Atrophic Scars Can Arise From Clinically Normal Skin

During a session at the annual Congress of the European Academy of Dermatology and Venereology, Dr. Sewon Kang, professor and chair of the department of dermatology at Johns Hopkins University, Baltimore gave the following findings at a sponsored talk by Galderma.

The bottom line is that any form of acne, whether mild or moderate should be taken care soonest as even non-inflammatory lesions can cause acne scarring.

I have put in the original article from Skin and Allergy News below:

“LISBON – Contrary to conventional wisdom, atrophic acne scars may arise from what was clinically normal skin 3 months earlier.

Inflammatory acne lesions clearly play a major role in atrophic scarring, but scars can arise from erythematous macules and closed comedones as well.

“And it’s also important to emphasize that we’re able to identify atrophic scars arising from clinically normal skin,” Dr. Sewon Kang said at the annual Congress of the European Academy of Dermatology and Venereology, during a session sponsored by Galderma.

His study of the natural history of acne over a 12-week time frame used computer-assisted spatial alignment and serial high-definition digital photographs to track new lesions and atrophic scarring in 25 subjects with untreated mild to moderate facial acne. Participants were formally assessed every 2 weeks.

Closed comedones accounted for 37% of all lesions, followed by erythematous macules at 26%, inflammatory papules at 15%, open comedones at 12%, with pustules and nodules accounting for the rest.

“Both non- inflammatory as well as inflammatory acne lesions need to be addressed in order to prevent the most terrible sequelae of acne: the formation of scars.”

At 12 weeks, a total of 219 inflammatory lesions were present: 176 papules, 35 pustules, and 8 nodules. Working backward via the serial tracking system, Dr. Kang and coworkers determined that 41% of the inflammatory lesions were preceded by closed comedones, 13% by open comedones, 12% from erythematous macules, and 6% from ice pick scars. Importantly, 28% of inflammatory lesions arose from clinically normal-appearing skin, said Dr. Kang, professor and chair of the department of dermatology at Johns Hopkins University, Baltimore.

Also present at 12 weeks were a total of 104 atrophic scars as agreed upon by at least two of the three independent examining dermatologists. Nearly 70% were ice pick scars, 30% were boxcar acne scars, and 2% were rolling scars.

Of note, 23 of the 25 study participants had one or more acne scars at 3 months of follow-up.

In all, 30% of the scars were already present at baseline. Another 20% arose from inflamed papules or pustules or from closed comedones. But fully half of the scars arose from noninflammatory lesions.

The clinical implication of these findings is that aggressive treatment should be prescribed from the outset in acne patients – even in those with mild disease – to prevent acne scarring.

“Both noninflammatory as well as inflammatory acne lesions need to be addressed in order to prevent the most terrible sequelae of acne: the formation of scars,” said Dr. Kang.

Based upon these findings, he said he favors multimodal acne therapy with a retinoid, an antimicrobial agent, and benzoyl peroxide.

Dr. Kang is a paid speaker for Galderma.”

Related articles for Noninflammatory Lesions Can Cause Atrophic Scars:

• Guide to Treating Acne Scars and Skin Damage (webmd.com)
• Moderate to Severe Acne: A Treatment Guide (webmd.com)

It is hard to concentrate when you are distracted and recent research done by Mikki Hebl at Rice University and Juan Madera at the University of Houston has shown that if you have a birth mark, severe acne or acne scars; your chances of landing that much wanted job could be hindered.

That is because the interviewer’s concentration is on the actual blemish or birth mark, which means less of what the applicant is saying is taken in.

“When evaluating applicants in an interview setting, it’s important to remember what they are saying,” Mikki Hebl, a psychology professor at Rice University, said in a university news release. “Our research shows if you recall less information about competent candidates because you are distracted by characteristics on their face, it decreases your overall evaluations of them.”

An experiment was conducted whereby volunteers posing as job seekers had special effects make up to create a blemished or scarred face.

Eye tracking was then used on 170 undergraduate students doing a mock interview on a computer. It showed that the more severe the blemish, the less they heard about what was said; but more importantly, when they were questioned later about the applicant, they recalled less and gave the person a lower rating.

Another experiment was done with 38 experienced managers used to hiring workers. Face to face interviews were arranged whereby the applicants were interviewed one on one. Despite having interviewed many candidates before, the managers were still distracted by facial scars and birthmarks. In fact, they were more distracted and gave an even lower rating than the undergraduates from seeing the facial blemishes first hand.

“The bottom line is that how your face looks can significantly influence the success of an interview,” Hebl said. “There have been many studies showing that specific groups of people are discriminated against in the workplace, but this study takes it a step further, showing why it happens. The allocation of attention away from memory for the interview content explains this.”

Both Hedl and Madera hope that by bringing this research to light, they will be able to raise awareness against this type of discrimination.

Read original article 1 and article 2 here.

Azficel-T Treatment – A Gentler Way to Erase Acne Scars

If you have moderate to severe acne scarring, a new procedure is underway to make those acne scars fade away according to the American Society for Dermatologic Surgery in their 2011 Annual Meeting.

