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So I had a big cyst and it left a hole that has been slooooowly healing. I'm about 5 or 6 weeks into healing now. There is still redness and even a little sensitivity at the center (it is closed)...the indentation is gradually rising, but I'm not sure if it's going to make it all the way (?). Staring "atrophy" right in the face. No pun intended...

In the case it doesn't and I'm left with some sort of rolling indentation, I've been reading up on my options to treat. I've seen a number of posts making claim that new scars respond better, that early treatment will get better results, etc...Also, I've read here that it's not considered a scar for a year, or maybe 6 to 12 months etc...I'm looking for a little clarity, because there are a few terms being used ambiguously..."new", "old", "early". Can someone please define these terms? I do understand that different wounds will require different time frames to heal (various factors like the size of the wound) Therefore, what other criteria should you take into consideration when determining when is a good time to embark on various treatments? 

Also, anyone have any idea how long a wound may continue to raise and fill in? Anyone know any tricks for helping it?

Thanks!


 

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5 minutes ago, TheBean said:

Also, anyone have any idea how long a wound may continue to raise and fill in? Anyone know any tricks for helping it?

 

 

The Four Stages of Wound Healing

[...] During the maturation phase, collagen is aligned along tension lines and water is reabsorbed so the collagen fibers can lie closer together and cross-link. Cross-linking of collagen reduces scar thickness and also makes the skin area of the wound stronger. Generally, remodeling begins about 21 days after an injury and can continue for a year or more. Even with cross-linking, healed wound areas continue to be weaker than uninjured skin, generally only having 80% of the tensile strength of unwounded skin.
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I would suggest talking to a dermatologist about when you should consider treating your scar and what the best option for your scar is. One thing I can say for sure is that you should definitely use sunscreen to keep your scar from getting worse. And, of course, for all the other reasons they say to use sunscreen.

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Good question! I’m actually wondering this myself. I’ve read about the 6-12 month scar remodeling period for wounds. But then it also seems like most people here don’t believe indented scars from acne can get better without treatment, so does that mean there’s no point waiting the 6-12 month period to see if the scar will improve on its own?

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@allysaurus No it means that the body heals at a extremely slow pace. People do not want to wait. So they get treatment ASAP. For some yes the scars will improve and heal on their own, ... perhaps they are not scars to begin with and only wounds. Each situation is different. There are various variables, health factors, how the person heals, the issues they are dealing with, age (younger people can heal better), what their concerns are, nutrition and auto immune / infections. Some call discolorations scars and it's simply wounding. I think the best thing one can do with wounds is use something like castor oil on the spots. With more mature scars stronger treatments are needed. Some heal poorly or they do not heal at all. I think a year after accutane one has a good grasp of what scars they have. 

I do believe some indented scars can get better, many find this after Accutane, or when they seem to get their acne under control. It's when the fat is damaged or tethering of the pits that often regeneration of collagen won't happen.

The body cannot heal as long as there is inflammation, the longer it's inflamed the worse the side effects can be resulting in scars.

I would not rush to do acne scar treatment too soon, ... try the at home and DIY options or natural remedies and them move onto stronger $$$$ treatments. Some have the money to see a derm any time they want (Hollywood) for the smallest of skin aesthetic issues. 
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5 hours ago, TheBean said:

It's shallow,  but wide...

20180615_081203.jpg


The enlarged pores are pretty noticeable. Have you received any treatments in the past, like laser or chemical peels? Numerous treatments will impact your skin texture (eg. thin skin will impair blood circulation), that in turn may have a negative effect on your healing ability.
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Oh, they do look bad here. They really aren't that bad...I took this picture really close up and went for the worst lighting I could get. I've never been the poreless skin type and I am in my mid-40s now-- they could be better,  but they are definitely exaggerated here.
To answer your question... the only thing I've done is Differin OTC, started in February. I gave up salicylic acid (which tightens pores) at that time,  because it interferes with the adapalene. Maybe putting it back in the a.m. routine would help that?

