Tom_Mason

Scarless Healing

6,960 posts in this topic

its never going to come out, sorry guys , going to end it.

It would be unwise to take your own life when we are so close to achieving a cure. An issue like this is not even worth you killing yourself over. Life is so much more than your skin. You have a lot to look forward to. Pick yourself up. Look at your calender. 2018. That is how long you have to wait. That is it. Live your life. Do not let something as stupid and pointless as scarring get in the way of your being happy. Screw scars. You are more than your skin, and you are not going to let something like this drag you down. Do not just "hang in there." Pull yourself up and go live life.

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Golfpanther and bozo, your main debate is actually that for bozo: you belive that atrophic scarring lack of any tissue... so while DE is an ECM it can be injectible and simply fill the void . That is where i disagree with you... Atrophic scar cannot regenerate because it HAS a scar tissue of a certain area which prohibit regeneration...

the only way to remove the scar is cut out an area of scar tissue, not just inject an ECM

Just imagine that scar tissue is like a wall, blocking air. In this case, air is our normal skin cells..

The only way for air to circulate is remove the wall, not make a small hole in the doror

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There is so much misinformation on this page . . .

I would implore everyone on this forum, as well as guests to this forum to only take heed of posts that actually utilize verified scientific information, sources, and common sense. On this page, golfpanther is about the only one that is on the right track. However, golfpanther, allow me to pose my counterargument.

Golfpanther and everyone, i may have an opinion to reply Bozo as stated in my second last post, but bozo there stated that atrophic scars are different than hyperthropic and keloid scars...

We all should reconsider about this.. even if hydrogel works, our acne atrophic scar may not get the same result im afraid

What do you guys think?

It's something to think about but immaterial to how the dextran hydrogel would function and be used (at least based on the trials with mice, which we're all familiar with).

The only way the dextran hydrogel works is to create a wound bed through excision or dissolving the scar tissue. At that point, the type of scar that it was (since it has now been removed from the body) is irrelevant. The dextran hydrogel would then be placed on the new wound bed that had been created and allowed to do its work.

Hopefully, it would then interfere with the normal scarring pathway for human healing and lead to a path of regeneration. It's not used as an injectable into already existing scars; it needs a wound bed to function properly. Just look at the original research paper; the investigators didn't scar the mouse, wait for scar tissue to form and then inject the hydrogel into the scar. They burned the mouse, removed the damaged tissue and then place the dextran hydrogel over the wound bed. We can assume the same methodology would be applied to humans if its found to be effective in our species.

Golfpanther, I think you slightly misunderstood my theory, and perhaps are not aware of the differences between different types of scarring. While I appreciate your speculation, arguing that it cannot be used as an injection because it can't does not seem particularly reasonable. Granted, my theory is just a theory, so let me again clarify why I think that DHG could be used as an injection.

Firstly, understand that the fundamental difference between a hypertrophic scar and an atrophic scar is that hypertrophic scars are the result of an over expression of collagen in response to injury, while atrophic scars are the result of an under expression of collagen due to internal damage of the ECM, and incomplete healing. Therefore, your statement about DHG only working after the scar tissue is excised or dissolved, while true in hypertrophic scarring, is not true to the type of scarring that we are talking about. The reason for this is that atrophic scars do not possess any actual scar tissue, and so there is nothing there to dissolve. And consider, just because the researchers applied DHG a certain way in the original research paper, does not mean that that particular method is the only one that is effective. Many different treatments and medicines have multiple ways that they treat an issue, and multiple ways that they can be used. The only reason, to the best of common knowledge, that DHG is not effective when applied directly to hypertrophic scar tissue is the same reason why any treatment is not effective when applied directly to hypertrophic scar tissue: the over expression of dense collagen fibers prevents regenerative cells from penetrating into the tissue. This is why I theorize that DHG, when injected into atrophic scarring, which possesses no over expression of dense collagen fibers, could be effective in treating the "scar."

