The TCA CROSS Method of Treating Acne Scars: New Hope for Deep Ice-pick Type Scarring

Due to the difficulty in treating icepick-type acne scars, there seems to be a great deal of interest in the TCA Cross procedure but relatively few sources of solid information online.

This article is based on the original research that first describes the method, "Focal Treatment of Acne Scars With Trichloroacetic Acid: Chemical Reconstruction of Skin Scars Method" by Lee, Jung Bock, et al.2002.

Researchers and doctors had known for some time that lower concentrations of trichlororacetic acid (TCA) was an excellent mild to medium chemical peel due to its ability to stimulate collagen growth; however, higher concentrations of TCA leads to scarring and skin discoloration.

Out of desire to use TCA at higher concentrations to treat deeper scars the focal TCA Cross method was born (focal means a small area). This method involves using a sharp wooden application to apply 65 to 100% TCA to the base of a scar. After about ten minutes, the scar forms a white crust signaling that the procedure is complete for that scar. Intuitively, it seems odd to apply acid to the bottom of a scar, but the purpose of the TCA is to damage and, thereby, stimulating collagen growth, effectively pushing the scar up from underneath.

In this original study, the researchers found that 100% was more effective than 65% TCA, as 30 of the 32 patients in the 100% group had "good" or "excellent" results based on the assessment of two physicians who didn't know which patients were in each group. Some patients had 5 or 6 treatments spaced 1 to 3 months apart. All the patient in the 100% group who had 5 or 6 treatments showed "excellent" results.

The authors claim to have had success using the TCA Cross technique on other types of scars like boxcar and rolling; however, all the research I've read only recommends this method for icepick scars.

Icepick scars seem to be the most difficult to treat because they're resistant to any sort of resurfacing technique like the older chemical peels and dermabrasion and the newer laser resurfacing. As opposed to rolling and many boxcar scars that can be improved, resurfacing procedures just can't penetrate deep enough to improve the appearance of icepick scars. In order to improve icepick scars, punch excision or TCA Cross will probably be necessary.

Punch excision is good technique; however, it involves more discomfort and can't be used to treat adjacent scars because the healing process causes the skin to tighten. The authors of the study claimed that no anesthesia was needed during the TCA Cross procedure and list no warnings about simultaneously treating multiple scars that are close together.

Unfortunately, based on reading multiple forum posts by real scar sufferers, it seems like few dermatologist are familiar with TCA Cross, so you'll probably have to search around. However, time search is time very well spent. Success depends on finding the right dermatologist or cosmetic surgeon who specializes in acne scars. For example, if I were seeking acne scar treatment, I would expect to be on a waiting list for several months and to travel out of state to a major city for a procedure.By: Erik Pearson

Keloid Scar Removal Without Surgical Excision

Every type of scar will require a special type of treatment. For the most part, all scar types can be treated effectively using surgery, however, if you're trying to treat a keloid scar then it's a bit more complicated because keloids tend to grow indefinitely and recur after surgical excision.

Fortunately, there are other forms of keloid removal that are less invasive than surgery but very effective. Depending on the size and location of the keloid you can either use one of these procedure to treat the scar or a combination of them. Here are some alternatives you can look into.

Usually the first option your doctor will give you are steroid injections. These injections help flatten scar tissue and make keloid scars less noticeable. However, the flattened keloid will still have a different feel than regular skin.

Steroid injections can be used at any time before, during, or after surgery. When injections are used in this manner, especially when undergoing keloid scar removal surgery, then keloid recurrence can be greatly hindered. The doctor will evaluate the situation and determine the best course of action.

Compression therapy is another type of treatment for keloids and raised scars. This type of treatment is one of the oldest scar removal alternatives. The compression devices and garments used are usually custom fitted and have to be worn for 24 hours a day and sometimes up to a year or more.

Other elements used, such as silicone sheets, are used to help flatten all types of scars, including keloids and other hypertrophic scars. If you are undergoing this type of treatment you should be wearing these sheets for a few hours a day for several weeks.

These sheets can often be found at your drugstore. They are very effective and a good alternative for keloid treatment. In fact, usage is quite simple. All you need to do is cut the sheet down to size so that it will fit the affected area.

