​New insights on neo-collagenesis for effective scar treatment

October 28, 2024
Healthcaretoday, AMSC, Aesthetic Medicine Surgery Conference Exhibition, Dr Oleksandr Turkevych, skin rejuvenation, neocollagenesis, post-burn, traumatic scars, scar treatments, skin aging, chronic inflammation, cell senescence, declining hormone, inflammaging, aging, skin firmness, skin elasticity, erbium lasers,
​​​​​​​Skin rejuvenation has advanced significantly with treatments incorporating injectables like hyaluronic acid (HA), polydeoxyribonucleotide (PDRN), poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), and polymethyl methacrylate (PMMA). Light-based treatments such as lasers, intense pulsed light (IPL), and LED therapy, as well as radio-frequency and ultrasound methods, have also become key in modern aesthetic practices. These methods aim primarily at stimulating neocollagenesis, though the effectiveness of each varies and depends on a careful understanding of collagen formation mechanisms.

Dermatologist Dr Oleksandr Turkevych (pix) from Ukraine, a specialist in dermatovenereology and oncology, discussed the complexities of treating post-burn and traumatic scars at the Aesthetic Medicine & Surgery Conference & Exhibition (AMSC). Dr Oleksandr emphasized that true progress in treatments lies in robust, randomized, double-blind studies that provide definitive answers and foster international consensus on effective scar treatments.

Key factors in skin aging and scar formation
Skin aging and scar development involve multiple factors, such as reactive oxygen species (ROS) production, chronic inflammation, cell senescence, and declining hormone and growth factor responsiveness. These stressors reduce mitochondrial activity and cellular turnover, significantly impacting skin resilience and rejuvenation.

Polydeoxyribonucleotide (PDRN) applications
PDRN treatments include various types:
  • Micro PDRN: Naturally sourced, such as Pharm PDRN and PM PDRN
  • Plenhyage: Includes Medi PDRN and MD PDRN
  • Hydrolyzed PDRN: Skin-penetrable, offering formulations like COS PDRN, CS PDRN, MESO PDRN, and MS PDRN

These variations allow for targeted therapeutic approaches to optimize collagen synthesis and skin repair.

Physiological neocollagenesis via A2A receptor stimulation and CAV-1 regulation
"Inflammaging," or chronic inflammation with aging, is a significant concern. Elevated pro-inflammatory cytokines like TNF-α, IL-1, and IL-6 contribute to aging, while anti-inflammatory molecules (e.g., IL-10 and TGF-β) are often insufficient to balance this activity. Adenosine, released under cellular stress, plays a critical role in moderating these inflammatory responses, ultimately aiding in the regulation of collagen formation.

Caveolae in ECM and dermal adipose tissue regulation
The aging process brings substantial changes to the skin's cellular structure and the extracellular matrix (ECM), impacting its stability. Caveolae and related proteins, such as cavins and caveolins, help regulate ECM composition, which is essential for skin firmness and elasticity. As these structures deteriorate with age, the visible signs of aging become more pronounced.

The precision of erbium laser treatments
For targeted treatment, erbium lasers offer unmatched precision by delivering energy absorbed efficiently by water. This technology allows clinicians to precisely control exposure depth and temperature, from superficial peeling to deeper thermal coagulation, creating controlled micro-wells in the skin. These wells facilitate enhanced drug delivery during the immediate post-treatment period, allowing active ingredients to penetrate deeply and support faster healing.

Advanced laser technologies for scar treatment
Recent advancements in laser technology, tailored for deep scar treatments, include:
  • Deep-spot technology: Designed for treating deep, fibrotic, and acne scars
  • Variospot technology: Automatically adjusts spot size with easy fluence control, optimizing energy delivery
  • Microspot technology: Features an adjustable micro-lens array for precision targeting

New deep spot microspot handpiece
This fractional skin ablation handpiece ablates 10-25% of the epidermis, enabling precise penetration up to 3mm in a single application.

Incorporating these advanced technologies and understanding the science of neocollagenesis bring us closer to effective scar treatments, promoting natural healing and lasting skin rejuvenation.

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