Skin Republic

Dear Dr. Jen,

I have hypertrophic scars due to acne.  I am currently under isotretinoin treatment.  I still have cystic-like nodules on my upper chest and back.  I have tried other treatments but they are not that effective with me.  I have been reading up on cryoshaping.  Is this treatment available in Cebu or the Philippines? I am willing to try this because of the high success rate. Thank you!

Carmel

Dear Carmel,

Keloid scars are more common in Filipinos or Asians and dark-skinned individuals.  Filipino skin scar so differently from Caucasian skin.  Scars especially the hypertrophic or keloidal ones, can be bothersome cosmetically.  It can also itch, burn or cause painful sensations. The usual mode of dealing with these scars are intra-lesional steroids or laser.  However, laser can be pricey and like with most keloid treatments, will take several sessions. 

Cryotherapy, by spraying liquid nitrogen on top of the scars, can also be a painless and quick treatment option.  Keloidal scars, should never be excised, or taken out with a scalpel.  This will still cause another keloid to pop up in it's place.

Cryoshaping involves the use of a long, thick needle into the scar, hooking it to a source of liquid nitrogen and freezing the scar from within.  The cryoshape needle may look like a knitting needle.  With this, there is an invasion into the scar tissue with the thick cryoshape instrument.  This may be akin to cutting it up and run the risk for further keloid formation.  Though some anecdotal evidence sounds promising, some papers still contest its effectivity. 

I would wait for more scientific studies to be made about it before using this procedure.  If you insist on this procedure, try testing it on one scar first, and wait and see for good results.  If you respond well to it, then maybe you can have it done on all the scars.

Dear Dr. Jen,

I've been using the same cleanser and facial scrub for years.  But lately, I noticed that my skin has been having some dry spots and seems rough.  What gives?  Is it time to change my regimen?

Mary

Dear Mary,

While your usual regimen might have worked for you for years, it is also time to take stock of changes in your lifestyle, environment and skin, so adjustments can be made.  If you are spending most of the day in an air-conditioned place, chances are your skin is getting drier. And the older you get, the less moisture your skin is likely to produce.  It's time to amp up your regimen!

At this point, you might want to discontinue using loofah, exfoliants or other facial scrubs.  This will cause more irritation to dry skin and may even cause it to break out.  Toners may also be of no use, especially if it is the strong kind.

Using a gentle cleanser, preferably non-soap based ones, may be kinder on your skin.  Liquid cleansers, that don't produce that much bubbles (which means less surfactant/less detergent effect) may be something that you need now.  Getting rid of excess oil and dirt is the goal of a good cleanser. You don't want to strip your skin of its natural, protective oils. Investing in a mild moisturizer during the daytime may help calm your skin down.  Give it 2 to 3 weeks to see an effect. 

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan.