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Do Icepick/boxcar Scars Fill In?

acne acne scars missing skin dryness

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#21 Augustina073

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Posted 01 August 2014 - 10:34 AM

Really? Thats great! Do you know how long it took and how many there were along with where were they? Thanks. You just gave me hope. Im just ready to give up. I feel so depressed.

#22 paigems

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Posted 01 August 2014 - 10:46 AM

That is not physiologically possible. A scar is an injury to the dermis, kind of like a wrinkle. It's both the result of loss of collagen and dense scar tissue. They don't "fill" in unless you get injections under the scar or subcision to release the scar tissue. I'm not trying to be rude and wouldn't normally argue, but for the sake of readers who get their hopes up from this common misconception, I think it's important to try and explain this. I was told my scars would go away from friends and family, years later- still here. Some topicals like hyaluronic acid and glycerin (to name a few) can help to plump up the skin making some scars disappear. I use Ceraves moisturizing lotion which does make a difference in my scarring. It's possible a product you are using is making your scars less visible. 

 


 

If there is redness in the scar and it fades over time, it will definitely make the scar less noticeable. Gaining weight can also make them look reduced or almost gone by stretching the skin (a lot of women report more apparent wrinkles after losing a lot of weight as there is no extra fat to "stretch" the the skin) but scars don't fill in even from lasers or other treatments. All of these treatments only tighten the skin so that the scars flatten out, which is why several years after treatments people report that they are visible again to varying degrees. The aging process continues and the skin isn't as tight anymore thus making the scars "reappear". 

I'm serious, some of my scars have disappeared over time. They were not red. I have also remained about 120 lbs for the past few years. They're gone.

I don't understand people on this website people telling me things are not possible when I have experienced them first hand. Some of my scars have filled in over time. That's that.



#23 slowdive

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Posted 02 August 2014 - 03:58 AM

I also have had many scars fill in over time.  Everyone is different, but it is absurd to state that it is physiologically impossible for scars to heal themselves.  Who told you that... a dermatologist?  Dermatologists also think that diet has nothing to do with acne... so I wouldn't take anything they say as gospel.  I get where you are coming from and agree that people shouldn't count on things getting better on their own, but I know what has happened to my own skin.

It took several years but most of the scarring from my acne in my late teens eventually went away, very gradually, over the course of 4-5 years.  Mostly boxcars.  They were pretty bad.  I also lost a lot of weight over that period, at least 30 pounds, so it wasn't that.  I was young and broke and thus never did any kind of treatment for scars.  Unfortunately I had a resurgence of breakouts in my late 20s that brought fresh scarring - I do not want to wait for years so will be more aggressive this time.



#24 missamua

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Posted 02 August 2014 - 06:30 AM

I'm not on here to attack anyone and that was not my intention, so I apologize if it came off that way. I have severe scarring and like most people I am desperate for a solution. I'm on here to share my experiences and also educate other people with what I know..and I definitely don't know everything.

 

I see a lot of holistic remedies for scarring, all based on pseudoscience and some just downright dangerous (ex water fasting). The things I do recommend are based off of years of obsessive researching not only for my own benefit but also for others. Scar cannot fill in, the skin around it can be tightened or stretched (which reduces the appearance) by various treatments (lasers, needling, weight gain etc) but the scar itself doesn't just fill up on it's own. Most scar treatments are designed to tighten all of the skin which is why they are typically used for people with general aging and wrinkles (and also tend to work better for). The only exception is subcision and injections that level/soften the scar tissue. There is no science or study anywhere that shows acne scarring just disappearing. If it was true, why don't wrinkles also fill up? They are caused by loss of collagen like acne scarring...and yet it's common knowledge that they don't go anywhere. In fact scars often get worse over time just like wrinkles due to the aging process and further loss of collagen.

 

I definitely don't think anyone is lying about their scars diminishing over time...that would be absurd, I simply don't think it "filled up" on it's own. 

 

I just don't want anyone to have unrealistic expectations like I did when I was first blessed with scarring. It's devastating on it's own, but to be told they it can just go away and wait patiently for that to happen is not a good mindset. There needs to be some level of acceptance as well as some level of realistic expectations that they can be improved (sometimes significantly), but let's not go around telling people their scars will go away because that happened to you.

 

On the bright side, treatments for scarring are improving and there's so many options today that make it easier to live with.

 

 If anyone is interested here are some general links on atrophic scars- treatment, aging, expectations on improvement  etc. there are a lot of studies/articles on ncbi that are good sources of information.

