痤瘡疤痕的治療

Treat Acne Scarring----痤瘡疤痕的治療

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Scars are areas of fibrous tissue (fibrosis) that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. With the exception of very minor lesions, every wound (e.g. after accident, disease, surgery) results in some degree of scarring. Scar tissue is the same protein (collagen) as the tissue that it replaces, but the fiber composition of the protein is different. Instead of a nice “basket weave” formation of fibers, the collagen in scar tissue is aligned in a single direction resulting in a pronounced and thicker appearance. Acne treatments for most are long term and can result in scarring. There are multiple causes of acne including hormone dysfunction, allergies, environmental factors and nutrition deficiencies. Acne scars result after skin follicles become blocked by excessive oils and the physiology of keratin and old skin cells trigger an inflammatory response reaction. The skin will attempt to heal and the scar tissue results as the collagen becomes deformed and thickens. Acne scars are categorized as being “ice- pick”, “rolling” or “boxcar.”

疤痕是取代正常皮膚損傷后纖維組織（纖維化）地區(qū)。疤痕的結(jié)果從創(chuàng)傷修復(fù)中的皮膚和身體的其他組織中的生物學(xué)過程。除了非常輕微病變，傷口每次（例如，事故，疾病，手術(shù)后）的結(jié)果在一定程度上疤痕。瘢痕組織是因為它取代了組織相同的蛋白質(zhì)（膠原蛋白），但該蛋白的纖維組成是不同的。的一個很好的“織籃”形成纖維代替，瘢痕組織在膠原蛋白中產(chǎn)生了顯著的和較厚的外觀的單方向取向。治療痤瘡大多數(shù)是長期，并可能導(dǎo)致疤痕。有痤瘡的多種原因，包括激素功能紊亂，過敏癥，環(huán)境因素和營養(yǎng)缺陷。皮膚毛囊成為阻止過多的油和角蛋白和老年皮膚細胞的生理學(xué)后痤瘡疤痕導(dǎo)致觸發(fā)炎癥應(yīng)答反應(yīng)。皮膚將嘗試愈合和瘢痕組織的結(jié)果作為膠原產(chǎn)生變形和變稠。痤瘡疤痕被歸類為“冰錐”，“滾動”和“棚車?！?/font>

How to treat acne scars/ surgical scars.

如何治療痤瘡疤痕/手術(shù)疤痕。

The Dermapen treatment can provide drastic results improving the appearances of the scars. The micro needles of the Dermapen® create new collagen and elastin to be generated and deposited called collagenesis, however the added benefit of new capillary growth is also a result which can improve blood supply to the area which helps create healthier existing skin as well as provide a healthy foundation for the new skin. The physical nature of “skin-needling” breaks up this fibrous and uneven scar tissue and stimulates the growth of new tissue. Currently there are ablative and non-ablative treatments offered which can damage the epidermis and evaporate the skin leading to thinner epidermis problems. The Dermapen® keeps the epidermis integrity full intact while treating the area which quickens healing time and causes less pain.

電動微針治療可提供疤痕大幅改善的結(jié)果的出現(xiàn)。要生成的電動微針的微針創(chuàng)建新的膠原蛋白和彈性蛋白和沉積稱為人類自體膠原，然而新的毛細血管生長額外的好處也是其結(jié)果是可以改善的血液供應(yīng)，這有助于創(chuàng)建健康存在的皮膚的區(qū)域，以及提供新的皮膚健康的基礎(chǔ)?！捌つw針刺”的物理性質(zhì)打破了這種纖維和不均勻的疤痕組織，刺激新組織的生長。目前有提供燒蝕和非燃燒的治療可能損壞表皮和蒸發(fā)導(dǎo)致更薄表皮問題的皮膚。電動微針可保持表皮完整的充分完整，同時把它加快愈合時間，并導(dǎo)致痛苦少的區(qū)域。

How many treatments?

需要多少次治療？

Your medical professional should consult on medical treatment. While each patient is different and conditions will vary, the typical treatment regimen will consist of 5-6 treatments.