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Okay, so I have an answer to one of my questions. I was watching one of Dr. Davin Lim's Youtube videos earlier today and he just threw it out there while talking about one of the treatments..."Early" scars--which respond very well to treatment, he considers to be in the 3 to 4 month range. 

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Goto a board certified Dermatologist who is knowledgeable with scars. 

I would start using silicone patches or liquid as these are fresh looking scars. 

The tissue deficiency can be corrected with filler or possibly will fill in itself over time.

Use concealer as healing takes months.

Vascular laser can speed along getting rid of PIE or wounding. See the FAQ under skin section, PIE. Several at home treatments including EMU oil. 

BA

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UPDATE: It's been making slow, but steady progress.  I had scheduled for rf microneedling this week,  but considering that it still seems to be filling in on its own,  I'm going to hold off on intervening,  lest it do more damage than good (those are among the risks). Sorry-- this info is duplicative of my other posting. I've attached an updated pic...
There is still slight redness (bloodflow-- I'm quite fair) but you can even tell in the pic how much has filled in... the doc said "wait 6 months" and it's only been 3.

20180805_075200.jpg

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This looks good, ... give it time. Collagen can take about 6 months to form. If the treatment was done in the last 2 weeks it could be swelling. Collagen is very slow to form over that time. 

The redness or PIE of the wound could take up to a year to heal, ... if not vascular laser would be used for the discoloration. 

Have you tried castor oil and or comfrey balm, both are very healing to the external skin.

Retin a - tretinorin/differin is also helpful for skin regeneration done nightly. 

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Thanks BA. I haven't done any treatment,  it's been 3 months since I lost the original scab. I'm holding off on treating since it still seems to be filling in on its own. 
I use my Differin every night. I've been using it almost 6 months. For a bit, it made my pores larger and seemed to be bringing scars to the surface that I didn't know I had. But now it's improving and the texture is looking better than it has in a long time. I'm sure the redness will fade with time when it's done healing. 

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Try taking vitamin c, vitamin e, and zinc. According to Linus Pauling institute, doctors and wound specialist prescribe it to their patient to promote wound healing. It is a know fact that vitamin c encourages wound healing. In my case with my pitted scars, time and salicylic acid were the only things that helped me. A lot of people have very good success with glycolic acid; it is believed to stimulate collagen synthesis. Also, make sure to wear plenty of sunscreen just like the others have said; unprotected UV exposure degrades collagen which is terrible for wound healing.
Hope this helps.

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I've seen two derms about this.

Thanks besimple. I've been taking extra vitamins and using spf, as well as covering up with sun hats, etc when I'm outside.  
I'm using Differin which is a retinol. It also stimulates collagen...I don't think I'm supposed to use GA while using it.

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12 hours ago, TheBean said:

I've seen two derms about this.

Thanks besimple. I've been taking extra vitamins and using spf, as well as covering up with sun hats, etc when I'm outside.  
I'm using Differin which is a retinol. It also stimulates collagen...I don't think I'm supposed to use GA while using it.

Differin is not retinol; it is a third generation retinoid while retinol is a first generation retinoid along with retin-a and retin-aldehyde. According to some experts, adapelene (the retinoid in differin) does not help with collagen  synthesis because it does not penetrate deep into the dermis. Differin (adapelene) mainly helps with desquamation thus the smoothening effect you have been getting. GA, on the other hand, is known to penetrate deep into the dermis like retinol and retin-a. If you will like to incorporate GA, you can simply use it during the day under your spf.
Hope I was helpful :) 
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If it's healing on its own, as it seems to be the case, then let it be.

If it gets to the point in which it stops healing on its own and you are not happy with the end result, seek for a treatment.

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besimple...thanks! That's very helpful. I do have a GA 10% treatment at home. It's not super strong, so I could try it and see how my skin handles that to start?

abraxas21...that's the conclusion we came to. As long as I'm seeing progress--let it be. I'm only at 3.5 months. That's nothing as far as scar aging/ healing time goes. The first derm I went to said, "give it 6 to 9 months". I thought she was full of it. I thought there was no way...but now I am thinking she could be right. 

Thanks! :)
 

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