Scar Treatment, Removal, and Correction by Dr. Igor Safonov

Dr. Igor Safonov specializes in the nuanced field of scar treatment, removal, and correction. Scars, a common human experience resulting from injuries, surgeries, or skin diseases, vary greatly in appearance based on numerous factors including the wound’s depth and treatment efficacy. Dr. Safonov understands that scars are not just physical marks; they often leave a deep psychological imprint, affecting self-esteem and confidence.

Recognizing the crucial window for effective scar treatment within the first few months post-injury, Dr. Safonov emphasizes timely intervention. He challenges the conventional wait-and-see approach, advocating for early action to prevent scars from integrating fully into the body’s tissue, which makes later correction more complex and costly.

With extensive expertise, state-of-the-art equipment, and a compassionate approach, Dr. Safonov’s goal transcends mere physical correction. He aims to render scars virtually invisible or significantly less noticeable, thereby helping patients to not only improve their physical appearance but also heal emotionally and regain confidence. His commitment lies in erasing the negative memories associated with scars and restoring his patients’ sense of self.

Acne Scars, Acne is a Disease

Summary: It is important to prevent and treat acne in time to avoid lifelong acne scars.

Having acne is a disease that can be very difficult to manage. It’s not just about having pimples on the face or back, but also that they can lead to scars that can affect one for life. Acne is an inflammatory disease that affects the sebaceous glands and is common among adolescents aged between 16 and 25 years.

It is important to start treating acne at the time of comedone (blackhead) formation to reduce the risk of scarring. Unfortunately, incorrectly prescribed treatment or waiting too long to start treatment can lead to scarring. These scars can be either depressed (atrophic) or raised (hypertrophic) and can be visible for life.

Acne commonly appears on the face, in the décolletage zone, and on the back, areas that have many sebaceous glands. The causes of acne can be hereditary predisposition, an acquired disease, or hormonal changes in adolescence due to male sex hormones. When the fat production of the sebaceous gland increases, the glands grow in size, and the natural processes for moving horn cells from the gland opening become abnormal, leading to the sebaceous gland being clogged at the follicle opening. This results in inflamed sebaceous glands and pimples.

There are some common questions that many have about acne. One of these is whether diet can help against acne, and in most cases, the answer is no. However, it is known that a high level of the female sex hormone estrogen can alleviate acne. Many women notice a deterioration in the skin before menstruation. Hormonal estrogen-containing contraceptives relieve symptoms, while progesterone worsens symptoms.

Another common question is whether to squeeze blackheads or not. If any part of the content is squeezed down instead of up, the symptoms of the disease will worsen, and an atheroma can occur, leading to a coarse scar. Instead, it is recommended to use a special cosmetic spoon that does not damage the skin to reduce comedones.

It is possible to avoid scarring if treatment begins at an early stage of the process. Once scars have formed, treatment is still possible, but it is very difficult to restore the original skin condition.

A common question is also whether sex life affects acne disease, and the answer is no.

Wash your face twice a day to prevent the skin from drying out or being irritated. Increased sweating can lead to complete obstruction and inflammation of the sebaceous glands, negatively affecting acne. Contact with vegetable or mineral oils and chemical products, medicines, or certain foods, as well as the use of corticosteroids or preparations for the treatment of epilepsy, can also cause intense acne outbreaks.

Using cosmetics is relatively allowed and advisable, as it can make one feel more confident. However, choose special cosmetics for oily skin that do not clog pores and avoid products containing lanolin, paraffin, and mineral oils. Face powder can actually absorb extra secretion from the sebaceous glands and is therefore a good solution.

Acne Treatment

For simple forms of acne (a few blackheads, small inflamed pimples), local treatment and mechanical removal of comedones are sufficient. When there are not many pimples, they do not leave scars. A simple treatment can be given as one or more combined preparations. The preparations affect microbes and horn cells. They reduce cell division of sebaceous glands and facilitate the outflow of fat from pores.