I appreciate all the factual information you are presenting and think it's helpful to talk about these things. However, I've talked to Guoming Sun (one of the author's of the original dextran hydrogel paper) and he assured me that you need a wound bed for DHG to work.

It's designed to take the normal healing response (scarring) and interfere in such a way that guides it more toward regeneration. Without the healing process being initiated the growth factors, fibroblasts, neutrophils and everything else won't be recruited to the site.

If you were to inject dextran hydrogel into an already formed scar, nothing would happen; or at least not a reversal of the scar tissue into regeneration. The reason is that since it's a wound scaffold it merely interacts with the natural healing mechanisms of the body. It doesn't send signals to the body to change the composition of scarred skin (i.e stop producing too much collagen or produce more depending on the wound type).

There is other research into ways to reverse already scarred tissue into perfect skin without excision, but the dextran hydrogel is not in that camp (this is one of the reasons it can be considered a device because as a scaffold it's not require a chemical action on its behalf—you would almost certainly need a catalyst coming from the treatment itself with an injectable as you described). The lack of active component means it can get to market to us sooner because you don't have to make sure the active component isn't also doing something terrible to your patients outside of what's being tested like say, forming a tumor, which is why anything with stem cells will take a long time.

Again, all of this is great information but the dextran hydrogel needs a wound bed to function as intended (at least for now and as far as I can tell it will remain that way). It requires excision or some other process to remove the scar completely in order to create said wound bed to allow the dextran hydrogel to guide the healing process toward regeneration. Trust me, I wish excision, debridement or nasty peptides that dissolve scars wouldn't be necessary for me to get regenerated skin. But for this method at least, that's what we have.

Edit:

One last thing, a while ago now I reached out to Erkki Ruoslahti (the leader of researcher into CAR-decorin) and he said pretty much what I said about his research:

"We make CAR-decorin in cultured cells. We have not tested CAR-decorin in old scars, mostly because there is no reason to expect that it would work. If the scar is first surgically removed, decorin should prevent the formation of a new scar, but we have no data on that." - Erkki Ruoslahti

The key part there is "there is no reason to expect that it would work" in regards to using it on an old scar without excision. Again, most of the research into the idea of complete regeneration is built on the need for a wound bed.

While you are correct on most all fronts, I believe you are still failing to make the distinction between atrophic scarring and hypertrophic scarring. Things become rather confused when we refer to both responses to injury simply as "scars," so I would remind you that atrophic scarring is not scar tissue, but rather it is the absence of scar tissue, as well as the absence of proper healing. Hypertrophic scars contain scar tissue, while atrophic scars do not.

Concerning the wound bed problem, while not completely sold to the concern as I have not seen any legitimate evidence that would provoke it, I have considered this. I believe you are not realizing a fundamental piece of my argument. Under my theory, a wound bed would be created: The wound from the injection. At the very least, utilizing the modality of treatment I have posed, small, deep scars (which are what most people with acne scarring deal with) could be treated using an injection of DHG into the center of the depression. The damage of the needle penetrating the skin would provoke a healing response, and then the injected DHG would take over from there.

I believe that, and correct me if I'm wrong, that "growth factors, fibroblasts, neutrophils, and everything else" do not simply lay dormant in reserve somewhere in the body. One would think that they are all around, circulating, and constantly changing. In fact, fibroblasts are found in shocking numbers throughout the body. Thus, even without the injection-induced wound, regenerative cells would still utilize the synthetic scaffold, perhaps to a lesser degree than if they were being motivated by injury, but nonetheless, they would find themselves along the scaffold.

While anything is possible, I unfortunately do not believe that the injection of DHG could be used to treat large areas of depression. It would be most effective, even if uncomfortable, to excise the afflicted area, and then apply DHG. However, luckily, many of us simply deal with small icepick scars.

