Collagen Stimulating Treatment

This technique has been used in the management of acne scarring. It is mainly used for rolling, linear and shallow boxcar scars. The instrument consists of needles attached on a drum and the device is rolled over the skin. Collagen stimulating treatment leads to the formation of multiple growth factors (fibroblast growth factor, platelet derived growth factors and transforming growth factors alpha and beta) which leads to increase number of fibroblasts. Increase production of collagen and elastin occurs.

Keratinocytes (epidermal cells) migrate occur the defect and lead to thickening of the epidermis. Five days after the procedure, a fibronectin matrix is laid down and collagen is deposited. Tissue remodelling occurs for months after the procedure. In the initial stages type III collagen is produced which is gradually replaced by collage type I.

The collagen stimulating device explained

The length of the needles can vary but the most effective length is 1.5mm. Depending on the degree of pressure applied the needles penetrate the scar tissue to a depth of 0.1 to 1.3mm. It is most useful in patients prone to post-inflammatory hyperpigmentation with lasers and who have rolling, boxcar or linear atrophic scars. Fresh scars or scars less than 12 months old tend to respond best.

This procedure can be repeated at 6 to 8 week intervals. The improvement tends to be greatest after the first session.

Collagen stimulating treatment is more effective in rolling scars and CROSS technique in ice pick and boxcar scars. Collagen stimulating treatment may be more effective in patients prone to post-inflammatory hyper and hypopigmentation as high strength TCA such as 100% TCA cross technique is associated with more pigmentatory disturbances in dark skin patients.