Modern View of the Etiopathogenesis and Classification of Acne Scarring

Scars are an urgent issue for many areas of practical medicine, especially for dermatovenerologists, cosmetologists and plastic surgeons. Every year, 100 million patients develop new scars and about 11 million of them are keloid. The issue of differential diagnosis of keloid and hypertrophic scars is still the subject of discussion among specialists. Despite the wide variety of available methods of treatment of keloid and hypertrophic – surgical excision, injections of glucocorticosteroids, laser therapy, cryotherapy, compression therapy and silicone bandages are the most effective and pathogenically rationalised methods for the correction of pathological scars. Promising methods of therapy are: injections of interferon, recombinant human TGF-β3 polypeptide, platelet-rich plasma, calcium channel blockers, lipofilling, the use of angiotensin-converting enzyme inhibitors, creams based on imiquimod and resiquimod, growth factors, stem cells. The article presents an up-to-date view on the processes of physiological and pathological scarring, the most important aspects of the differential diagnosis of keloid and hypertrophic scars, the understanding of which is important for choosing the right therapeutic strategy. Particular attention is paid to the pathophysiological mechanisms of action, the advantages and features of the use of silicone dressings. The authors present the clinical experience of successful two-stage correction of keloid scar – post-acne with the use of injection therapy with hyaluronidase and silicone dressings.

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Post-inflammatory hyperpigmentation post-acne: possibilities of topical therapy

Zhukova,

Ostretsova,

Kostetskaia

et al. 2024

Medicinskij sovet

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Post-inflammatory hyperpigmentation (PIH) is one of the most significant problems in patients with acne. The prevalence of PIH among patients with acne varies from 45 to 87%. Post-acne, including PIH, has an extremely negative impact on the quality of life and psychological well-being of patients, as it is often resistant to therapy and can persist for even several years. Successful acne treatment does not guarantee complete elimination of PIH and other post-acne symptoms. In the development of PIH, a key role is played by the mechanism associated with the production and distribution of melanin, which is activated by inflammation and the release of cytokines that promote an increase in the level of immunoreactive tyrosinase, which stimulates melanocytes, activation of melanogenesis and further transfer of melanosomes to surrounding keratinocytes. It is important for clinicians to recognize the psychosocial impact of PIH and manage inflammation, as well as proactively address residual PIH with appropriate treatment. Thus, prevention and correction of PIH should be one of the goals of acne treatment. Topical therapy for PIH in acne is considered the most acceptable and can be prescribed both as monotherapy and as part of combined methods. Tyrosinase is a target for topical anti-pigmentation agents, including hydroquinone, kojic acid, and resorcinyl thiazole derivatives. The latter includes isobutylamidothiazolyl resorcinol – thiamidol. The article provides a brief overview of data on the epidemiology of PIH, its pathogenesis, impact on the quality of life of patients and the perception of their image by people around them. Clinical experience with the use of anti-hyperpigmentation serum with thiamidol, licochalcone A and sodium hyaluronate is presented, which confirms the effectiveness, safety and feasibility of prescribing products with thiamidol for the treatment of PIH caused by acne.

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Modern View of the Etiopathogenesis and Classification of Acne Scarring

Cited by 5 publications

References 5 publications

Topical enzymatic therapy of atrophic acne scars

Topical enzymatic therapy of atrophic acne scars

Actual view on skin scarring and clinical experience of conservative treatment of keloids

Post-inflammatory hyperpigmentation post-acne: possibilities of topical therapy

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