And concerning decorin, firstly, understand that there is a bit of a distinction to be made here. CAR-decorin is a specialized type of decorin that is being researched, and is independent to conventional decorin and its research. Regarding Erkki Ruoslahti's statement, I should not have to point out why it is moronic and not applicable to argument. It simply states that they have not tried it on existing hypertrophic scars, and do not intend to. This does not in any way support arguments against its effectiveness. In fact, I would say that if anything, it supports arguments for its effectiveness. There is no possible way for them to know whether or not it would work on chronic scarring until they test it, and given the current evidence that indicates that it would be effective on chronic scarring, we can safely theorize that it would be effective on chronic scarring. Welcome to science. And in case anyone needed further convincing: http://www.ncbi.nlm.nih.gov/pubmed/24384090

Allow me to write out the title of the paper:

"Decorin blocks scarring and cystic cavitation in acute and induces scar dissolution in chronic spinal cord wounds."

"Induces scar dissolution in chronic spinal cord wounds."

An excerpt from the abstract, " . . . in chronic lesions, Decorin-induction of tPA and MMP (concomitant with reduced complimentary levels of TIMP and PAI-1) leads to dissolution of the mature established scar by fibrolysis." In other words, and I cannot emphasize this enough, do not blindly follow those who utilize, and do not find yourself utilizing, questionable, circular, "it is this way because it is" reasoning, even if the person utilizing this reasoning is a professional. Regardless of profession, many people are simply incorrect. This way of thinking inhibits progress.

All good stuff, but I think you're getting hung up on types of scarring and as I've said repeatedly that is of little material importance to how the dextran hydrogel works.

In your theory (injecting the material into the scar and creating a wound via the injection itself) I guess it's conceivable that it could work but I see one major problem; the surrounding tissue aside from that small injection would be scar tissue. Scar tissue blocks the body's normal flow and regulation of things that comprise healthy skin (e.g. decorin for example is found in far less in scarred tissue than it is in the rest of the healthy skin in the body). The surrounding scar tissue would hinder the body's (and it does with things like skin grafts currently for example, which is one reason why the entire area is debrided) ability to recruit the things needed in a normal wound response that would allow the hydrogel to do its work.

Atrophic scars typically result from a loss of fat and muscle (hence their depressed appearance). There is nothing in the present research with the dextran hydrogel that indicates an injection (even with the creation of a small wound bed) would provide complete regeneration. Sure, we can get into conjecture about what might be possible, but I fail to see what good that will do. Would an injection be preferable to excision, debridement, lasers etc.? Heck yes, but the dextran hydrogel gives no indication that it is such a treatment.

On decorin, scar dissolution in a spinal column is not the same as complete regeneration in the skin. Human skin (and the healing process of it) is one of the most complex organs in the human body. Skin has appendages like hair, sebaceous glands, sweat glands so merely dissolving the scar tissue wouldn't automatically equate to complete regeneration. I'm not downplaying the importance of the research paper you linked in terms of what it can do for spinal cords, but making the assumption that two very different parts of the human body would react identically to the same treatment is too far a reach. That's not science, it's conjecture—science would require actually testing the hypothesis you presented. And Ruoslahti didn't merely say they hadn't tried it, but instead said, "there is no reason to expect that it would work." In a perfect world there would be limitless resources and everyone could try everything. But Ruoslahti (like all scientists) is building his research on expectancies that have been forged from previous work and with skin at least the implication seems to be that you need a wound bed in order to steer the body toward regeneration.

I agree that it's good to question assumptions by peope in authority like Ruoslahti. However, I also feel like reaching for conclusions that lack (at present) empirical evidence can be just as much a hindrance to advancing things further. Bottom line, what difference does it really make? If after excision and application of the hydrogel you get complete regeneration (regardless of what type of scar was removed) then everyone on this board would have gotten exactly what they wanted, no? Sure, if an injectable comes along later everyone would jump at that, but the DHG we've come to talk about so much on here has no evidence to support it will be that treatment. Things could change, but if it works, it works. Cut out that scar and slap it on there!

