摘要

Objectives: 1. Non-invasive management of hypertrophic scars in acne and after dermal remodeling. 2. Modify the structure of the reparative tissue and limit the hypertrophic component in the inflammatory skin healing phase. 3. Lower the score on the Vancouver and P.O.S.A.S. scale. Introduction: Hypertrophic scarring represents one of the most insidious complications in the skin repair in post acne and in surgery outcomes that can be addressed by hypodermic injections of auto-cross linked hyaluronic acid 200 KDa combined with endodermal radiofrequency technology and high flow carboxytherapy. Materials / method: 5 surgical scars and 2 acne scars in the comedo-cystic phase were selected and treated with the following protocol: One application of auto-cross linked hyaluronic acid 200 kd every 15 days for two months. Alternate use of emitting Radiofrequency (RF) followed by galvanic current via ultra-thin electrodes for two times in the same session with epidermis insufflation of high flow Carboxy-therapy every 15 days apart for 2 months. Application of trichloroacetic acid 33% modulated with hydrogen peroxide for 5 minutes at the end of all session. Use of SPF 130+ for 4 months two times a day. Results: In scars that had a score of 7-9 points on the Vancouver scale at baseline, a score of 2-4 points was obtained 15 days after the combined approach and 75 days after the start. At the same time, scars that at baseline had a POSAS score from observer perspectives of 28-33 points and a from patient perspective score of 45-56 points, after 15 days from the combined approach and 75 days from the beginning, they achieved a total score of 17-24 points respectively of 23-35 points. Conclusion: This combined treatment for scars resulted in all treated cases in tissue remodeling with reduction of the inflammatory component, smoothing of the scar and replacement of disorganized fibrous tissue with homogeneous repair tissue that could be confused with the surrounding skin tissue associated with contraction and reduction of amplitude along the transverse axis.