 

https://www.healthta...estions/1000279

http://www.realself....moval-treatment

http://dermapproved....cars/learn-more

Google "Practical Evaluation and Management of Atrophic Acne Scars", a fantastic article on NCBI with some great information.

 

 

 

 

I also have had many scars fill in over time.  Everyone is different, but it is absurd to state that it is physiologically impossible for scars to heal themselves.  Who told you that... a dermatologist?  Dermatologists also think that diet has nothing to do with acne... so I wouldn't take anything they say as gospel.  I get where you are coming from and agree that people shouldn't count on things getting better on their own, but I know what has happened to my own skin.

It took several years but most of the scarring from my acne in my late teens eventually went away, very gradually, over the course of 4-5 years.  Mostly boxcars.  They were pretty bad.  I also lost a lot of weight over that period, at least 30 pounds, so it wasn't that.  I was young and broke and thus never did any kind of treatment for scars.  Unfortunately I had a resurgence of breakouts in my late 20s that brought fresh scarring - I do not want to wait for years so will be more aggressive this time.

 

 


I also have had many scars fill in over time.  Everyone is different, but it is absurd to state that it is physiologically impossible for scars to heal themselves.  Who told you that... a dermatologist?  Dermatologists also think that diet has nothing to do with acne... so I wouldn't take anything they say as gospel.  I get where you are coming from and agree that people shouldn't count on things getting better on their own, but I know what has happened to my own skin.

It took several years but most of the scarring from my acne in my late teens eventually went away, very gradually, over the course of 4-5 years.  Mostly boxcars.  They were pretty bad.  I also lost a lot of weight over that period, at least 30 pounds, so it wasn't that.  I was young and broke and thus never did any kind of treatment for scars.  Unfortunately I had a resurgence of breakouts in my late 20s that brought fresh scarring - I do not want to wait for years so will be more aggressive this time.


Edited by missamua, 02 August 2014 - 07:18 AM.


#25 slowdive

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Posted 02 August 2014 - 08:12 AM

Hey, I really appreciate your thoughtful response. Like I said, I agree that people should not just accept their scars to improve. I also agree that there is a ton of misinformation out there, and through debating various points based on evidence (whether scientific papers on specific topics, foundational science, or anecdotes), we can get one step closer to the truth. I am not a doctor and have no specific medical training, but I work in field that requires deep research and deductive analysis, which has aided me in my quest to learn more about acne and other health conditions.

 

 

Nothing in the links you posted suggests that collagen synthesis just magically stops in acne-scarred tissues. I am highly skeptical that this would be the case. I am also highly skeptical that many treatments only work through tightening the skin. The following excerpt is from a study that was published in the Journal of Dermatological Treatment. It clearly shows that Fraxel drove an increase in collagen synthesis. That is why they work in wrinkles as well - wrinkles are driven by age-related collagen loss. Lasers and other interventions stimulate collagen synthesis. Yes, they are crude in many ways, which is why they don't work perfectly.

 

Four weeks after the final treatment, the mean overall improvement in objective grade was 2.0 when the Fraxel SR 750 was employed and 2.9 when the Fraxel SR 1500 was used. Confocal microscopy revealed an increase in procollagen-1 in dermis, with no difference or a slight increase in the levels of elastin and MMP-1. Side effects were minimal.

 

http://www.ncbi.nlm....pubmed/20653485

 

 

 

The following excerpt is from Medscape, which is a reference resource for physicians. It states that collagen is synthesized and remodeled over time, but never regaining the perfection of the original tissue. This entry is not directed at acne scarring per se, but logically the same biological mechanisms should be at play, taking into account a greater degree of initial collagen loss (pitting) which is driven by the inflammation and resulting cytokines.

 

When the normal collagen in our tissues is injured and replaced by scar collagen, the connective tissue does not regain this highly organized structure. That is why scar collagen is always weaker than the original collagen. The maximum regain in tensile strength of scar collagen is about 70 to 80 percent of the original.http://www.medscape....rticle/423231_2

 
 
 

I also do think that some holistic remedies can work, to the extent that they have a basis in science. The water fasting that you mention certainly carries many risks of its own risks, but there is some evidence that it works. Some likely pathways would be i) increased hGH secretion which has been shown to occur during fasting ii) reduced cytokine-derived factors such as IL-1 and TNF-a which reduce collagen synthesis and perhaps iii) reabsorption and remodeling of scar tissue due to autophagy (basically, during periods of protein restriction, your body looks for damaged cells to recycle protein).