Do not mechanically affect places with many pimples and in groups, or with large nodules. Medication is preferable. You will receive an individual medication from the doctor that suits your stomach, intestines, and any liver disease. You need good patience to await the first results. Treating acne can take many months.

To positively move towards perfect skin on the face, your doctor or cosmetologist may recommend a gentle peel – treating the skin with fruit acids.

Treatments

It is important to quickly get a good treatment to prevent scarring. Scars are permanent but fade over time. These scars can become less prominent with cosmetic methods. What is perceived as cosmetically disturbing is often the shadowing that occurs when the skin is not smooth. Treatments are given to even out the skin to reduce shadow. It is important to have realistic expectations. Completely smooth skin after treatment is not possible.

Scars are of various kinds and types, and each scar may require its unique treatment. Several methods can be done in a skin treatment. It may also be that several skin treatments are needed with a few weeks’ intervals for optimal results.

Treatments that are often performed:

• Dermabrasion, skin sanding.
• Punch-excision, skin is punched out from scars and other skin is taken from the body and transplanted.
• Subcision, a needle – cannula with a small scalpel blade is inserted under scars and gel is injected which lifts and evens out. The scar heals back to the new level and the gel slowly dissolves and disappears naturally.

BASIC METHODS FOR TREATMENT OF KELOIDS AND HYPERTROPHIC ACNE SCARS Cryosurgery.

The mechanism of action is based on tissue damage through brief freezing. This leads to the formation of intravascular and intracellular ice crystals that hinder microcirculation and destroy cytoplasm and cell organelles. Treatment of hypertrophic acne scars on the face with the cryosurgery method is often considered to yield positive results.

Corticosteroids.

Corticosteroids are administered locally (to prevent keloid formation) through intralesional injections of crystalline suspension for the treatment of active keloids and hypertrophic scars. Cortisone injection reduces collagen synthesis by inhibiting fibroblast mitosis and increases collagenase concentration (enzyme that destroys collagen). In addition, steroids have a strong anti-inflammatory effect.

For hypertrophic acne scars on the face, the following methods are recommended: cryosurgery, intralesional injections of corticosteroids directly into hypertrophic scars, and microneedling treatment (dermaroller, dermapen). Topical therapy with creams and ointments and gels does not yield any visible result.

Laser treatment for hypertrophic acne scars. Ablative laser is not recommended for hypertrophic acne scars on the face because it irritates fibroblasts (the cells that produce collagen fibers) and there is a very high recurrence rate after treatment of 90-100%. Laser treatments can be applied for atrophic acne scars and usually yield positive results.

Corticosteroids – as previously described.

Treatment of hypertrophic acne scars with dermaroller. Hypertrophic acne scars can be treated with positive results using a dermaroller/dermapen. In the case of hypertrophic scars, microneedles destroy collagen fibers and fibroblasts. This leads to reduced scar size and improved skin elasticity.

Treatment of atrophic acne scars is almost always done with treatment techniques such as microdermabrasion, laser treatment, microneedling (dermaroller, dermapen), subcision.

Atrophic acne scar treatment on the face with microdermabrasion is a highly valued method that both can sand scar edges and pull scars towards the skin surface. The method is necessary in the treatment of acne scars of the rolling and box type.

Acne scar treatment with dermaroller. In an atrophic scar, there is a lack of collagen fibers and fibroblasts (skin cells that produce collagen fibers). When fibroblasts are damaged with microneedles (dermaroller/dermapen), it leads to a stimulation of fibroblast mitotic activity, more cells are formed. Which results in increased collagen production.

Laser method as the only treatment cannot resolve acne scar removal. Each type of scar needs the right type of treatment, otherwise, we risk worsening the treatment process.

ACNE SCARS ON THE CHEST
Acne scars on the chest are often a result of inflammation from Propionibacterium acnes.

First, an inflammation spot occurs in a sebaceous gland. Then pus forms in the sebaceous gland, and a pimple arises. When the pus reaches a critical mass, the pimple swells up and the pus comes out. At this spot, a scar forms. Acne scars are a result of the body’s fight against Propionibacterium acnes. Often hypertrophic scars and keloids are formed. The hypertrophic scar can over time change into a keloid.

