Dermaroller S.a.r.l., France

“Acne is a common disorder experienced by up to 80% of people between 11 and 30 years. For most patients acne remains a nuisance. For other less fortunate persons, the severe inflammatory response to bacteria (propionibacterium acnes) results in permanent disfiguring scars. Stigmata of severe acne can lead to social ostracism, withdrawal from society, and severe psychologic depression.”  (Carolyn I. Jacob et al, 2001, Acne scarring).

Once scars have completely matured, physicians have limited options - mainly surgical ones like punch excision and subcision - to improve the skin’s appearance.

So far we have never seen that laser, dermabrasion or acid peeling have considerably improved acne scars. In most cases patients judge the results subjective as better or good. From the technical and physiological point of view these “resurfacing” therapies can only have a limited effect. The reason is simple: These methods can only work superficially but never in deeper skin.

As the acne scar treatment with the Dermaroller is extremely successful, especially compared with conventional procedures, we would like to focus on the NEW THERAPY.

According to the tens of thousands of acne scar treatments performed by many physicians around the world within the last 3 years, acne scars respond very positive to Dermarolling. Depending on the affected skin area and quality of the scars, several treatments (2 to 5) may be necessary in order to achieve a maximum possible result. The improvement may vary from 30 to 80%. Any better result should be considered as a bonus.

Before acne scar treatment with the Dermaroller is performed one principle has to be followed: Acne must be completely healed.

Usually acne scars are atrophic or depressed. This means the scar base is below skin level and therefore the skin often looks like a crater landscape. Due to the scary edges the tissue in and around scars is less pigmented and looks pale or even violet in colder climates. We also observed that acne scars are often associated with pigment spots, mainly on darker skin.

Type: ICE PICK
This type is like a small channel, usually not wider than 2 mm on the surface. It reaches from the skin surface into the deep dermis, sometime into the sub-dermal tissue. This scars respond to the Dermarolling, provided they are not too narrow. An option for small and deep ice pick scars could be a surgical punch excision.

In order to be fair to the patient, he/she must be told that the possible disadvantage of an excision is, that a new, but possibly smaller scar, will be left in the skin. If the patient suffers from all 3 types of acnes scar – which is usually the case - we recommend to start acne scar treatment with the Dermaroller in the first place. If after 2 to 3 treatments the ice pick scars have not improved, a surgical excision can still be considered.

Type: ROLLING SCARS
This is the most common and most disfiguring form of acne scars. In most cases the lower part of this scar type is connected to the deeper fascia by collagen fibers. Some improvement may be achieved by subcision. This means in simple words, the surgeon will cut these fibers with a special scalpel. Although these scars will have less tension after subcision, it should be pointed out that a scalpel also causes a scar, although it may be small.

TYPE: BOXCAR
At present we cannot say how many percent of improvement a Dermarolling will bring on this type of acne scar. However, in April 2007 we start a study on 125 patients performed by 5 different dermatologists. We hope to get more knowledge and a better understanding by the end of the year 2007.

The fine but extreme sharp surgical needles perforate the scar bed and scar edges. Each skin part is Dermarollered about 15 to 20 times in order to achieve an intensive perforation. This takes off the tissue tension and softens it. This procedure also perforates and breaks down the fibrotic fibers that often connect the scar base with the fascia. This ensures that in most cases a subcision of this fibers become obsolete.

Soon after scar perforation new capillaries and fibroblast can migrate through the scars walls into the former “scar crater”.

After several treatments the former “acne scar crater” is filled with new collagen layers, thus brings the previous depressed scar to normal skin level.

Colored skin is different from Caucasian skin and usually has more melanin. For some unknown reasons acne scars are often associated with pigment spots. We do not know why these spots disappear after Dermarolling, but it is a fact.

As new collagen formation needs time to mature we recommend intervals of six weeks before the next treatment should be considered.

So far various ablative methods were used for skin rejuvenation. The disadvantages of these techniques are, that the epidermis is removed and the tissue reacts to this massive cell damaged with the body’s repair and wound healing mechanism by forming a FIBROSIS.

The appearance immediately after a COLLAGEN-INDUCTION-THERAPY. The face is pinkish to red that lasts on Caucasian skin in average about 12 to 24 hours.