Scars skin preparation

The patient consulted us regarding macular acne scarring. After preparation with sunscreens and 10% glycolic acid lotion at night for 2 weeks, she was treated with 30% salicylic acid peels once a month for 3 consecutive months. Figure 13.6 shows the remarkable improvement of skin texture and macular spots. 

Garg HG, Siebert JW, Garg A, Neame PJ. Inseparable iduronic acid-containing proteoglycan PG(IdoA) preparations of human skin and post-burn scar tissues evidence for elevated levels of PG(IdoA)-I in hypertrophic scar by N-terminal sequencing. Carbohydr Res 1996 284 223-228. 

After the procedure, the patient is advised to use water-based lotion creams and potent sunscreens. The erythema gradually resolves over about 2-month period. During this time, makeup foundation is encouraged. In dark skin patients (Fitzpatrick skin type 3 or 4), the application of Kligman preparation is recommended to prevent reactive hyperpigmentation. In after-procedural flare-ups, minocycline or systemic isotretinoin are prescribed immediately to avoid new scars creation. 

Litton [284], one of the pioneer physicians in chemical skin peeling, ranaiked that almost all the scarring he had seen following chemical peels was due to TCA [284], A full-thickness injury and hypertrophic scarring may occur wheu the 50 % TCA solution is incorrectly prepared (50 g TCA in 50 mL distilled watCT rather than the correct 50 g TCA in 1(X) mL distilled water), resulting in a concentration much higher than 50 % [337]. 

Fig. 49. Reticulin preparation of a skin wound in a guinea pig receiving 2 mg. of vitamin C daily, after healing for 1 week. Note equal intensity of reaction by scar tissue and surrounding mature connective tissue.

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