Pigmented scars

Post-acne pigmentation scars are easy to treat (Figure 21.32). 

Pigmented scars are also observed in iron, stone, silver and flour-mill employees. Cases of skin pigmentation from the external therapeutic application of iron salts, such as ferrous sulfate and ferric chloride, have been described. Hare (1951) reported red-brown, punctate, perifollicular pigmentation from deposition of iron granules on the forearms of a metal worker employed in pickling metal in hydrochloric acid. The pickling fluid contained iron salts in an acid medium. 

The inner part of the forearm and the upper back may be used for intradermal injections. The area should be hairless areas near moles, scars, or pigmented skin areas should be avoided. The nurse should cleanse the area in the same manner as for SC and IM injections. 

I understand that there is a small risk of developing permanent darkening or undesirable pigment loss at the treated site.There is a rare chance that a scar could develop.There is also a small risk that a bacterial infection could develop or there could be a flare of a pre-existing Herpes infection at the treated site,orthe condition being treated could worsen after the peeling procedure. The benefits and side effects of the procedure have been explained to me in detail. All of my questions have been answered. 

Kumar LR, Goyal BG. Pigmented hairy scar following smallpox vaccination. Indian J Pediatr 1968 35(245) 283-4. 

Phenol Face peeling antipruritic Milia persistent erythema skin pore prominence telangiectasia scarring pigment alterations (SEDA-7, 166)... 

Lesions on sun-exposed skin, particularly the backs of the hands, forearm, and face, are present in all patients. These lesions are identical to those seen in the other bullous porphyrias (Table 32-4). Increased mechanical fragility of the skin, with trivial trauma leading to erosions, is present in virtually aU patients. Subepidermal bullae, hypertrichosis of the face, and patchy pigmentation are also common. Erosions and bullae heal slowly to leave atrophic scars, milia, and depigmented areas. Patchy or diffuse sclerodermatous changes are less common and, unlike the other skin lesions, may affect areas of the trunk that are not exposed to sun. 

Complications associated with i.m. administration include nerve injury, muscle contracture, and abscess formation. Less common problems include intramuscular hemorrhage, cellulitis, skin pigmentation, tissue necrosis, muscle atrophy, gangrene, and cyst or scar formation. In addition, injury may occur from broken needles and inadvertent injection into a joint or vein. ... 

Post-acne pigmentation on the back does not respond readily to ETCA alone. The protocol developed for treating stretch marks produces excellent results, however - not only on the residual pigmentation but also on the depth of the acne scars. 

Scabs should not be pulled off in the post-peel period. Aggressive use of OT can cause scarring and/or pigmentation problems. Intense application of OT can cause patches of erythema that can persist for up to 3 months. This prolonged erythema can be treated by the application of topical corticosteroids and total sunblock. 

Pigmentation disorders (as well as scars) are often preceded by persistent localized erythema that must be treated as quickly as possible (see above). Once again, the patient should have an overall treatment program. The patient... 

Benzodiazepines " and strong analgesics" sedate patients and prevent scratching, secondary infections, pigmentation problems and permanent scars. Daily doctor-patient contact is essential to reassure the patient that the herpes lesions are healing properly. 

The modern makeup base, in liquid, cream, or cake form, must provide a quality finish, adequate coverage, and appropriate pigmentation. Consumer selection of foundation makeup should be based on skin type (e.g., presence of scars, enlarged pores, uneven skin tones, etc.), degree of sebum production ( oiliness ), skin color (e.g., sallow yellow, ruddy red, or neutral), and depth of skin color (light, medium, or dark). General types of materials used in most foundation makeups may be classified as part of the powder phase, aqueous phase, polyol phase, or oil phase. 

Blue-black pigmentation confined to sites of scarring or inflammation on the face... 

Circumscribed blue-gray pigmentation within acne scars confined to the back... 

---