“For patients with moderate to severe distensible depressed acne scarring, this can provide an excellent option for partial and possibly complete improvement in the appearance of this type of scarring,” explained Girish (Gilly) Munavalli, MD, lead clinical investigator and medical director of Dermatology, Laser, and Vein Specialists of the Carolinas, PLLC, and assistant professor of dermatology at Wake Forest University School of Medicine in Winston-Salem, North Carolina, about the azficel-T technique.

Less invasive and abrasive than laser and ablative methods, azficel-T an autologous cellular product, uses fibroblast cells taken from the patient’s own skin to create collagen.

The harvested collagen from the skin sample would be reproduced in a Fibrocell Science Lab under controlled conditions. Once ready, the collagen would be injected back into the patients acne scars to help fill and smooth it out.

In a controlled study, subjects were injected with azficel-T and a placebo over a 3 year period. Patients reported in many cases, significant improvement in their acne scars’ appearances.

“This is a very safe treatment with an excellent safety profile and minimal risk of scarring or pigmentary alteration of the treated skin,” said Dr. Munavalli.

The treatment is still under going further studies and awaiting US Food and Drug Administration approval.

 Watch the interview here with Dr. G. Munavalli

Read the original article here

Asian Acne Treatment

If you are Asian and you suffer from acne, is there a special way or specific Asian acne treatment you should be looking at?

According to IMS Health, a healthcare information service provider, there are 460 million Asian acne sufferers with more than 90% being teenagers. It does not mean adults are exempt from them – in fact, Asian women are more likely than Asian men to suffer adult acne.

So is there a difference between Caucasian and Asian skin when it comes to acne?

Unfortunately yes and Asians tend to suffer more from the condition than their European or American counterparts.

This is due to a higher level of melanin production.

What is melanin?

According to MedicineNet.com

“Melanin: A skin pigment (substance that gives the skin its color). Dark-skinned people have more melanin than light- skinned people. Melanin also acts as a sunscreen and protects the skin from ultraviolet light.

Melanin is produced by cells called melanocytes. It provides some protection again skin damage from the sun, and the melanocytes increase their production of melanin in response to sun exposure. Freckles, which occur in people of all races, are small, concentrated areas of increased melanin production.”

Hyperpigmentation

This higher concentration of melanin is also called hyperpigmentation, which can manifest themselves as freckles, sun spots and age spots.

“In fact, even among Asians, acne-related hyperpigmentation is more common in darker-skinned Asians”, said aesthetic physician Dr Nicholas Ngui from the DRx Clinic.

Add to the fact that Asians has a higher tendency to develop the thick tissue keloid scars in addition to the pitted and indented scars from acne and you are left wondering whether anything can be done.

Dr. Ngui has this suggestion :

“Scarring develops when the skin is so damaged by acne inflammation that it cannot regenerate normally, and is replaced by fibrous scar tissue. So curbing the acne inflammation as quickly as possible can prevent or minimize irreversible damage to the skin.”

Unfortunately, most people will try and deal with it themselves with over the counter acne products or home acne remedies before seeking professional help. By which time, the damage is already evident.

“For people at risk of hyperpigmentation, the faster you treat the acne, the better. When you start getting scars from acne, it can become a real catastrophe,” said Dr Pawin.

And this could mean depression and psychological issues.

A study in Hong Kong showed that out of the 90% teenage Asian acne sufferers, more than 26% were psychologically disturbed by their acne skin and almost  83% were bothered by their blemished appearance.

Bottom line – Don’t wait. Seek appropriate professional Asian acne treatment as soon as you can

 You can read the original article here

What is Acne?

 Acne is more likely caused by overactive oil glands than uncleanliness.

Male sex hormones called androgens increases at puberty. A type of protein called keratin and an oily skin lubricant sebum, are stimulated by the increase of androgen.

A blemish arises when sebum tries to go through the pores, but gets trapped by an over production of sebum that cannot get through fast enough. The pores becomes filled up with the oily substance sebum, attracting and trapping bacteria, which leads to acne.

Blackheads

A blackhead arises when the trapped sebum, together with skin pigment, blocks the pores.

Whiteheads

A whitehead arises when the scales below the skin’s surface gets filled up with sebum.

When a whitehead builds up and spreads below the skin’s surface, a more severe form of inflammation occurs which can lead to acne scars if not properly taken care of.

Factors that contribute to break outs

Factors that can contribute to skin ruptures such as blackheads, whiteheads and pimples include hereditary, oily skin, menstrual cycles, candidiasis,  and hormonal imbalances. 

If drugs such as steriods and oral contraceptions are taken, it could also contribute to break outs.

Add an unbalanced diet high in saturated fats and animal products, with not enough fresh fruit and vegetable; together with environmental and industrial pollutants, and you can get very aggravated skin ruptures.

Although more than 20 million teenagers suffer from this skin disorder, acne affects adults increasingly aswell. Whilst teenage acne tends to concentrate on areas such as the face and the upper body, adult acne tends to be along the jaw line and can be more severe and painful.

There are many ways to get rid of acne and acne scars. Before trying antibiotics and more severe forms of medication and surgery, try more holistic approaches, and you may find that  clear and beautiful skin will be your once again. 

  Don’t Live With Acne Anymore!