA) has been used for over 50 years to rejuvenate and repair the skin in a variety of conditions. The CROSS Technique, (Chemical Reconstruction of Skin Scars) using 100% TCA, has the advantage of reconstructing acne scars by focusing on the dermal thickening and collagen production that occurs with higher TCA concentrations. It has proven very effective for acne scars in dark complexioned patients, including Asian and black skin (types IV-VI skin), known to readily develop reactive darkening. The CROSS Technique involves the focal application of TCA using a sharpened wooden applicator. It is pressed down firmly over the entire depressed area of the scar. It produces multiple, frosted white spots on each acne scar. Healing is more rapid and has a lower complication rate than conventional full-face medium to deep chemical resurfacing, because the normal tissue and adnexal structures around the scar are spared.
Before CROSS is performed, the skin will be primed with 8Quin nightly for 2 weeks, and thereafter for the duration of the sessions. Local anesthetics or sedation are not needed for CROSS. The area is cleansed and prepped with alcohol. The TCA is focally applied until a "frosted" appearance is achieved. Mild stinging is usually encountered, easily controlled with an electric fan. An antibiotic ointment is applied to the treated areas after the procedure, and used as needed until crust formation occurs. The skin will be cleansed daily with a non-drying cleanser and moisturized with a moisturizer-sunscreen. No antibiotic or antiviral therapy is needed with after CROSS. When the crusts fall off, usually within a week, 8Quin will be resumed at night, along with the cleanser and moisturizer-sunscreen. The application of makeup is allowed after CROSS. CROSS is repeated every month until maximal change is achieved, usually within 4-6 sessions.
Although possible, side effects or complications such as persistent redness, permanent darker or lighter skin color, bacterial infections or herpes simplex flare-up, or scarring are unlikely to occur. Patients sometimes encounter mild redness or temporary darker color, both disappearing in 4-6 weeks.
Repeated CROSS application can help normalize deep rolling and boxcar scars, and deep ice pick scars, but it is likely that other procedures will be used to obtain the most change. The degree of clinical improvement in the original study was proportional to the number of courses of CROSS treatment, with good improvement after three to six courses being recorded in more than 90% of cases. This technique can also treat chicken pox scars and dilated pores, as well as reconstructing depressed surgical scars.
The CROSS Technique is another color on the palette of therapies for acne scars and other depressed surgical scars. A consultation will be necessary to evaluate each patient's needs and develop a comprehensive and individualized approach to scar rejuvenation.
I’ve had many clients come to my office to receive help in getting rid of or reducing their acne scars. Collagen Induction Therapy (CIT) or also known by other names, including Micro-Needling, Dry Needling, Multitrepannic Collagen Actuation (MCA), , and Per Cutaneous Collagen Induction (PCI) is very effective in achieving this goal. If you can imagine a wall with holes then think about how you might go about filling-in these holes…most likely your approach would be to fill in and plaster over the holes making the surface smooth… This concept is basically what CIT does for skin afflicted with acne scars. The collagen induction process works via small needle clusters which target only afflicted areas; the needles penetrate through the epidermis into the dermis where the skin is “tricked” into believing it is wounded. This fake wounding triggers the inflammatory response, the cascade of growth factors and finally the formation of healthy collagen. The healthy collagen is similar to the plaster used to smooth the surface of the walls. The major benefit of the CIT approach in reducing acne scars is that the epidermis is left intact, which means that it is not traumatized. Chemicals peels and ablative lasers do traumatize the epidermis, which may cause pigmentation problems, scars and thinner skin. Additionally CIT is reasonably priced and offers less risk.
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