We're both on the same team here, but I just don't see the point in talking about hypotheticals when it comes to how the dextran hydrogel might work or could work in the future as an injectable. I'd rather just stick with what we have at our disposal. Now, if I was myself a researcher in this field I'd probably be the first to jump in with both feet toward a more consumer friendly method of application (e.g. one that didn't involve cutting big chunks of skin off). But as I'm not, I'll just do my best to keep up with the literature that's being presented in journals and if DHG works, I don't really mind having to go through excision.

I agree, we are on the same team. I also agree, what is said on this forum, in reality, has no impact on the development and treatment methods of DHG. I am more concerned with the people of this forum understanding the pathology of their condition. It is a dangerous thing for desperate people to possess misinformation. And yes, I am getting caught up on the different types of scarring, as the differences are fundamental to my theory, and I fear that you still are not understanding why.

"I guess it's conceivable that (your theory) could work but I see one major problem; the surrounding tissue aside from that small injection would be scar tissue." Remember, we are talking about atrophic scarring here, which is the absence of tissue, including scar tissue. Atrophy does not inhibit regeneration as hypertrophy does, as there is no over expression of collagen. Atrophy is merely not capable of regenerating without provocation. The difference must be understood here. The only reason that atrophy does not regenerate is due to the loss of a native scaffold for cells to utilize (excluding cases of fat loss). This is why I believe that my theory, even without a wound bed, could be plausible. We are not talking about hypertrophic scarring that inhibits regeneration. We are talking about atrophy that simply requires an ECM to provoke healing. As to the science behind the theory, I am not basing my theory off of the indications of DHG itself, what is known about it, what its researchers know about it, or how it is conventionally utilized, as you seem to imply. I am basing my theory off of an understanding of how a synthetic ECM works. And that is what DHG is: a glorified synthetic ECM. It is not some newfangled technology. ECM's have been around for decades. DHG is simply a more effective ECM than we have seen in the past.

"Atrophic scars typically result from a loss of fat and muscle (hence their depressed appearance). There is nothing in the present research with the dextran hydrogel that indicates an injection (even with the creation of a small wound bed) would provide complete regeneration. Sure, we can get into conjecture about what might be possible, but I fail to see what good that will do. Would an injection be preferable to excision, debridement, lasers etc.? Heck yes, but the dextran hydrogel gives no indication that it is such a treatment." 1.) It is my understanding that, save for severe cases, atrophic scars such as those seen in cases of acne scarring result primarily from a loss of collagen due to damage of the native ECM. I just wanted to get that out of the way. 2.) Correct, within the single research paper published that pertains to DHG, they did not test nor mention DHG as an injection treatment. This does not mean it is not plausible. Again, working off of an understanding synthetic ECM's and prior research about them, we can safely theorize that DHG could possibly be used as an injection treatment. We do not say this because of what is known about DHG in and of itself, but rather because of what is known about ECM's as a whole. 3.) Yes, as I have mentioned, in the interest of not placing all of my chips on an untested theory, I do not pretend to know that DHG used as an injection would 100%, undoubtedly elicit complete regeneration. But I do not pretend to know that it cannot. And if it could only achieve some amount of regeneration, then I believe this would still be a useful and preferable method to those whose scarring is not particularly apparent. As you said yourself, injection would be preferable to other forms of treatment. A compromise between regeneration and comfort would most certainly be an option for some. This is assuming that DHG, when injected into atrophy, would not provoke complete regeneration. 4.) If you fail to see the benefit of conjecture about what might and might not be possible, then I question your purpose for being on this forum.

As for decorin, I will not go too deep into the subject, as I do not particularly concern myself with it. You state that it is a far reach to assume that decorin could have the same effect on external scar tissue as it does on internal scar tissue. Again, you fail to understand the pathology of the condition. Scar tissue, at large, is scar tissue. Scarred skin is not even actual skin. It is made out of the same stuff (albeit a different kind of the same stuff), which is collagen, but lacks the same properties, purposes, and functionality as skin. I do not know how much you actually read of the research paper on decorin that I posted, but if you read thoroughly and possess an understanding of scar tissue, you will see that the scar tissue that was treated in the spinal cords of the test subjects is the same scar tissue that can be found externally among skin. Scar tissue is scar tissue. It is an over expression of collagen, independent to where it is found on or inside the body. Thus, it can only be assumed that decorin would have a beneficial effect on scarring of the skin.

