so far i've been through a week of topical application, and i THINK i'm seeing a reduction in redness. i don't want to jump the gun and say i'm definitely seeing one because i've been disappointed so many times before with treatments that i thought were working, so i think i'm going to give it another week or two. but so far it seems promising! it feels nice on the skin, i'm only using fresh urine so the smell is minimal to none (and any active constituents don't get much of a chance to break down cause it's not sitting in a bottle for days), and there's no irritation either, which is always a huge plus.
fair point about topicals being relatively ineffective. yes, when the skin is wounded, the body's first response is to fill it in asap to prevent infection and restore the skin barrier, without worrying about orientation of fibers. however, i think there are a few important things to remember.
#1 science does not know everything, if much at all, about scarring and wound closure. nearly every paper i've read about scarring and wounds has started off by stating how little is actually known about how this process happens and what cells do exactly what. while it's important medically, it's not as extensively studied (maybe not as urgent or as profitable? i don't know), so what we know about the mechanism of wound closure is a limited model at best. and i like to try to push a little outside the box if i can
#2 it's important to remember that collagen is not the only thing involved, which is why i'm using the urea cream. yes there is definitely collagen (in "whorl" shapes apparently), but there's also elastin and keratin and blood vessels, at least. the very top epidermal layer of the skin (the horny layer) is made only of keratin, and there are papers that report upregulation of genes that cause overactivation of keratinocytes (cells that produce keratin) that persists for many months after wound closure. i haven't yet found a paper that talks about keratin in scars that are many years old, but if i were to theorize based on what i've been given, since hypertrophic scars stop growing and stabilize after a certain point in time, that upregulation may eventually be normalized. think of it as the cells getting agitated and aggressively trying to heal, and then needing more time to calm down that "anxiety" than they needed to actually get the job done. in that case, that would result in extra deposits of keratin that just keeps renewing itself, even though skin signals have gone back to normal, so we need to find a way to bring THAT down too, in addition to helping remodel the collagen and whatever else is in there. again, this is just my theory, but it gives me hope nonetheless
#3 remodeling! i think people make a mistake in viewing healing as "breaking down" scar tissue. obviously your body is not going to eat away at the hole it plugged in order to replace it better. instead, you want to focus less on breaking down, and more on gradual reorganizing and normalizing, ie, remodeling. and yes, attempting to reactivate skin is is definitely why people do things like dermarolling or lasers, to promote a second intent healing response. and while i do believe this is a great method for things like icepick or rolling scars, i don't believe it will do anything at all for raised scars (especially keloids, since they already have issues with stopping their production cycles). as long as you have a blood supply to the scar (ie as long as it still gets red), there's still remodeling possible. so, the idea is to somehow stimulate the scarred area to start picking apart the disorganized tissue very very gradually, and protect it while it does so. stimulation doesn't have to mean re-injury, it can be chemical too, which is where the urine comes in.
urine contains a ton of (natural) chemicals. it's always listed as being mainly water with some urea and salts, but there's more than just that. think about it, when you go to the doctor's office and they do a urine test, what sort of things can they test for? the list is enormous! they don't just take samples to look at sodium and potassium levels, they can check for all sorts of things. granted, usually they use blood samples instead of urine for a lot of things because it gives a better idea of what's still actively circulating rather than being expelled, but urine is just filtered blood (ie blood minus any living cells). for example, blood and urine can contain:
- the whole range of amino acids (molecular building blocks used to make proteins, including molecules made with sulfur, which is a commonly used skin healing agent).
- vitamins and minerals! including things like vitamin A, vitamin C, copper and zinc, all of which are implicated in skin health.
- hormones, including the corticosteroids which are prescribed by doctors in synthetic cream form to help bring down swelling, as well as any other adrenal hormones that may be secreted. there are sex hormones like estrogen and testosterone (estrogen has been shown to improve skin elasticity and improve wound healing...it's partly why women don't normally get as aggressive wrinkles as men until they hit menopause ) there's also DHEA, a testosterone derivative molecule which is being implicated for its beneficial effects in aging skin, not to mention thyroid hormones and sleep hormones, and whatever other endocrine regulators that have gotten filtered.
- growth factors! epidermal growth factor (EGF) is one of the things that makes it out of the body through urine, and it does exactly what it sounds like it does: it regulates skin growth. and hey, the appropriate receptors for that are right there in the skin, aren't they?
- there are antigens that basically profile your body's immune response at the time and can stimulate cells to mount an immune response if introduced back into the body (this is the basis for the kind of urine therapy where you drink your urine, that by re-introducing antigens into the body, you mount another immune response and keep fighting whatever it is your body is trying to fight).
- some claim it contains entire enzymes, but i'm not so sure about that as those are gigantic and tend to be dependent on things like pH and temperature to function properly, so without specific evidence, i'm inclined to believe they would likely have trouble crossing the skin barrier to get back in anyway, let alone function properly again...but if they are there, then there's that too.
so while the urea is very moisturizing, and the salts are good for fluid balance and regulating cellular activity, there are so many other things in there that may contribute to "waking the skin up" so to speak.
