Process wound repair

The pineal gland hormone melatonin is known to have both anti-inflammatory and immunomodulatory effects. Given this, we propose that melatonin is an ideal candidate to enhance the process of wound healing. The present study assessed the effects of exogenously administered melatonin, on scar formation using a full-thickness incisional rat model of dermal wound healing. Melatonin treatment significantly improved the quality of scarring, both in terms of maturity and orientation of collagen fibres.

An increase in nitric oxide synthase (NOS) activity and therefore nitric oxide production is detrimental during inflammation but is favourable during granulation tissue formation. Melatonin treatment significantly decreased inducible NOS (iNOS) activity during the acute inflammatory phase but significantly increased iNOS activity during the resolving phase. Cyclooxygenase-2, which has been shown to have anti-inflammatory effects, was elevated in the melatonin-treated rats following wounding.

In addition, melatonin treatment also accelerated the angiogenic process, increasing the formation of new blood vessels and elevating the level of vascular endothelial growth factor protein expression during granulation tissue formation. Melatonin treatment increased arginase activity (which generates proline, a building block for collagen synthesis) from earlier time points. The protein profiles of hemoxygenase-1 (HO-1) and HO-2 isoforms, vital participants in the repair process, were also upregulated upon melatonin treatment. This study has therefore demonstrated, for the first time, that melatonin can significantly improve the quality of wound healing and scar formation.

Acne scar treatment tips

Acne scar treatment tips

1. Using tretinoin speeds up the skin's remodeling process and helps heal post-inflammatory changes.
2. Surgical removal (or excision) of acne scars is especially effective for ice pick and boxcar scars.

3. Accutanea may be prescribed for severe cases.
4. Acne staining can be treated with exfoliating creams and facials.
5. Skin grafting may be necessary under certain conditions.
6. Lasers of various wavelength and intensity may be used to recontour scar tissue and reduce the redness of skin around healed acne lesions.
7. Hippocrates serum for treatment of acne scarring is a high potency resurfacing serum to retexturize your skin.
8.Cellex-C is yet another acne scar removal cream that is recommended by many.
9.Elicina cream is a natural day and night protein cream for all ages and skin colours.
10. Mederma is a type of acne scar removal cream. It is actually a gel based medication and has been very helpful in many situations.

Acne scar removal and treatment

Acne scars associated with loss of tissue similar to scars that result from chicken pox  are more common than keloids and hypertrophic scars. Using tretinoin speeds up the skin's remodeling process and helps heal post-inflammatory changes. Acne scars is two types of tissue response to the inflammation of acne increased tissue formation and loss of tissue. Nearly 80 percent of people aged 11 to 30 years have acne, most often on the face, chest and back. Scars caused by increased tissue formation are called keloids or hypertrophic scars. The typical keloid or hypertrophic scar is 1 to 2 millimeters in diameter, but some may be 1 centimeter or larger. Hypertrophic and keloid scars persist for years, but may diminish in size over time. Accutaneä may be prescribed for severe cases. Depressed fibrotic scars are usually large scars that have sharp margins and steep sides.

They are similar in appearance to deep chicken pox scars. Superficial and deep soft scars are variable in size, and have sloping edges that merge with normal skin. Most serious scarring is caused by the more severe forms of acne, with nodules more likely to leave permanent scars than other types of acne. Acne staining can be treated with exfoliating creams and facials. Acne scar removal cream is designed to help diminish and in some cases removing the scarring altogether that has occurred on a person's skin after they have suffered with acne. These creams are supposed to help flatten as well as soften and smooth a person's skin with various different ingredients. Use this acne scar removal cream with a topical Vitamin A product. Use these creams at separate times during the day. There are several topical creams in the market, claiming to be the best and most suitable. Hippocrates has developed an skin care tailored for scarring using high-potency serums.

Hippocrates treatment works on the surface of the skin, epidermis, as well as deep within the dermis layer. Hippocrates serum for treatment of acne scarring is a high potency resurfacing serum to retexturize your skin. Cellex-C is yet another acne scar removal cream that is recommended by many. Elicina cream is a natural day and night protein cream for all ages and skin colours. The product regenerates photo aged skin, reduces wrinkles, age spots, serious skin discolouration and erodes away actinic keratosis. One of the best known of the acne scar removal creams available today is Mederma. Mederma is a type of acne scar removal cream product. It is actually a gel based medication and has been very helpful in many situations. If the acne scars are brown in color you can use bleach with hydroquinone along with the acne scar removal cream.