Several times, you have cited a lack of empirical evidence, but this is simply not true.

Okay, I like a lot of your points, but since the DHG as used resulted in complete regeneration in mice that is the model I'm working off. Some benefit from injection is not the same as what most of us want from the hydrogel. Marginal improvements exist in other treatments and if someone wants that, more power to them. But what got everyone so excited was that DHG was capable of providing complete regeneration in a mammal. I don't think many of us here would be pleased with a compromise between regeneration and scar tissue when it comes to the DHG.

On conjecture, if any of us were in a position to take the basis of our conjecture and test it as a hypothesis, I'd be all for that on this board. However, as far as I can tell none of us have that ability, so for any of us to make assumptions about how one treatment might work with a different methodology (e.g. excision vs. injection) seems to sway the board away from its most positive attributes (e.g. the combined efforts of posters to link to tested, provable and vetted research and keep each other informed).

I can make a guess that something might work a different way, but that just shifts focus from the facts we have at our disposal. Now, if we were to write the researchers currently working on the issue and suggest injection, I think that would have more merit because they're the ones with the know-how and resources to test it and potentially make it a reality. But on a board like this I fail to see how it provides anything of tangible import and just distracts from what has been proven to this point.

On scar tissue in general, just because the body's response to injury produces the same scar material in all parts of the body doesn't automatically equate to one treatment providing the exact same therapeutic benefit across all tissues. Scar tissue might be the same, but what comprises healthy skin is not the same as what comprises a healthy spinal column. So sure, you may break down the scar tissue using the decorin for any part of the body, but that doesn't necessarily compute to complete regeneration in skin. Your focusing solely on the nature of the scar tissue (and how it's the same throughout the body) instead of acknowledging the differences that exist between all the types of healthy tissues found in the body. Might it be beneficial? Sure, I'd agree with you there. But complete regeneration is what I thought this board was discussing in terms of the DHG.

And the paper doesn't say that decorin gave back 100% healthy spinal cords or that it even elimiated scar tissue completely. It says it attenuated the scar tissue. Attenuation means a thinning or weakening, not absolute destruction of the scar tissue with complete regeneration back to the spinal cords normal tissue. Again, benefit is possible, but not the same as what this board is really looking to achieve; at least from what I understand of this board, correct me if I'm wrong. It's called scarless healing, which is open to a lot of scrutiny. Perhaps a new board should be made just for things that implicate complete regeneration.

For me, being on this board isn't about playing an armchair scientist; it's about sticking to the facts as we know them from published papers written by reputable researchers like Gerecht's team at JHU. That's why I just reference the original paper and the methods used therein. Making guesses about how something might work, or work for the most part, with a different application process without the ability to provide meaningful data just ends up clogging up the board IMO.

Edited by golfpanther
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its never going to come out, sorry guys , going to end it.

It would be unwise to take your own life when we are so close to achieving a cure. An issue like this is not even worth you killing yourself over. Life is so much more than your skin. You have a lot to look forward to. Pick yourself up. Look at your calender. 2018. That is how long you have to wait. That is it. Live your life. Do not let something as stupid and pointless as scarring get in the way of your being happy. Screw scars. You are more than your skin, and you are not going to let something like this drag you down. Do not just "hang in there." Pull yourself up and go live life.

Now to 2018 is exactly the same as 1 round worth of college

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Golfpanther and bozo, your main debate is actually that for bozo: you belive that atrophic scarring lack of any tissue... so while DE is an ECM it can be injectible and simply fill the void . That is where i disagree with you... Atrophic scar cannot regenerate because it HAS a scar tissue of a certain area which prohibit regeneration...

the only way to remove the scar is cut out an area of scar tissue, not just inject an ECM

Just imagine that scar tissue is like a wall, blocking air. In this case, air is our normal skin cells..