您應(yīng)該咨詢專業(yè)醫(yī)療人員。而每個患者都是不同的，條件是變化的，典型的治療方案將包括5-6治療。

Acne Scars: Over 90% of adolescents have acne and 1% of the population have acne scars.

痤瘡疤痕：超過90％的青少年有粉刺和有1％的人有痤瘡疤痕。  

Why Acne Scars?  Acne scars are created by the wound healing process occurring after the acute process of inflammation, follicular rupture and perifollicular abscess formation.  

痤瘡疤痕怎么產(chǎn)生的？ 痤瘡疤痕由炎癥，濾泡（發(fā)炎腫大的毛囊）破裂和毛囊周圍膿腫形成的急性處理后發(fā)生的傷口愈合過程中產(chǎn)生的。  

Types of Acne Scars.  The resulting acne scars may be atrophic or hypertrophic (Fabbrocini et al., 2010).  Approximately 80% of scars are atrophic associated with a net loss of collagen during the matrix remodeling process.  A minority of scars are hypertrophic or have keloid formation.  Atrophic scars are classified as:

痤瘡疤痕的類型。由此產(chǎn)生的痤瘡疤痕可能萎縮或增生（Fabbrocini et al., 2010）。大約80％的疤痕是與膠原蛋白在基質(zhì)重塑過程的凈損失相關(guān)萎縮。疤痕少數(shù)有肥厚，或有瘢痕疙瘩的形成。萎縮性疤痕分類為：

Ice pick (70%) – These are the narrow < 2mm punctiform depressions with a “V” cross-section.

冰鑿（70％） - 這是狹窄<2毫米點狀凹陷帶“V”的橫截面。  

Boxcar (20%) – These are round or oval scars with well-established vertical edges with a wide base and a “U” cross-section.

棚車（20％） - 這些是圓形或橢圓形的傷痕與具有寬基座和一個“U”形橫截面既定垂直邊緣。

Rolling scars (10%) – These wide > 4 mm scars have an “M” cross-section and give an undulating appearance to the skin.

軋制傷痕（10％） - 這些寬“4毫米傷痕具有”M“的橫截面，并給予一個起伏的外觀的皮膚。

痤瘡疤痕等級1 ，癥狀：黃斑，臨床特點：紅斑高血糖或低色素平痕。這些不存在的輪廓缺陷，而是色差問題。

痤瘡疤痕等級2 ，癥狀：溫和，臨床特點：輕度萎縮或肥厚疤痕并不明顯，在>50厘米深度和可能受化妝或面部毛發(fā)所遮蓋。

痤瘡疤痕等級3 ，癥狀：溫和，臨床特點：中度萎縮性或增生性疤痕是明顯的在>50厘米的深度，無法被化妝品或面部毛發(fā)所遮蓋。痘坑可以通過手動皮膚伸展展平。

痤瘡疤痕等級4 ，癥狀：嚴重，臨床特點：重度萎縮性或增生性疤痕是明顯的在>50厘米的深度，無法被化妝品或面部毛發(fā)所遮蓋。痘坑不會通過手動皮膚伸展展平。

Acne Scar Treatments There are many treatments for acne scars, each with characteristic side effects. For most treatments, the principle treatment side effect is postinflamatory hyperpigmentation (Fabbrocini et al., 2010) which is most pronounced in darker skin types (Shah and Alexis, 2010). Postinflammatory hyperpigmentation may result from dermabrasion, chemical peels and laser resurfacing.

痤瘡疤痕治療有許多方法，各有特色和副作用。對于大多數(shù)治療方法，在治療上副作用是炎癥后色素沉著（Fabbrocini et al., 2010），這是最明顯的膚色較深的類型（Shah and Alexis，2010）。皮膚磨削術(shù)，化學(xué)換膚和激光換膚可能導(dǎo)致炎癥后色素沉著。

處理類型：化學(xué)剝脫                        

機制 - 指示：最好的結(jié)果與黃斑疤痕。唯一的變數(shù)結(jié)果與冰錐和滾動疤痕。   

副作用：暫時色素沉著或刺激。

處理類型：皮膚磨削術(shù)

