Effect of retinoic acid on hypertrophic scars

[bpb]

Hello.

I'm little confused about using retinoic acid as a treatment for scars, especially hypertrophic ones. It seems that skincare professionals rarely recommend retinoic acid for any scar treatment, saying that it increases production of collagen and may make the situation even worse.

On the other hand, I have found scientific papers about trials on using different substances (retinoic acid, bleomycin, 5-fluorouracil, etc..) on scar treatment. There are claims that retinoic acid may actually shrink hypertrophic or even keloid scars, improving color and texture.

People on this forum are using retinoic acid and Infadolan containing retinyl acetate together with needling, but should they only be used with scars that do not have excess collagen like hypertrophic scars?

Thank you.

[SarahVaughter]

There are several studies concerning retinoic acid and hypertrophic scars and keloids. Unfortunately in many cases you have to pay for the study to view them.

     

  The local treatment of hypertrophic scars and keloids with topical retinoic acid

  A. M. P. JANSSEN DE LIMPENS

   

  SUMMARY

  “In a clinical trial twenty-eight intractable cases with scars were treated with daily applications of a 0.05% solution of retinoic acid.

  The results were evaluated objectively and subjectively. Slight to marked reduction of the size of these scars and decrease of such complaints as itching were noted in the majority of the cases. A favourable result was obtained according to the patients in 79%, and according to the opinion of the medical examiner in 77% of the patients.”

     

  Selected therapeutic applications of topical tretinoin.

  Haas AA, Arndt KA

 

Abstract

  “Since topical retinoic acid was first used for acne in 1959, many additional uses have been described for lesions on the skin, oral mucosa, and ocular surface epithelia. The topical application of retinoic acid has been shown to be effective in the treatment of several disorders of keratinization, keloids and hypertrophic scars, and various infections and inflammatory, pigmentation, and malignant and premalignant disorders. This article briefly reviews the use of topical retinoic acid for selected cutaneous conditions”.

   

      Scar tissue contains the same collagen as scar-free skin but the collagen fibers are differently aligned.

  Vitamin A is essential for normal activity of skin cells.

  Vit. A  increases neovascularization of the dermis which could improve the scar since scars tissue is typically badly vascularized.

  Vit. A  also increases skin cells mitosis and thus acceleration skin´ s renewal which might contribute to the improvement of a scar tissue.

  The effect of vit. A is actually not yet fully understood but in a way it “normalizes” skin.

   

SUGGESTED TREATMENT:

 

Needle the scar (once a month) and apply A-Ret immediately after. Continue applying A-Ret.

  Combine it with the pressure massage. Apply pressure with your fingers onto the scar for approx. 20 seconds, spot by spot. Repeat daily.

[kyrakitty]

Hi Sarah,

Can I add Kelocote to the following steps:

• Needle the scar (once a month)
• Immediately after apply pressure with your fingers onto the scar for approx. 20 seconds, spot by spot. Repeat daily.
• Immediately after apply A-Ret (Continue applying A-Ret nightly)
• Apply Kelocote last

[kyrakitty]

Hello,

I have 2 derma rollers I purchased with here along with lidocane and the retin A and also the vit A ointment.  Hope to learn if I can add kelacote as described above.  I have very large scars I want to work on after having my implants removed when they gave me a breast lift.  They look bad but they have gotten a lot better than they did 2 years ago after the surgery.

Thanks

[SarahVaughter]

I answered you yesterday but I have accidently posted it somewhere else.

Yes, you can combine the A-ret and silicone.

If you want to apply it right after needling, a silicone sheet is a better idea than a silicone cream (kelo-cote) because it is not a good idea to get silicone into your bloodstream (which may happen in case of silicone gels or creams. Normally, the skin is impermeable for most substances, including silicone but needling will enable the substances to penetrate.

The effects of silicone should be limited to the skin's surface and there is absolutely no reason to be getting it deep into the skin.
 
You can start applying a silicone gel or cream a day after needling.

https://http://forums.owndoc.com/dermarolling-microneedling/kelo-cote-cream-for-hypertrophic-scars

[kyrakitty]

Wow, thank you Sarah.  I would have never thought about the silicone going into my blood stream.  I definitely don't want that in my system.  If I use it after I roll I will use the silicone sheets.