Laser therapy can also be implemented as an effective keloid scar treatment. In this case, pulsed dye lasers are used to flatten keloids. In fact, the use of laser therapy has proven so beneficial that it can also help reduce the redness that is common in most keloid scars.

Smaller keloids, especially those caused by piercings, can be treated with cryotherapy. This form of treatment uses liquid nitrogen to flatten the keloids. Even though it is successful in treating keloids, cryotherapy can also make the treated area darker than the surrounding skin.

Remember that it is important that you consult with your doctor to find out what possibilities you do or don't have. If surgery is a viable option for you, then it is quite possible that it can be combined with one or more of the previously mentioned alternatives. However, if you're not willing to undergo surgery be assured that there are other less invasive alternatives out there. By: Martha Fitzharris

White Scars & Hypopigmentation: Their Causes & Cures

White scars and hypopigmentation (loss of skin coloring) can result from trauma to the skin.

Scars take on a white appearance because melanocyte production has been impaired. Melanocytes make melanin- the pigment that gives the skin its color. If melanocytes are damaged, so is the skin's ability to produce darker skin tones.

After damage to the skin, whether or not hypopigmentation or white scarring occurs depends on how the injury took place.

Causes of hypopigmentation and white scarring

For example, if you were riding a bicycle, fell and only scrapped your knee, this would have created a superficial abrasion on the skin. A scab would develop to protect the wound. Over the course of the few days, the scab would fall off. Once the scab shed away, the skin would then produce pigment in response to sun exposure and eventually, the color of the scar would match that of the rest of the skin.

On the other hand, had the bicycle fall involved a deep gash to the knee, most of the pigment producing layers of the upper skin would be damaged while the deeper layers of the skin would need to repair the injured tissue.

To start the dermal repair process, the skin would then knit together collagen and elastin to protect blood vessels beneath the skin. If blood vessel damage occurred, increased amounts of inflammation would accompany the wound healing process. Under these circumstances, a mild form of fibrosis, or excessive scarring, may happen because of the increased in skin damage and inflammation.

With this build-up of scar tissue, melanocytes may not reach the surface of the skin where they make melanin and give color to the skin. This results in white, coarse scar tissue.

Laser resurfacing & hypopigmentation

Unlike bicycle accidents, laser re-surfacing is a form of intentional scarring. Since laser resurfacing corrects skin damage by inflicting tiny wounds in the skin, laser treatments can cause hypopigmentation. At times, the hypo-pigmented spots may not show up until two to six months after the laser treatment.

Treatments for white scarring and hypopigmentation

Treatments for white scarring that result from acne scars or accidents include medications for vitiligo. Vitiligo is a skin disorder of unknown cause involving loss of pigmentation in patches of otherwise normal skin.

Dermatologist Dr. R.W. Urbanek, reported to E Skin and Allergy News that a product know as V-Tar helps combat the effects of hypopigmentation. According to Dr. Urbanek, this compound causes the skin to produce melanocytes which in term create melanin and restore the skin's normal pigmentation.

Dr. Urbanek has seen improvements with using V-Tar in as little as eight daily applications. However, side effects of V-Tar include a burning sensation when exposed to direct sunlight. This can be mitigated with using a sunscreen. You can ask you doctor for V-Tar.

Ironically, when hypopigmentation results from skin resurfacing, the treatment could involve more laser resurfacing. In a study published in Dermatologic Surgery, Dr. James E. Fulton revealed his method for treating hypopigmentation that resulted from laser or chemical skin resurfacing.

Dr. Fulton gave 22 patients who had hypopigmented scars a pre-treatment with a vitamin A and glycolic acid lotion. Next, the patients received a series of laser and chemical resurfacing treatments. After the resurfacing treatments, researchers specially bandaged the treated hypopigmented scars and allowed them to heal.

At the conclusion of the study, melanocytes did return to the previously hypopigmented area and ultimately the skin spot blended with the rest of the skin's natural tone.