#4 now, if all these things are so good for you and important for wound healing and skin health, then why wouldn't your body just direct them to the scars from the inside in the first place? well, because a scar is just not important to your body. it's the lowest priority for the body to deal with and it just doesn't care about getting enough nutrients there to remodel and improve, just so long as the skin barrier isn't disturbed. so by putting all these ingredients straight onto the area we want them to go helps bypass the body's limitation in getting beneficial nutrients there. again, activating that part of the skin IS why people perform second intent injuries, and for severe cases of atrophic tissue, yes, you want to induce a growth response, so second intent injury seems like a good idea, but honestly, for cases where scars are mild, i personally don't see how that would help versus just worsening the scar. if you do try to re-injure skin for healing of minor scars, it has to be a very gradual and gentle process of exfoliation and moisturizing/healing. but where exactly is that sweet spot where you're seeing improvement but not irritation that may result in further scarring? well, that's what everyone is constantly trying to figure out
#5 on the subject of active ingredients: so when people say oh why bother with urine just get a urea cream...well, it's not just about the urea. yea the urea is very moisturizing, it helps take away excess keratin and this is documented and well utilized in medical practice (it's used for skin conditions like eczema and keratosis pilaris, as well as for calluses and thickened nails), but i find that this isolation and purification of "active ingredients" is a problem in the medical field. now this is just my opinion of course, but, even if there is an active ingredient in any plant or natural product, there are *always* countless other molecules that can work in conjuction with or contribute to the active's actions, and we can never really tell what kind of accessory effect they have. by isolating the compound that we think is doing the heavy lifting, we eliminate any side interactions that may actually contribute as well. also remember that synthetic molecules don't always mean that they're precisely the same as the natural molecule. a lot of the time synthetics are built to look just enough like the natural thing to fool the body into thinking it's real, but again, we don't know what kind of positive effects we're missing out on or what negative effects we're causing.
(urea is a bit extreme of an example for this, but think about birth control pills. the hormones in those are not actually estrogen and progesterone. they are made of one type of estrogen (estrogen is a catch-all term for a few different molecules, there's at least three kinds of in the body), and progestin, which is a synthetic molecule made to have properties that act on progesterone receptors AND androgen (male hormone) receptors (which is why women can have problems with libido or hair growth or aggressive mood swings on certain pills...those are all controlled by progesterone and androgen activity). the idea behind synthetics is not to reproduce the natural thing, it's only to get a product that does what it's claimed to do, that at best mimics a net effect, but what happens on the molecular sidelines that accumulates over time is not very well known, studied, or sadly, cared about. again, urea is not quite as dramatic as the concerns for something like the pill, but that's the general idea.)
side effects or missing out on positive effects by using synthetics is also the idea behind eating whole foods instead of taking nutrition supplements. or using pure organic essential oils and plant extracts for healing by aromatherapy instead of synthetic ones (like chemical vitamin A derivatives that cause dermal swelling versus something like rosehip seed oil). obviously isolating active ingredients works well in plenty of cases, and you do get a more aggressive response from synthetics because they're more concentrated, but it's not without its drawbacks and limitations, as well as potential permanent side effects. for example, when the doctor prescribes a steroid cream, it can thin your skin out permanently if you use it more than a week or two, and that's terrifying to me! and yet, corticosteroids are a naturally produced compound within your body. the difference is that the synthetic cream you use is not biologically regulated. or when you get antibiotics, yes they work and they've saved many many people from bacterial disease over the years, however, we're now running into super bacteria that are resistant to our drugs, but that seem to still be affected by natural products like tea tree oil, oregano or thyme oil, or, well, even urine
so, that line of thinking is why i'm opting for using the natural urine product instead of sticking to just a urea cream because it has more than just urea and water in it. i'm adding the urea cream because the urea content really is low in urine, and there's no harm in supplementing it to help speed exfoliation and at least get at the pigmentation
and just as a side note, regarding toxins that people may be worried about...toxins are broken down and deactivated mainly in the liver before they're put back into the blood to be filtered out. they come out in pieces basically, so they aren't really toxins anymore, but just jumbled up building blocks. so as long as you don't have a urinary infection (bacteria and viruses are teeny and they make it through the kidneys intact), i don't think there's much of a reason to be worried about re-absorbing toxins.
now, for all my talk and extrapolation and theorizing there just aren't enough studies to really *prove* anything about urine therapy (no profit in something free and easy like urine, right? science and medicine still all comes down to what's profitable to study and market), and that's why i'm here. anecdotal evidence is still valuable, because even if we don't know HOW something works, we can still take advantage of its effects (which again, is a very commonly used principle in medicine and science). which is why i'd love to hear about anyone that's had results with urine therapy for scars, or pigmentation
sorry for the giant post! i hope that addressed some of your concerns i do plan to re-post with my progress (if any), as time goes on. maybe this will help with at least the pigmentation. i expect if it can have any effect on skin texture, it will be a very slow process that unfolds over time, so it may be a while before we see about that. but i figure why not try it for a few months, it takes very little time and effort to do, and costs me nothing compared to all the products i've bought and attempted to use over the years
Edited by purpletulip, 12 June 2013 - 11:53 AM.