A MIXED MODEL FOR TREATMENT OF ATROPHIC ACNE SCARS BASED ON BLUNT BLADE SUBCISION

doi:10.4066/2591-7951-C5-014

A MIXED MODEL FOR TREATMENT OF ATROPHIC ACNE SCARS BASED ON BLUNT BLADE SUBCISION

Joint Event on International Congress on DERMATOLOGY AND TRICHOLOGY & 2^nd WORLD NEPHROLOGY AND THERAPEUTICS CONGRESS
September 20 - 21, 2018 | Rome , Italy

Zahra Akbari

Shahi Beheshti University of Medical Science, Iran

Scientific Tracks Abstracts : Arch Gen Intern Med

DOI: 10.4066/2591-7951-C5-014

Abstract:

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.

Biography:

Zahra Akbari is a board-certified dermatologist currently working as Managing Director of Research at the Laser Application in Medical Sciences Research Centre (Shahid Beheshti University of Medical Sciences, Tehran, Iran). She is graduated from the Tehran 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, particularly 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.

E-mail: zahra.akbari@sbmu.ac.ir

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