機制 - 指示：徹底消除了表皮的乳頭狀或網(wǎng)狀真皮層。將把冰錐和滾動疤痕。   

副作用：全身麻醉和感染的風(fēng)險。顯著患者的停機時間。膚色較深的可能會褪色和斑點。

處理類型：微晶磨皮術(shù)

機制 - 指示：除去表皮的外層。沒有深深的傷痕。

副作用：只有罕見的并發(fā)癥。

處理類型：電動微針

機制 - 指示：表皮基本完好，6周的作用機制后，看到全效提高膠原蛋白的產(chǎn)生。

副作用：炎癥后色素沉著比其他程序的風(fēng)險最低。

處理類型：CO2點陣激光治

機制 - 指示：燒蝕比非燒灼性更有效。40～80％的痕深度量化的改善。

副作用：病人必須停止異維A酸使用。黝黑的皮膚是炎癥后色素沉著的風(fēng)險。采用傳統(tǒng)的共色素沉著2 激光為36％（阿爾斯特和西部，1996年）

Dermapen Treatment of Acne Scars.  The Dermapen is a convenient and effective way of performing needle dermabrasion.

電動微針治療痤瘡疤痕。電動微針是執(zhí)行針磨皮的一種方便和有效的方法。  

The Dermapen adjustable needles penetrate a controlled depth into the dermis.  The dermis develops multiple microbruises, which start a cascade of growth factor release and collagen production.  Punch biopsy histology demonstrates thickening of the skin with dramatic increases in new collagen and elastin fibers (Fabbrocini et al., 2010).  As collagen is deposited, the skin texture improves.  Results are initially seen in six weeks and full effect will take three months to develop.  

電動微針可調(diào)針穿透的受控深度進入真皮。真皮開發(fā)多種微創(chuàng)傷，其開始生長因子釋放和膠原蛋白的產(chǎn)生的級聯(lián)。穿刺活檢組織學(xué)證實與急劇增加新的膠原蛋白和彈性纖維皮膚增厚（Fabbrocini等，2010）。膠原沉積，皮膚紋理得到改善。結(jié)果最初出現(xiàn)在六個星期，全部效果將需要三個月來養(yǎng)護。

Severity grade of rolling scars has been shown to be statistically reduced in a clinically meaningful fashion after two sessions of needle dermabrasion (Fabbrocini et al., 2009).  Importantly, there was no sign of hyperpigmentation in the 32 patients studied.

強度等級的軋制傷痕已顯示在具有臨床意義的方式進行統(tǒng)計減小針磨皮的兩個會話（Fabbrocini et al., 2009）之后。重要的是，在32例患者的研究沒有任何有色素沉著的跡象。

References

參考

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Camirand A, Doucet J (1997) Needle dermabrasion.  Aesthetic Plast Surg 21: 48-51.

Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D (2009) acne scarring treatment using skin needling.  Clin Exp Dermatol 34: 874-879.

Fabbrocini G, Annunziata MC, D’Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G (2010) Acne scars:  Pathogenesis, classification, and treatment.  Dermatol Res Pract 2010: 893080.

Goodman G (2003) Post acne scarring: a review.  J Cosmet laser Ther 5: 77-95.

Goodman GJ, Baron JA (2006) Post acne scarring: a qualitative global scarring grading system.  Dermatol Surg 32: 1458-1466.

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Levy LL, Zeichner JA (2012) Management of acne scarring, Part II:  A comparative review of non-laser based, minimally invasive approaches.  Am J Clin Dermatol 13:331-340.

Shah SK, Alexis AF (2010) Acne in skin of color:  practical approaches to treatment.  J Dermatolog Treat 21:206-211.

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回頭一笑

版主中文英文通吃??！看來你應(yīng)該是治療痘痘的專家。國內(nèi)的文獻滿足不了你。

心曠神怡⊙軍

回頭一笑 發(fā)表于 2015-5-31 13:55
版主中文英文通吃啊！看來你應(yīng)該是治療痘痘的專家。國內(nèi)的文獻滿足不了你。

這些其實都是平時查詢資料的時候收集整理的，時不時的發(fā)一篇出來，
也可以讓大家看到國內(nèi)外，對于痤瘡和痘坑修復(fù)治療的觀念。