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S e p t e m b e r 2 0 - 2 1 , 2 0 1 8 | R o m e , I t a l y
Joint Event on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
Dermatology Congress 2018 & World Nephrology 2018 Archives of General Internal Medicine | ISSN: 2591-7951 | Volume 2
2nd WORLD NEPHROLOGY AND THERAPEUTICS CONGRESS
DERMATOLOGY AND TRICHOLOGY
&
International Congress on
Zahra Akbari, Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C5-014
A MIXED MODEL FOR TREATMENT OF
ATROPHIC ACNE SCARS BASED ON BLUNT
BLADE SUBCISION
Zahra Akbari
Shahi Beheshti University of Medical Science, Iran
Atrophic acne scar is a common sequelae of acne vulgaris that can have
a significant negative impact on patients. Treatment of this type of
scar is based on repeated ablation of the surface skin with ablative lasers,
peeling or dermabrasion. These methods are time consuming and show a
30-40% improvement at most. Since patients can present with multiple
types of atrophic acne scars, no single procedure would yield significant
improvement. We have developed a comprehensive treatment protocol that
targets all three types of atrophic acne scars and their pathologic basis (loss
of dermal collagen and anchorage of adhesive fibrous bands to deeper layers
of skin). Firstly, chemical reconstruction of the skin scar is performed using
high concentrations of trichloroacetic acid. This is particularly effective in
treating deep-seated icepick scars which are usually unresponsive to laser
or dermabrasion. Tumescent solution is then injected throughout the scar
area, acting as a topical anaesthetic in preparation for later steps as well as
creating fibrous hydro dissection to dissociate adhesive fibrous bands. Blunt
blade subcision is then performed using BSBB cannula. Five types of BSBB
cannula are available according to different lengths and widths and can shear
the entirety of adhesive anchoring bands between the dermal and hypodermal
layers in two planes (superficial and deep), particularly underneath the scar.
Lastly, the acne scar area is treated with ablative fractional carbon dioxide
laser. The subcision procedure and ablative laser have impressive effects
on rolling as well as boxcar scars. The whole protocol is repeated two or
three times within one month. So far, we have performed this protocol in
more than 500 patients with skin phototypes II-IV and achieved at least 60%
improvement in acne scars. No significant complications have been observed
except self- limited long-lasting erythema. We present our comprehensive
protocol as well as reviewing common surgical and laser procedures for the
treatment of atrophic acne scars.
Zahra Akbari is a board-certified dermatologist cur-
rently working as Managing Director of Research at
the Laser Application in Medical Sciences Research
Centre (Shahid Beheshti University of Medical Sci-
ences, Tehran, Iran). She is graduated from the Teh-
ran University of Medical Sciences and ranked third
in Iran’s National Board of Dermatology exam. She
has several years experience of working as a Clinical
Dermatologist in hospitals and private professional
dermatology clinics and the red crescent dermatology
clinic. In her career as a dermatology researcher she
has developed substantial research skills, particular-
ly in clinical trials and has published several articles
in high impact journals and has been serving as an
Editorial Board Member of Journal of Laser in Medical
Sciences.
BIOGRAPHY