Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
acid is able to increase fibroblast proliferation and extracellular matrix components synthesis in vitro.12-14 All these biological properties make retinoids a very useful tool for dermatologists in the prevention and treatment of acne scarring.Management of Acne Scars Anecdotal experience and medical investigations have shown that most cases of acne scarring cannot be solved by a single “best” treatment. Acne scars can vary for type and depths and each of the currently available treatments is ideally suited to ad dress a subset of this spectrum. Below, we summarize the most used therapeutic techniques available for acne scars management, their indications/contraindications, evidence for efficacy, and potential adverse effects.Chemical Exfoliation Chemical exfoliation is obtained by applying chemicals to the skin to destroy the outer damaged layers and accelerate the repair process. Active inflammation, dermatitis or infection of the area to be treated, isotretinoin therapy within 6 months before peeling procedure, pregnancy, and delayed or abnormal wound healing are general contraindications for all types of chemical exfoliations. Different agents have different depths of penetration and therefore, chemical peels can be divided into four different groups based on the histologic level of necrosis that they cause (Table 3).Glycolic acid (GA): GA is the most commonly used alpha hydroxyl acid as a peeling agent. GA acts by thinning the stratum corneum, promoting epidermolysis, and dispersing basal layer melanin. It increases dermal hyaluronic acid and collagen
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