ACNE SCARS ON THE BACK
On the back, three types of scars occur: keloids, hypertrophic, and atrophic scars. Genetics determine the intensity of edema and inflammation and the size of the scars. Treatment of acne scars on the back.

Topical therapy, such as ointments and creams, cannot alone give good results and remove scars. But in combination with other methods, they can show quite good results.

Different ointments or creams are applied depending on the type of scar. For hypertrophic scars and keloids, those that reduce collagen synthesis, normalize blood circulation, and press on the scar surface are used. These are Kelo-cote, Dermatix, Strataderm, MedGel, Kelofibrase, Scarguard, Contractubex, Aldara. In the case of atrophic scars, creams are used that stimulate or participate in collagen synthesis and increase immunity in the wound area.

For acne scars on the back, Antioxidant Complex, amino acids, Centella Asiatica (gotu kola) are used. Among the creams is Elicina, which contains 80% snail mucus that normalizes collagen production and accelerates regeneration. Elicina cream can be used for all types of acne scars.

Laser treatment of Acne Scars. Ablative laser produces a high recurrence rate of 90-100% when used on hypertrophic scars and keloid treatment. Therefore, laser treatments are only used on atrophic scars, but even there, positive results are often lacking.

Corticosteroids – have been previously described. Cryosurgery is used to create tissue damage through brief freezing. The freezing forms intravascular and intracellular ice, which hinders microcirculation and destroys cytoplasm and cell organelles. When cryosurgery is applied as the only method, the results are a complete elimination of keloids and hypertrophic scars in about 51-74% of cases. Dermaroller treatment of hypertrophic acne scars. Hypertrophic acne scars can be treated with a dermaroller/dermapen and achieve good results. In the case of hypertrophic scars, micron needles destroy collagen fibers and fibroblasts. This leads to the scar’s size becoming smaller and improved skin elasticity.

Dermaroller treatment of atrophic acne scars In an atrophic scar, there is a lack of collagen fibers and fibroblasts (skin cells that produce collagen fibers). When fibroblasts are damaged with micron needles (dermaroller/dermapen), it leads to the stimulation of fibroblast cell renewal, which in turn increases collagen production.

Scar treatment, removal and correction with Dr. Igor Safonov

Cicatrices, often commonly referred to as scars, are an invariable companion to the humans. A person with no scars can hardly be found in this imperfect world. Our skin is subject to endurance test on a day-to-day basis throughout our life. Common injuries, cuts, burns, accidents, surgeries and mere inflammatory skin diseases constitute an incomplete list of reasons for scarring.

Scar appearance varies depending on multiple factors: depth and mechanism of wound or inflammation, adequacy of treatment, localization, to mention a few. Yet, they possess a common feature – scars remain imprinted on the soul. Each and every patient is unsatisfied with the scar appearance, willing either to get rid of the scar or improve scar appearance at the very least.

Scar treatment, removal and correction are lasting and assiduous process which does not always yield the desired results. This is why many experts are reluctant to deal with the issue. Hence there is a common fallible belief even among highly professional surgeons: “Let`s just wait a year or so and then we`ll see what we can do about it!”, which, in fact, can well be interpreted as: “Doesn’t get on my nerves with your scar!” The reality is that one year is already too late to treat a fresh scar. Within a 4-6 month period blood vessels grow through scars, 9-12 months – with nerve endings, becoming a part of the bearer`s organism. Scars must be treated within the first hours after injury. In one year they are subject to correction only, which is a more lasting and costly process.

Scar treatment, removal and correction is very impotant task because scars can cause inferiority complex and undermine self-confidence to the extent that psychological aid might be required. Our goal is to make the scar unseeable or less conspicuous and erase the scar-related unpleasant memories. We possess knowledge, experience, and modern equipment to scar treatment, removal and correction. The decision is yours!

Dr. Igor Safonov