Previous surgeries, injuries, burns or even severe acne outbreaks can leave behind hypertrophic (thickened, raised) scars or keloids, which can severely affect a patient’s self-image and confidence, especially if it is in a highly visible area. They are caused by excessive or persistent signals by the body to repair an injury, leading to an overproduction of scar tissue. Patients with genetic predisposition to keloid formation (those who have keloids before are more likely to develop keloids again to new injury), Asian patients, and injuries in highly mobile parts of the body (chest for example, which is moving all the time with breathing) are more likely to develop keloids. Traditional treatments such as the injection of steroids directly into the scar can help resolve the hypertrophic scar by reducing the body’s response to the injury and mitigating the excessive healing response, but is often unsatisfactory in the treatment of keloids, as the keloids tend to recur over and over again, requiring new injections each time. With the triple therapy, physicians can now combine the effectiveness of intralesional steroid injections, with a vascular laser that shrinks the blood vessels near the keloid (reducing the excessive repair signals going into the area), with tiny doses of Botox injected into the skin surrounding the keloid (which reduces movement and stretch around the keloid, that are proven to trigger the persistent healing response). After the initial 6-8 sessions, this technique can help some keloids resolve completely and permanently, while significantly increasing the time between recurrences for others, which is often a great source of relief for the patients.
Once the skin is free from pathologies, we can then begin working on the desirable outcome of skin quality. Youthful skin is hydrated, soft, supple, smooth, while being free of fine lines, wrinkles, uneven textures and open pores. This is possible because youthful skin regenerates collagen effectively, which holds moisture in the skin. Well hydrated skin looks and feels good, and is also healthier and more resilient. As we age, due to environmental factors such as sun and UV exposure, pollution and smoking, our cells gradually lose the ability to repair themselves and to regenerate lost collage. Consequently, our skin loses its ability to retain moisture, leaving it dry, rough, and sallow, with textural irregularities, and the appearance of fine lines and open pores. Daily sun protection, a healthy lifestyle, smoking cessation, skin supplements, as well as skincare containing moisturisers, antioxidants such as Vitamin C, signalling peptides and other ingredients that promote repair and new collagen formation, can help to slow the process of skin aging. Energy based treatments such as lasers, IPLs, RF devices and focused ultrasound devices can help encourage the skin to regenerate collagen by stimulating repair and new collagen formation, with a good example being LIOBs generated by specialised picosecond lasers encouraging the skin to heal and make new collagen, which helps the skin retain moisture better. Finally, injectables such as hyaluronic acid and other biostimulators can similarly stimulate the body to make new collagen, as well as hold water on their own when deposited under the skin as in the case of hyaluronic acid based fillers or skinboosters. The end result is skin that is more hydrated, smoother, softer, with less apparent fine lines and open pores, and that holds makeup well so that heavy occlusive makeup is no longer required to cover and hide flaws, and light makeup is all that is required to enhance the natural beauty of healthy skin.