The only way for air to circulate is remove the wall, not make a small hole in the doror

Thecureforscars, in the interest of allowing you to understand the pathology of your condition, allow me to yet again explain:

Hypertrophic scarring does in fact possess this "wall" as you describe it. This is what is medically known as scar tissue, or an over expression of collagen in response to healing. This dense deposit of collagen prevents cells from mobilizing into the wound site and repairing damage. Atrophy, however, does not possess any scar tissue. It is categorically an absence of tissue, including scar tissue. This is why I do not like to refer to atrophy as "atrophic scarring," as this perpetuates confusion. Theories aside, as I think both Golfpanther and I have made our points, this is a scientific, medical, and undeniable fact of atrophy. I just wanted to clear up any confusion that you might be experiencing on the subject.

And yes, I can relate! By the time I get out of college, DHG should be on the market, or very nearly there. Though, I suspect by then, I will not care very much, as I will be more concerned with devoting finances to my future family. I think the issue will become less and less pressing for me as my life unfolds. I can rest assured knowing that my kids will never struggle with acne or scarring due to developing treatments, and that they will be some fine mamajamas.

Edited by Bozo

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The resveratrol I bought failed to make a noticable improvement.

But there is still hope. I have done additional research and ordered something different that I have great faith will work. If so, I'll be able to confirm this within 2-3 days.

Watch this space.

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The resveratrol I bought failed to make a noticable improvement.

But there is still hope. I have done additional research and ordered something different that I have great faith will work. If so, I'll be able to confirm this within 2-3 days.

Watch this space.

Thanks for your efforts

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Looks like my order will arrive a bit later than expected. I had thought it would reach me either yesterday (wednesday) or today (thursday) but it didn't so I'm hoping for tomorrow friday instead. If I'm very unlucky I might have to wait until next week (monday or tuesday).

If the thing I've ordered does work to treat my hypertrophic scars, partially or completely, I will link to the product here.

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Article just published today:

http://health.ucsd.edu/news/releases/Pages/2014-11-20-wnt-signaling-and-cell-reprogramming.aspx

"While investigating a rare genetic disorder, researchers at the University of California, San Diego School of Medicine have discovered that a ubiquitous signaling molecule is crucial to cellular reprogramming, a finding with significant implications for stem cell-based regenerative medicine, wound repair therapies and potential cancer treatments."

...

"We’ve shown that WNT signaling is required for cellular reprogramming,” said Willert. “Some of the processes that occur during cellular reprogramming resemble those that occur during regenerative processes and wound repair. For example, limb regeneration in organisms like axolotl and zebrafish require cells at the injury site to de-differentiate (change their function) and then rebuild the damaged tissue. WNT is essential for these amazing regenerative processes."

Edited by cycloverid

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Has anyone heard of Interleukin-10? I was reading the abstract from an article from earlier this year that I hadn't seen yet. (Unfortunately the full text requires you to fork over cash).

http://online.liebertpub.com/doi/abs/10.1089/wound.2013.0461

Quotation: "Efforts to develop IL-10 as an anti-scarring agent have demonstrated promising results."

Here's another one from the same journal in case you're curious:

http://online.liebertpub.com/doi/abs/10.1089/wound.2013.0471

As I said, the full text requires you to pay, and I'm not advertising for you to pay, but even the abstracts are interesting to read.

I also did a search and found that someone was talking about IL-10 back in 2008:

Edited by cycloverid

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If the DH is supposed result in scar-free healing, why does Gemstone feel that by incorporating growth factors and/or stem cells it will further enhance cell recruitment and vascularization to improve wound healing? I suppose they are referring to large and / or chronic wounds as opposed to acute wounds, the latter of which would result in scar-free healing with just the use of the DH alone.

Edited by ujb1

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If the DH is supposed result in scar-free healing, why does Gemstone feel that by incorporating growth factors and/or stem cells it will further enhance cell recruitment and vascularization to improve wound healing? I suppose they are referring to large and / or chronic wounds as opposed to acute wounds, the latter of which would result in scar-free healing with just the use of the DH alone.

