24th International Congress of Aesthetic Dermatology and Anti-Aging Medicine
IADE 2024
AUTOR:
dr Agnieszka Gorna
paediatrician, aesthetic medicine doctor
Scar treatment – especially when scars are a significant source of stress and embarrassment for patients – is a major challenge for aesthetic medicine practitioners. Scars are not only physical changes in the skin but also a cause of deep insecurities, lack of confidence, poor well-being, and often even restricted mobility.
There is no effective method to completely remove an existing scar; however, most scars can be treated and their visibility, discomfort, and pain significantly reduced. Much depends on the patient’s age, general health, the size of the scar, and its type. Scars often result from untreated or improperly treated acne, mechanical injuries, burns, or surgical procedures. They are generally classified as atrophic or hypertrophic. Atrophic scars result from collagen loss, while hypertrophic scars are caused by excessive collagen production.
Depending on the type and location of scars, a wide range of treatments is available:
- microneedling,
- chemical peels (glycolic, pyruvic, or trichloroacetic acid),
- platelet-rich plasma (PRP),
- microneedle radiofrequency,
- ablative fractional laser,
- steroid therapy.
Platelet-rich plasma (PRP)
Platelet-rich plasma is a preparation obtained from the patient’s own blood. As an autologous and biocompatible product, it does not cause allergic reactions or skin irritation. Skin revitalization occurs through regeneration and biostimulation of skin cells driven by the patient’s own growth factors and mesenchymal stem cells (CD34+). The release of active growth factors is initiated during the blood clotting process and begins after activation.
What determines success in PRP therapy?
- First, whether the injected material is truly platelet-rich plasma (and not platelet-poor plasma).
- Second, whether appropriate tubes are used for plasma separation and whether the centrifuge parameters are correctly selected.
- Third, the injection technique. PRP is administered via needle mesotherapy, where—apart from the injected substance—the micro-injury itself stimulates regeneration.
Contraindications:
- active infections, hepatitis, HIV, HSV, syphilis,
- treatment with antiplatelet or anticoagulant drugs,
- autoimmune urticaria, delayed pressure urticaria,
- active autoimmune diseases,
- cancer,
- anemia (hemoglobin below 10 g/dl),
- thrombocytopenia.
PRP therapy requires a series of treatments to achieve satisfactory results. The number of sessions and intervals between them are determined by the physician based on treatment progress, although a minimum of three sessions is typically recommended.
Microneedle radiofrequency
One of the most advanced therapies used in aesthetic medicine, including scar treatment, is microneedle radiofrequency. This method uses radiofrequency energy delivered deep into the skin via micro-needles. As a result, collagen and elastin production is stimulated, leading to tissue regeneration and improved skin structure.
The radiofrequency energy creates controlled micro-damage in the tissues, which triggers natural repair processes. At the same time, increased collagen production helps fill in scars and skin irregularities, resulting in smoother skin.
Microneedle radiofrequency is an innovative method for reducing various types of scars, particularly acne scars, post-surgical scars, and post-traumatic scars. Treatment outcomes depend on the type, thickness, and location of the scar. The procedure can lead to a noticeable improvement in skin appearance, increased elasticity, and – most importantly – a reduction in scar visibility.
Medication Discontinuation Before Procedure
| Medication | Discontinuation Time Before Procedure |
|---|---|
| Abciximab | 48 hours |
| Eptifibatide | 4–8 hours |
| Tirofiban | 4–8 hours |
| Heparin | 2–4 hours |
| LMWH (Low Molecular Weight Heparin) | 10–12 hours (prophylactic dose) |
| Rivaroxaban | 22–26 hours |
| ASA (Aspirin) | 8–9 days |
| Clopidogrel | 7 days |
| Ticagrelor | 5 days |
| Warfarin | 4–5 days |
| NSAIDs | 24 hours |
| Prasugrel | 7–10 days |
