“How to Treat” series No. 2 What is a ?

A scar may be defined as a mark left on the skin after significant injury or trauma has occurred. Damage to the creates a deep structural change where fibrous tissue replaces normal tissue, affecting the texture and tone of the above. Very superficial damage only to the epidermis however does not result in the formation scars.

Scarring is indicative of a defective wound healing response and can affect any skin type, color, heritage or condition. Every significant wound or skin trauma results in scarring to some degree; the greater the initial damage and the more defective the wound healing response, the greater the scar size and appearance becomes. Scar tissue is not just restricted to the face and can affect anywhere on the body.

Scars may be categorized into 3 types:

1. Atrophic - depressed / indented 2. Hypertrophic / - raised 3. Contracture / Burn - fused

1. 2. 3.

What forms of scars are microneedling treatments effective for?

Microneedling is suitable for the treatment of all scars

• Post-acne • Post-surgical • Rolling • Boxcar • Icepick • • Hypertrophic • Keloid • Contracture How do microneedling treatments provide effective results for Scars & Striae?

Microneedling treatments work in three ways to reduce the appearance of scars and :

1. Release and break down existing fibrous tissue via mechanical methods. 2. Promote the growth and proliferation of regulated tissue via the release of regulatory growth factors and normalized wound healing. These include transforming growth factor (TGF) and firoblast growth factor (FGF) 3. Enhance the infusion of active drugs and chemical resurfacing mediums to accelerate treatment results. These can aid further stimulation of collagen or provide a regulatory effect.

Before After 3 Treatments *Courtesy of Dr Hasan El-Fakahany (Egypt) 3MD Clinical Treatment Protocols

Technique: 3 passes in 3 different directions over the affected areas. May require more passes Tx Course: 4-6 treatments Tx Endpoint: Pinpoint Bleeding - scars with color including skin colored Blood drops (more bleeding) - white scars Tx Intervals: 6-8 week intervals Tx Follow-ups: 6-8 week intervals as required

Keloid scars require specialized attention and must only be treated by an experienced practitioner

Procedural Requirements - Dp Dermaceuticals™

Pre-Op Prep: Tri-Phase Cleanser™ Tx Medium/Meso glide: Hyla Active™+ Retinal Active™ mix = Hyla-Retinal Mask: Hyla Active 3D Mask™ Post-Op Care: Antioxidant Cocktail™ followed by Vitamin Rich Repair™ Camouflage: Cover Recover™ in the appropriate shade

Combination Therapy Options:

• Dp Cryo (atrophic or anetoderma scars only) Use post needling on affected tissue • Chemical peels (atrophic or anetoderma scars only) Use post needling • PRP - Use During treatment. Apply first and needle over the top • Topical anti-mitotic (fluorouracil / 5-Fu) infusion (Keloid scars only) • Steroid injections (hypertrophic or keloid scars only) Before After 1 Treatment *Courtesy of Dr Abbas Al-Taiff (Australia)

Dp Dermaceuticals - Pre / Post-Op & Maintenance

Every day regime for 2 weeks prior to treatment and 5 days post treatment: Cleanse: Tri-Phase Cleanser™ Morning: Antioxidant Cocktail™ or Brite Lite™ for pigmented scars Evening: Retinal Active™ Moisturize: Vitamin Rich Repair™ Protect: Cover Recover™

2-3 times per week: Micro Derm Exfoliant™ + Hyla Active™ 3D Mask (face only)

Before After 3 Treatments *Courtesy of Dr Hasan El-Fakahany (Egypt)