Preventing hypopigmentation and white scarring

Since hypopigmentation and white scarring have historically proven themselves difficult to cure, the best treatment is really prevention. You can help prevent hypopigmentation by properly bandaging deep wounds immediately after they happen. In the case of skin resurfacing, ask your health practitioner what steps she is taking to avoid post hypopigmentation and what you can do, in addition to wearing a good sunscreen, to prevent possible hypopigmentation.

Sources:

Norra MacReady. Tar Product Tackles Hypopigmentation Quickly. E-Skin and Allergy News: March 2002, Vol 33, no 3, p 39.

Fulton J.E., A.D. Rahimi; S. Mansoor; P. Helton; P. Shitabata. The Treatment of Hypopigmentation After Skin Resurfacing. Dermatologic Surgery. January 2004, Vol 30, no 1, pp 95-101(7).

By Naweko San-Joyz

The Best Natural Pimple Treatments

Consider cheaper, alternative, natural, effective treatment methods to get the best cure for your acne, zit, pimple or blackhead problem. The key to healthy, clear skin is to choose a skin care regimen that's right for you based on the type of acne condition you have. By their mid-teens, nearly 35% of teenagers have acne severe enough to require some type of treatment from a medical professional.

Nearly 17 million people in the United States have acne. In a survey conducted in Great Britain, 95% of 16-year-old males and 83% of 16 year-old females had acne. There are several different types of acne. People of all races and ages have acne.

Understanding that hormones may have some influence on the cause of acne is still being researched. If you've heard that dirty skin causes acne, it doesn't - it's a myth. The liver gets rid of toxins from bad food, drugs and chemicals and sends them through the skin resulting in eruptions, acne, pimples and other skin disorders.

Make sure not to use hot water on your face, always use lukewarm water. Shave carefully and try both electric and safety razors to see which works best for you. The treatment plan for acne includes trying to heal the pimples, stopping new pimples from forming, preventing scarring and helping reduce embarrassment.

Try applying a thin layer of coconut oil and massaging it deep into the skin to heal and soothe the affected area. Never underestimate the healing, restorative power of a good night's sleep. It bears repeating, you want to be good to your skin and never pop or squeeze a pimple no matter how tempting.

Too many chemicals can strip your skin of its natural oils and the skin will overproduce oil to compensate for it, blocking your pores and causing more acne. Try a diligent application of coconut oil several times a day and at bedtime to see the healing benefits. Coconut oil is one of the best, if not the best, treatments I've found for acne.

If you're going to buy acne products, it's much more worth your while to buy acne-treating products that work against current pimples and prevent the occurrence of new ones. It's always best to seek non-invasive and natural treatment for any skin condition. Acne and its treatment is one of the most misunderstood topics there is when it comes to acne skin care.

Coconut oil is very inexpensive; it's a good, cheap, natural home remedy. A new, non-invasive treatment using red light and blue light in combination has been extremely successful on severe acne.

When you change your diet, your lesions should start getting better within a week or two, with significant improvement the first month. People with skin disorders such as acne, rosacea, and psoriasis often suffer from constipation; if you are, make sure you're drinking lots of water every day and add more natural fiber from raw fruits to your diet. Whether you eat a natural diet of living fruits and vegetables or eat dead junk food, what you eat may have a direct or indirect affect on the male hormones which may or may not play some part in acne.

When your liver gets overloaded with toxins it'll send the toxins out through your skin as well as other organs of elimination. Drink lots and lots of pure, filtered water every day.

Eating foods with essential fatty acids are particularly important to people with dry skin or acne. For an easy fiber boost, mix in two tablespoons of ground up flaxseeds into raw applesauce, from two to three apples, made in your food processor. Concentrating on a diet, of mostly fruits and vegetables (preferably uncooked), and no junk food, should give you an observable improvement in your skin within 30 days.

Good clear skin is often a reflection of a good digestive system. Eat high-fiber snacks like raw nuts, raw seeds, fresh or dried fruit, such as dates, and figs.

Analyze all the acne treatments available and make the best decision for you, based on your circumstances. In any case, try not to panic about your acne and take it day by day. Acne prevention is always a better choice than having to search for the right cure.

By Helen Hecker