Hydroxy acids, like salicylic acid and glycolic acid, are widely used as exfoliating substances and for skin peels. They remove devitalized skin cells and also loosen and slowly reduce or dissolve skin lesions like age spots, acne scars, skin tags, moles, burn scars, keloid scars, stretch marks, surgical scars, and sun damage marks.

The secret of hydroxy acid's effects is that your healthy, normal skin has an elevated resistance to such acids. In contrast, most skin lesions have less structural integrity and are more easily broken down by the acids. The repeated application of such acids over periods of a month or longer slowly minimizes and even dissolves most skin lesions. This is essentially a modification of the classic skin peel techniques where a very strong hydroxy acid (or other peeling agents like TCA or phenol) are used as skin peels. Such methods work very well under ideal circumstances. However, hydroxy acids can be highly irritating if the subsequent healing reaction of the skin is inadequate to fully heal the acid-treated skin. If there is too little skin rejuvenating, then the peeling substance can cause further scarring or inflammation.

Skin Abrasion Also Speeds Scar Reduction

Methods that mildly abrade skin like microdermabrasion and subcision (needling) also are useful in accelerating scar reduction in concert with Hydroxy Acids. Some old scars are very hard and tough and physical breakdown allows the hydroxy acids to start reducing the scars. For raised or flat scars, microdermabrasion serves well. For depressed scars, like pitted acne scars, subcision with needles is often performed by estheticians to break up the deeply buried scar tissue.

Skin Remodeling is the Key to Scar Elimination

The elimination or reduction of scars, blemishes, and stretch marks from the skin depends on a mechanism known as "skin remodeling". The skin is designed to cure wounds quickly to prevent blood loss and infection. Scars are made from a rapidly formed "collagen glue" that the body deposits into an injured area for protection and strength. In perfect skin healing, the damaged skin is rapidly closed, then the healed area is slowly rejuvenated to remove the residual collagen scars and blend the skin area into surrounding skin. Scar collagen is eliminated and replaced with a combination of skin cells and fine collagen fibers. This skin remodeling can continue in a skin area for 10 years. In children the remodeling rate is elevated and scars are usually rapidly eliminated from injured skin areas. But as we reach adulthood, this rate decelerates and small scars can remain for years. One way to speed up remodeling is to produce a small amount of controlled skin damage with a needle, laser, or other procedures, and then let the body's repair mechanisms rebuild the skin area. A second method is to use skin healing accelerators that elevate the body's biological healing mechanisms to obtain an even better final result.