 

The following study demonstrated that fasting mice showed greater collagen synthesis and wound healing.


http://www.woundsres...ing-female-mice

 

 

 

There are many holistic remedies that are complete zeroes as well.  My point is that there are rarely conclusive answers when it comes to health-related topics. The body is very complex and modern science's grasp is only cursory at best.


Edited by slowdive, 02 August 2014 - 08:12 AM.


#26 missamua

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Posted 02 August 2014 - 09:10 AM

The treatments I mentioned do encourage collagen synthesis, which precisely why they tighten the skin. That is why they are commonly referred to as collagen induction treatments.That does not, however, fill in the scar. The added collagen in the skin acts in the same way that extra fat would, tightening the area and reducing the appearance. This is why many people report that their scars are shallower but wider after laser treatments. That is also why as the aging process continues, scars eventually reappear to some extent, because the skin is not "tight" anymore and collagen is depleted again (unless of course the scar tissue itself was leveled or softened by subcision for example).

 

I would have to respectfully disagree that water fasting has any benefit of promoting healing to scars. The study you posted is based off a case where the mice fasted while a wound was created. The scar tissue we are referring to is no longer a wound, it has already formed and matured. An injury of some sort needs to be created in order to initiate the wound healing process again, which is where needling and laser treatments come in.


Edited by missamua, 02 August 2014 - 09:23 AM.


#27 slowdive

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Posted 02 August 2014 - 10:08 AM

I get what you are saying, but I still don't buy it - do you have a source? Where would the new collagen go, if not into the recessed valley?

 

 

The following is specifically about acne scars, from the journal Dermatology Research and Practice (http://www.ncbi.nlm....les/PMC2958495/):

 

  1. Granulation Tissue Formation. Damaged tissues are repaired and new capillaries are formed. Neutrophils are replaced by monocytes that change into macrophages and release several growth factors including platelet-derived growth factor, fibroblast growth factor, and transforming growth factors α and β, which stimulate the migration and proliferation of fibroblasts [16]. New production of collagen by fibroblasts begins approximately 3 to 5 days after the wound is created. Early on, the new skin composition is dominated by type III collagen, with a small percentage (20%) of type I collagen. However, the balance of collagen types shifts in mature scars to be similar to that of unwounded skin, with approximately 80% of type I collagen [17].
  2. Matrix Remodelling. Fibroblasts and keratinocytes produce enzymes including those that determine the architecture of the extracellular matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs. MMPs are extracellular matrix (ECM) degrading enzymes that interact and form a lytic cascade for ECM remodeling [18]. As a consequence, an imbalance in the ratio of MMPs to tissue inhibitors of MMPs results in the development of atrophic or hypertrophic scars. Inadequate response results in diminished deposition of collagen factors and formation of an atrophic scar while, if the healing response is too exuberant, a raised nodule of fibrotic tissue forms hypertrophic scars [19].

 

 

Skin needling is a recently proposed technique that involves using a sterile roller comprised of a series of fine, sharp needles to puncture the skin. At first, facial skin must be disinfected, then a topical anesthetic is applied, left for 60 minutes. The skin needling procedure is achieved by rolling a performed tool on the cutaneous areas affected by acne scars (Figure 6), backward and forward with some pressure in various directions. The needles penetrate about 1.5 to 2x2009.gifmm into the dermis. As expected, the skin bleeds for a short time, but that soon stops. The skin develops multiple microbruises in the dermis that initiate the complex cascade of growth factors that finally results in collagen production. Histology shows thickening of skin and a dramatic increase in new collagen and elastin fibers. Results generally start to be seen after about 6 weeks but the full effects can take at least three months to occur and, as the deposition of new collagen takes place slowly, the skin texture will continue to improve over a 12 month period.



#28 Augustina073

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Posted 02 August 2014 - 10:57 AM

Everyone is saying scars don't fill in, but I've had some holes on my face that have definitely filled in. I had a few scars that just vanished over time.


How long did it take? Where were they? & were they big ?

#29 missamua

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Posted 02 August 2014 - 11:12 AM

With laser resurfacing and needling, the collagen forms evenly throughout the skin, not necessarily just into the recessed area. Even when stamping an individual scar, you're supposed to target the scar and area around it so that the newly formed collagen can stretch the scar from all different angles otherwise you'll still have harsh edges.

