Thank you for
your question.
You’re asking a very straightforward conceptual question about timing as to when is it best
to treat a scar when it’s less than 3 months or greater than 3 months.
And you stated in your question that you recently started doing Dermapen treatments for scars.
And you submitted two very good photos to help guide us in what your situation is.
So I’m going to give you a little bit of background, I’m a Board-certified cosmetic
surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon.
I have been in practice for over 20 years in Manhattan and Long Island.
We do a lot of treatment for acne scars and active acne.
In fact, I was an early adopter of the Dermapen so I have a lot of experience with this device
so I’m going to start by helping you by first understanding the thinking of treatments
of scars and more broadly, wound healing so that you understand the ideas of the different
ways that we treat tissue that is early or later of the wound healing process.
So to begin with, first of all, Dermapen is a microneedling device.
It is essentially a device that is one of many of that category of devices which has
multiple clusters of needles that enter the skin that can be adjusted in terms of depth
as well as the rate and frequency of which it penetrates the skin.
Now this device can be used in different depths, different levels and different rates in order
to treat different types of issues.
So when it comes to something that is early in the healing process, well, it’s not likely
that derma needling would be optimal for that situation.
When something is at the early healing process, you want to try to prevent an undesirable
scar from forming.
So, when someone is in that situation, sometimes we use an approach such as the use of a regenerative
medicine technology such as platelet-rich plasma (PRP).
Platelet-rich plasma (PRP) is derived from your own blood and it’s a concentration
of the growth factors or the wound healing factors necessary when you have a cut.
So we have found that helping people who recently had an inflammatory issue or they’re recently
healing or maybe they’re having some early signs of scarring, platelet-rich plasma (PRP)
has a role.
Now that’s just one part of the equation.
There is a role for also steroids, be it a topical, injectable steroids.
There’s also a role for other modalities such as the use of silicone topical sheets.
The understanding that microneedling or Dermapen is just one strategy or one tool I should
say in a broader strategy is better than thinking about it in just as an early or late treatment.
This is a very versatile tool but it’s not the only tool that’s available to help someone
like yourself who’s dealing with some inflammation and wound healing issues.
We spend a lot of time in our practice because we are also very innovative with the use of
platelet-rich plasma (PRP) and Acellular matrix.
Acellular matrix is actually something that we use to help enhance wound healing.
And so, a lot of times, we use that to rehabilitate skin, to improve skin quality and to restore
volume with a different strategy.
And clearly, you’ve already found someone to help you with some scarring but I think
you need to have a good conversation about what is the broad strategy for your treatment
and where these other modalities may potentially play a role.
There are lasers.
We have a laser in our practice that we use to treat active acne.
So it might have a value for if any reason you are not either responding or not tolerating
topical treatments or oral treatments or it can fit in with a strategy with those treatments.
There are almost infinite variables that can play a role in how a doctor strategizes your
type of treatment based on your conditions and the outcomes as well as how you respond
to these different treatments.
These aren’t, unfortunately, probably specific enough for you because a proper examination
and a relationship with the doctor is still necessary.
I think you’re asking a very good question and I think the general feeling in the medical
world is if the wound is more recent, it is easier to work with before it becomes scar
tissue, that is scar tissue that is more solid and requires more intervention.
While in the earlier phases of wound healing, you could make a lot of impact in that process.
It might be of interest for you, wound healing basically has four phases: there’s a hemostatic
phase where it’s basically the initial healing and to stop bleeding.
Then there’s the inflammatory phase, and proliferative phase.
The proliferative phase, the body is generating collagen, blood supply, etc. and then there’s
a remodeling phase.
And we have different strategies to help people throughout those different phases of wound
healing.
So microneedling and Dermapen has its place in different phases but learn more about your
other options so you can possibly incorporate them and this is a discussion best to have
with your own doctor.
So I hope that was helpful, I wish you the best of luck and thank you for your question.