Acne therapy evolves and improves

Acne treatment continues to evolve, which is good news for the tens of millions of teenagers and adults who experience mild-to-severe versions of this medical disease. More choices and newer formulations of existing compounds give everyone an opportunity to successfully treat this skin disease which has the ability to scar physically and emotionally. According to many adults who experienced moderate-to-severe acne as teens, the fear of it reemerging is always present; any new pimple a reason for concern.

Although there haven't been many new chemical compounds developed for acne treatment that have been approved for use recently, improvements in formulations have enhanced efficacy and improved skin tolerability. There is a new microsphere cream formulation with benzoyl peroxide, which is available in a tube, or as a novel single-dose applicator, that has demonstrated efficacy and an excellent tolerability profile. There is also a solubilized and micronized 5% formulation of benzoyl peroxide that's available as part of a three-step acne treatment system or as a gel that has been shown to be effective in reducing inflammatory acne lesions and more effective in reducing non-inflammatory acne lesions. Some patients do experience some stinging in the first week of use that is usually mild and dissipates with continued use.

Another new gel formulation consists of 2.5% benzoyl peroxide and 1% clindamycin formulated in a novel vehicle. Efficacy with once daily application appears to be comparable to that achieved with twice daily use of the jar/pump gel formulation of benzoyl peroxide 5%--clindamycin 1%, although head-to-head studies have not been performed. The tolerability profile with the benzoyl peroxide 2.5%--clindamycin 1% gel appears to be highly favorable.

More news includes the use of an ingredient called dapsone, which, although not new, is now available as a topical 5% gel. Topical dapsone 5% gel is available in a formulation designed to solubilize the active ingredient and optimize its ability to penetrate the skin without significant absorption in the body, if used continuously over time. As a result, blood testing is not mandatory, according to the FDA-approved product labeling, as no systemic safety signals have emerged with use in over 1,500 patients treated with topical dapsone.

Several studies have demonstrated that in patients with acne vulgaris of all severities, that concomitant use, from the outset, of the tube gel formulation of benzoyl peroxide 5%--clindamycin 1% gel in the morning, and a quality topical retinoid at night, produces the quickest and greatest reduction in both inflammatory and non-inflammatory acne lesions compared to the topical retinoid alone, or as compared to staggering the therapies. Such studies have been completed with several topical retinoids including tazarotene 0.1% cream, adapalene 0.1% gel, and tretinoin microsphere 0.04% gel.

Acne in pregnancy

Acne and pregnancy interact in a variable way. In the majority, pregnancy has a beneficial effect on the activity of acne, and this is through the sebosuppressive effect of estrogens. In a small number of cases, there is a flare-up of acne requiring active intervention, especially if scarring is a threat. Acne may also appear for the first time during pregnancy. There are reports of women experiencing acne only during pregnancies. If an acne patient during active treatment conceives then careful assessment of teratogenicity issues needs to be carried out and the safety to carry the pregnancy to term needs to be determined. There are times when a medical termination of pregnancy may be a safer option.

It is difficult and challenging to treat acne in a pregnant woman as most drugs are contraindicated or considered unsafe. For comedonal acne, BPO is safe and may be sufficient. Azelaic acid, although not contraindicated, is not recommended. Topical retinoids are controversial in pregnancy because of concerns of systemic absorption. However, in clinical studies of topical adapalene and tazarotene, plasma concentrations were found to be below 3 nM, which is similar to or lower than endogenous tretinoin, suggesting that the teratogenic potential of topical retinoids is negligible.

Inflammatory acne may be treated with BPO or topical antibiotics, or a combination of the two. Macrolides are generally regarded as safe in pregnancy. Oral erythromycin is permitted for scar-threatening acne, and may be given for 3-9 months as needed. Presumably, it is just as safe to administer newer macrolides, roxithromycin, clarithromycin, and azithromycin, in usual acne dosages. Any such intervention must be well justified, and the perceived benefits must outweigh the uncertainties. Tetracyclines (including doxycycline, minocycline, lymecycline) being unsafe in the second and third trimester of pregnancy (vide supra) are best avoided at all stages of pregnancy, whereas oral retinoids being highly teratogenic are absolutely contraindicated.