 

The very last part is actually correct, scar tissue can take up to 12 months to completely mature, meaning the scar tissue can slightly soften within that period of time. I believe (meaning I read it in some study that I now cannot find, go figure lol, will post later if and when I do) that after 6 weeks about half of collagen synthesis has taken place, and very slowly over the course of typically about 12 months it can increase. That number may be a little more or less, I don't remember. Anyone feel free to correct may if you can find that information before I do because I forget. I know that with laser resurfacing, results are expected to be seen at about 6 months but maximum at 12 months. Collagen synthesis wouldn't take 4-5 years to completely form, though, like what I've read here and there on this forum. The anti-aging effects lasers don't even last that long.

 

Back to the water fasting..I don't think it'd be a good idea to fast on and off for 12 months for little if any benefit.

To the OP: You're better of keeping the area moisturized while the scar matures and try not to use anything that can increase inflammation in the area.

And, have you seen any softening in the tissue? And do you have any pictures? Your scarring sounds like it's mild, so there is definitely hope for you.



#30 blahblah82

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Posted 02 August 2014 - 04:47 PM

First you are trying to extrapolate from animal models to humans, which we know is helpful in understanding general physiological mechanisms that influence wound healing, but is an over-simplification.  Second, Missuama is correct in pointing out that the effects of fasting on wound healing in that study were NEWLY created wounds that are still healing and remodeling.  Fasting would have a negligible effect on long-standing scars that have already fully matured.  If your scars are only months old, then I can see a remote possibility that it could influence healing.  

 

Virtually all scar treatments work through CONTROLLED damage to essentially create a NEW wound so that it can heal in a more aesthetically acceptable fashion.  Subcision, excisions, lasers, dermabrasion, chemical peels, CROSS, and needling are all scar therapies that induce scar remodeling through inflicting damage on the scarred areas.  Fillers, which work by replacing lost volume, are basically the only modality that doesn't rely on inflicting controlled damage to a effect a change in the scarring.  

 

 

 

I get what you are saying, but I still don't buy it - do you have a source? Where would the new collagen go, if not into the recessed valley?

 

 

The following is specifically about acne scars, from the journal Dermatology Research and Practice (http://www.ncbi.nlm....les/PMC2958495/):

 

  1. Granulation Tissue Formation. Damaged tissues are repaired and new capillaries are formed. Neutrophils are replaced by monocytes that change into macrophages and release several growth factors including platelet-derived growth factor, fibroblast growth factor, and transforming growth factors α and β, which stimulate the migration and proliferation of fibroblasts [16]. New production of collagen by fibroblasts begins approximately 3 to 5 days after the wound is created. Early on, the new skin composition is dominated by type III collagen, with a small percentage (20%) of type I collagen. However, the balance of collagen types shifts in mature scars to be similar to that of unwounded skin, with approximately 80% of type I collagen [17].

  2.  

  3. Matrix Remodelling. Fibroblasts and keratinocytes produce enzymes including those that determine the architecture of the extracellular matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs. MMPs are extracellular matrix (ECM) degrading enzymes that interact and form a lytic cascade for ECM remodeling [18]. As a consequence, an imbalance in the ratio of MMPs to tissue inhibitors of MMPs results in the development of atrophic or hypertrophic scars. Inadequate response results in diminished deposition of collagen factors and formation of an atrophic scar while, if the healing response is too exuberant, a raised nodule of fibrotic tissue forms hypertrophic scars [19].

  4.  

 

 

Skin needling is a recently proposed technique that involves using a sterile roller comprised of a series of fine, sharp needles to puncture the skin. At first, facial skin must be disinfected, then a topical anesthetic is applied, left for 60 minutes. The skin needling procedure is achieved by rolling a performed tool on the cutaneous areas affected by acne scars (Figure 6), backward and forward with some pressure in various directions. The needles penetrate about 1.5 to 2x2009.gifmm into the dermis. As expected, the skin bleeds for a short time, but that soon stops. The skin develops multiple microbruises in the dermis that initiate the complex cascade of growth factors that finally results in collagen production. Histology shows thickening of skin and a dramatic increase in new collagen and elastin fibers. Results generally start to be seen after about 6 weeks but the full effects can take at least three months to occur and, as the deposition of new collagen takes place slowly, the skin texture will continue to improve over a 12 month period.


Edited by blahblah82, 03 August 2014 - 03:36 AM.





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