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Monday, August 23, 2010

How to Combat Scars, Stretch Marks and Cellulite

Scars, stretch marks and cellulite: these are three of the biggest complaints I get from my patients. Many who have experienced pregnancy suffer from stretch marks and want to know how to make them go away.  Scars are another problem, especially for my acne patients. And cellulite is a real problem when the weather turns warm and the shorts come out.

I want to help you differentiate fact from fiction about how to approach the management of these three problems.

Scars are the result of the skin healing after suffering an injury. Our skin is designed to be our first barrier against infection. If we cut ourselves, suffer an injury or choose to have a piercing done, our skin barrier has been breached, and the body responds by closing it up as quickly as possible. The problem is that scar tissue is very different than the surrounding skin tissue. As a result, it stands out and can be an obvious blemish. Over time, scars will diminish in appearance.

I tell my patients that there is no single treatment that is best for everyone. Here are a few procedures that we can try to see how they work for you:

  • Laser resurfacing treatments
  • Dermabrasion
  • Surgery
  • Tissue Fillers

Stretch marks occur when the skin of your body has been stretched, most commonly from pregnancy. However, there are some of my patients who suffered from rapid weight gain which also caused stretch marks. Fortunately, they are harmless and typically fade over time, but never completely go away. You may see ads for creams and ointments that promise to erase your stretch marks. These products will contain ingredients like vitamin E, cocoa butter or glycolic acid. They are good for your skin, but they really won’t erase the marks.

There are some treatments that are somewhat effective at helping to minimize the appearance of stretch marks including:

  • Pulsed dye laser therapy
  • Microdermabrasion
  • Tretinoin Cream (Retina A)
  • Fractional photothermolysis
  • Excimer laser

I like to work with my patients to determine the best approach to take for them. We will take into account how long they have had the stretch marks, how convenient a particular treatment would be for them, price and expectations they may have about the results. Most treatments are really only partially effective. No treatment ever completely eradicates stretch marks.

Cellulite is the result of lumpy deposits of fat near the surface of the skin that causes us deep embarrassment as soon as shorts and swimsuit season comes around. These fat deposits push against the connective tissue underneath your skin which makes your skin dimple and pucker its characteristic way. Most women will develop cellulite at some point in their lives. (If your mother had cellulite, chances are very good that you will develop it as well.)

Weight loss, a healthy diet and exercise is your best defense against cellulite as these strategies will certainly improve the appearance of the dimpling in your skin. Unfortunately, even at your ideal weight, cellulite is unlikely to go away completely.

Liposuction is ineffective on cellulite as it only targets deep fat stores, and cellulite is near the skin’s surface. So too are most of the devices, products and creams that are available to treat cellulite. There is little to no scientific evidence that any of these things eliminate cellulite.

Mesotherapy has been used by a number of spas as a treatment for cellulite, but in April of this year, the FDA condemned it as an unsafe practice and discourages its use.

Cellulite is a skin problem and not a fat problem. Cellulite is caused by abnormal attachments between your skin and the underlying tissue in your body. Cellulite formation can be  influenced hormonally as well as by your genetics. A nutrient rich diet that emphasizes essential fatty acids, amino acids and antioxidants will help to reduce cellular inflammation, reduce fluids and increase skin circulation. This is my recommendation as a noninvasive approach to increase the collagen production in your skin, but unfortunately, it’s not a cure for cellulite.

There are two devices that the FDA has recently approved to battle cellulite. One is the TriActive, which is laser light. The other is VelaSmooth that emits high levels of energy. Both work through a combination of light energy ,tissue manipulation and negative pressure. Neither of these treatments are inexpensive, and both treatments are available through your  doctor. Again, these treatments may decrease the appearance but they are not a cure for cellulite.

While scars, stretch marks and cellulite make us individuals, the good news is that there are a number of ways to try to minimize the appearance of such distinguishing characteristics.

Do you have problems with scars, stretch marks and/or cellulite? What have you tried? Has it worked? What didn’t deliver the goods? Ask questions and share your tips with the Skin and Beauty Community.

Posted by: Susan Evans, MD at 9:13 am

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