Well, some of this has to do with Gerecht's lab and their initial aims for the research. Originally, the dextran hydrogel paper for which we are all now acutely aware of, wasn't expected to give complete regeneration in a mouse. Their findings were a complete shock because they hypothesized going into the study that it would achieve better results than the control and other existing methods, but nothing close to complete regeneration.

The idea all along was to test out the DH, see how well it performed and then introduce stem cells and other growth factors to improve it. But you can't really improve on complete regeneration so that kind of put everything into a state of flux, because they weren't (and to my knowledge, still aren't) sure of how the DH worked so well.

As you said, I think part of why they're moving ahead with that is for hard to heal wounds that might need something extra to get the desired result and also because that was the through-line of the research all along. But they are still testing the DH by itself without anything added so it seems we're still on track.

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So, what's it looking like, then? Three years at the earliest? I wonder how long it'll take for it to hit the market after the first human trials in mid-late 2016.

One concern that I have the DHG is that, if the existing acne scar must be excised before DHG is administered, then that will get very expensive very fast. For example, I have well over 50 scars on my face. At $250 per excision (which is generous), that's at least $12,000. This doesn't even factor in the cost of the hydrogel itself. Not to mention the downtime and physical pain that would accompany so many excisions. One could pick and choose which scars would be excised, but it almost doesn't seem worth it.

I wonder if it's possible to utilize the hydrogel in a different way but still get results. I mentioned injection before. That could potentially be beneficial for scars, provided the wound bed created by the needle is severe enough to warrant a sufficient wound repair response. Perhaps a laser could be utilized before administering the hydrogel. I'd imagine that would work to an extent, even if it doesn't achieve 100% improvement. I'd rather have 70% global improvement at $3,500 than 100% improvement on isolated scars at upwards of $12,000.

Yeah, I think light/laser treatment followed by hydrogel treatment is the best bet if injection isn't effective. Injection would certainly be the cheapest, most ideal option.

Another issue will be actually finding doctors that will be willing to use hydrogel on their patients, let alone for acne scar treatment. As far as I know, the hydrogel's current purpose is primarily to treat wounds, not get rid of scars. Someone would have to convince a doctor to try something new (which doctors are not very fond of). And, like I said, the most effective method of administering the hydrogel would have to be discovered, whether it be after excision, laser treatment, or through injection. Then, we'd have to convince a doctor follow this course of treatment. I'd imagine it would be difficult to find a willing doctor locally for many of us, so travelling out of the area would most likely be required. However, this time away coupled with the downtime from the treatment may not be acceptable as many of us have jobs and other responsibilities.

There are definitely some obstacles. What do you guys think?

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So, what's it looking like, then? Three years at the earliest? I wonder how long it'll take for it to hit the market after the first human trials in mid-late 2016.

One concern that I have the DHG is that, if the existing acne scar must be excised before DHG is administered, then that will get very expensive very fast. For example, I have well over 50 scars on my face. At $250 per excision (which is generous), that's at least $12,000. This doesn't even factor in the cost of the hydrogel itself. Not to mention the downtime and physical pain that would accompany so many excisions. One could pick and choose which scars would be excised, but it almost doesn't seem worth it.

I wonder if it's possible to utilize the hydrogel in a different way but still get results. I mentioned injection before. That could potentially be beneficial for scars, provided the wound bed created by the needle is severe enough to warrant a sufficient wound repair response. Perhaps a laser could be utilized before administering the hydrogel. I'd imagine that would work to an extent, even if it doesn't achieve 100% improvement. I'd rather have 70% global improvement at $3,500 than 100% improvement on isolated scars at upwards of $12,000.

Yeah, I think light/laser treatment followed by hydrogel treatment is the best bet if injection isn't effective. Injection would certainly be the cheapest, most ideal option.

Another issue will be actually finding doctors that will be willing to use hydrogel on their patients, let alone for acne scar treatment. As far as I know, the hydrogel's current purpose is primarily to treat wounds, not get rid of scars. Someone would have to convince a doctor to try something new (which doctors are not very fond of). And, like I said, the most effective method of administering the hydrogel would have to be discovered, whether it be after excision, laser treatment, or through injection. Then, we'd have to convince a doctor follow this course of treatment. I'd imagine it would be difficult to find a willing doctor locally for many of us, so travelling out of the area would most likely be required. However, this time away coupled with the downtime from the treatment may not be acceptable as many of us have jobs and other responsibilities.

There are definitely some obstacles. What do you guys think?

The cost of the procedure when using excision is definitely something to think about. It's not going to be cheap since you'd need an anesthesiologist and a surgeon of some kind. Given the nature of removing scars with precision (as would be needed on the face) I'm guessing they would require some training that would increase cost. Still, while it's a hurdle it will be overcome due to how much money could be made. Driving down costs to make it more affordable to a greater number of people (especially with something so many would want) is inevitable, but yes, it might take some time.

While it might vary in some areas, I don't see it being too big of an issue finding a doctor if the results are the same in humans. Yes, as I wrote above I think they'd need some specialized training, but if you're a dermatology office that's already doing scar revision surgeries, which require excision, then you're already set up to implement something like this. The potential revenues would make it a no brainer.

One thing that is genuinely odd (at least to me) about the medical community is how little doctors seem to know about the research that is going on. So Gemstone will likely need to be active and effective with their marketing in order for the product to reach the ears and then hands of the doctors that could do it.

It's tough to say on lasers, but yes, that would be preferable if it could achieve the same results or at least results people could find sufficient. However, i don't think lasers that are currently being used would ablate the surface deep enough for the hydrogel to work the way that it was used in the research paper. And I don't think there's anyway of knowing at this point what the tangible benefit would be if the surface of the skin was only ablated to a moderate depth.

Scar excision costs around $1500. Now, I'd imagine that if you had several scars on your face the surgeon would remove a large portion of your skin that encompassed several scars instead of just excisions for each individual scar (this would likely include healthy tissue around the scars, but if the hydrogel achieved complete regeneration this wouldn't be an issue). Then the hydrogel would be placed over the resulting wound bed to completely regenerate the entire area. Obviously, this method only makes sense if complete regeneration with the dextran hydrogel is possible in humans. No one would want perfectly good skin being excised to come back at less than perfect. :)

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with full ablative lasers CO2 & Erbium you can go as deep as you need and they are much more precise, they can ablate layer by layer, micron by micron or a deep ablation in one time, it depends on the power settings, normaly for resurfacing they do not go very deep because of the risk of scarring, but they are surgical lasers useful to remove even cancer tissue precisely, so you can go any deep you need.



So it is possible to create a wound bed in each scar without touching good skin.

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Guys, is this product aims toward scar free healing on acne scars?

What is your ETA?

What if i have atrophic scars thats 10 years old?

Tks for the reply..

Greetings,

Rudy

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Oh jesus nobody knows the answer to those questions, no matter how often they are repeated.

And there is also no point in making calculations about costs at this point.

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To Rudy,

The Hydrogel is made to treat wounds leaving no scars behind. However, I believe it can treat already existing scars by doing an excision and applying the Hydrogel. This includes acne scars or any atrophic scarring. I don't think the age of the scar matters but I am uncertain of all of this. (I emailed Gemstone about this just to see if this is right)

For now just wait and see. On their website Human Clinical Trials are planned in 2016 so hopefully it will be marketed and commercialized in like 2017.

I will occasionally visit their site in case of update and news of the Hydrogel.

I hope this answered your questions.

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^ le troll mastur

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Yeah i was just trolling out of desperation

Btw, i think it will come sooner than 2018, and like seabs said it will (if no procrastination occur) only 1 human trial in 2016 and the product should be on the market by mid or late 2017

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Yea, I suppose. I hope to see that this gains publicity so more people know and won't feel hopeless.

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