Step by Step® Treatment of Acne Scars Niti Khunger
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Ablative fractional laser resurfacing 149
Ablative lasers 280
Acetic acid 67f
Acetone 85
Acne 11, 16, 17, 19, 28, 31, 49, 49b, 68f, 178, 238, 246
active 67f, 138
severe 269
aggravation of 76
comedonal 56
control 270
of active 241
evaluation of 2
excoriée 33, 52f, 65, 66
flare 275, 289, 294
fulminans 9
hormonal 55
hypermelanotic macules 160
improvement of 75f
active 68f
lesions, inflamed 49
moderate 52
nodulocystic 53
pathogenesis of 18, 18f, 19
premenstrual flares of 8
role of diet in 11
severe 51, 251
steroid-induced 49, 50f
treatment of 1, 52, 249
with isotretinoin, flare of 54
Acne scar 17, 18, 23, 31, 46, 57, 59, 62, 79, 144, 153f, 169171, 182, 193f, 196, 253, 259, 263, 299, 304, 307, 308, 311, 319, 334, 350, 357
appearance of 305f
atrophic 33, 233f
camouflage techniques for 311
classification of 33, 358fc
combination treatments for 329
complications of 263, 281t
deep 271
distensible 226
excision techniques for 105t
fillers, newer 171
grading of 42
hyperpigmented 66
hypertrophic 157
imaging techniques for 304
laser devices to treat 145t
light devices to treat 145t
makeup products for 314
management of 263, 330
minimally invasive techniques for 331t
moderate 156f
morphological types of 32t, 33
newer laser technologies for 165
pathophysiology of 16, 23
peculiar features of 264b
prevention of 48, 49, 49b
procedure for 271
severe 151f
stages of 268b
superficial 138
system 42
technique for 304
treatment of 45, 146, 263, 321
mild-to-moderate 150
types of 160t
types of 23f, 31, 32f, 91, 221, 324, 331
Acne vulgaris 1
management of 3t
pathogenesis of 19
Acneiform eruption 161, 288, 289, 294
folliculitis 164f
Adapalene 4, 53, 272
cream 203
Adipocyte 190, 197
Adrenaline 184
Allergic reactions 179, 288, 290
Allium cepa 248
Alpha hydroxy acid 59, 60, 142, 276, 332
Alpha-keto acid 60
Aluminum oxide 133
crystals 134f
microdermabrasion 133
Amoxicillin 6
Analgesics 283
Androgens, circulating 19
Anesthesia 94, 161, 188
infiltration 242
topical 234
tumescent 190
Anetodermas 238
Angiogenesis 21
Anti-acne
regimen 269
therapy 4
Antibacterial agents 4
Antibiotics
post-treatment 280
topical 2, 4, 286
Anticoagulant therapy 175
Antifungal agents, topical 294
Anti-inflammatory agents 4, 286
topical 332
Apoptosis, inhibitor of 22
Arbutin 295
Aseptic precautions 188
Aspiration, functional 324
Aspirin 93
Atrophic acne scars, mild-to-moderate 155
Atrophic scars
classification of 360fc
depressed 35
M-shaped 45
U-shaped 44
Atrophic shiny skin 298
Atrophy 75
Auricular nerve paresthesia 327
Autoimmune diseases 171
Autologous fat
grafting 193f, 197
one session of 225f
transfer 182, 232f
lumpy appearance after 225f
Autologous fibroblast 225, 226
Automated rollers 118
Azelaic acid 2, 5, 53, 295
Azithromycin 5, 6, 7
B
Bacterial colonization 18, 18f
Bacterial infection 161, 269, 292
secondary 159, 275
Bacteriostatic agent 188
Bent insulin syringe 82f
Benzoyl peroxide 24, 52, 53
Beta-hydroxy acids 276
Biopsy punches, disposable 103
Bipolar microneedling radiofrequency 226
Bipolar radiofrequency 323
Bleaching
agents, postprocedure 274
regime 343, 345
Bleeding diathesis 175
Blindness, higher risk of 234
Blood
cells 190
dyscrasias 6
oozing 286
vessels 21
Body dismorphophobic disorder 159, 331
Bovine collagen 169
Boxcar scars 25, 26f, 32f, 36, 37f, 148, 158f, 212214, 220, 236, 331, 335, 341, 352
atrophic 81
complications of 218
contraindications of 214
deep 214f
indications of 214
limitations of 215
management of 362fc
multiple 219f
punched-out 213f
postprocedure care of 218
precautions of 215
preprocedure preparation of 215
superficial 148
technique of 215
therapy for 336
treatment of 213
Boxcar with sharp vertical contours 213f
Bradycardia 299
Breast
cancer 8
enlargement 8
Bridging scars, management of 364fc
Brimonidine gel 318
Bruising 178, 288
C
Calcium hydroxylapatite 177, 236
Camouflage makeup 313
Candida 294
infection 283
Carbon dioxide 145, 222, 231, 236
laser
fractional 149
principle of fractional 147f
resurfacing, fractional 296f
Carboxymethylcellulose 172
Cell
death, programmed 195
lysis 191
Cervical cancer 8
Chemical peels 3, 10, 65, 260, 276, 280b, 281, 339, 353
gel-based 323
medium-depth 66, 236
superficial 66, 71, 77, 295
Chest 29f
Chickenpox scars 93
Chronic disorder 1
Citric acid 67f
Clindamycin 4, 5, 53
Clostridium difficile infection 6
Cobblestone appearance 210
Collagen 21, 170, 171
gene expression 60
injections 171
regeneration of 183
Combination techniques, advantages of 330
Comedogenesis 19
Comedonal acne, mild 52
Comedone 138
extraction 3
Correct technique pinpoint frosting 84f
Cosmetic
camouflage 312
procedures 138
Cross-hatching technique 176f
Cryosurgery 276
Cryotherapy 57, 59, 62, 248, 249, 252
Crystal microdermabrasion
machine 133, 134f
principle of 134f
Cutaneous infestations 308
Cutibacterium acnes 1, 16, 17
Cyst 1
drain eye of 57f
Cystic acne 26, 38, 287f
treatment of 57f
Cystic lesions 27
D
Dapsone 2, 5, 53
Darker skin 219, 236
complications in 257t
problems in 264
types 253, 299
treatment for 257
Deafness 298
Dehydroepiandrosterone sulfate 2
Demarcation lines 297
Depigmented macules 34f
Dermabrasion 260, 276
Dermal chromophores 285
Dermal hyaluronic acid 60
Dermal injury 261
Dermal tissue, loss of 237
Dermapen 119
Dermaroller 119
therapy 286
Dermastamp 118
Dermatitis 52
contact 60
irritant 312
Dermatoses, evolving 139
Dermatosurgical procedures 286
Dermoscopy 308
Diabetes 186
mellitus, uncontrolled 139
Diamond microdermabrasion 136
machines 137
tips 136
Diamond peel 137f
Diarrhea 299
Digital photography 304
Diode laser 157
Distensible scars, moderate-to-severe 225
Diuresis 8
Dizziness 6, 8, 298, 299
Donor site selection 188
Dot peels 150
Doxycycline 5, 6
Drospirenone 7
Drowsiness 299
Drug reaction 7
Drugs, photosensitizing 271
Ductal corneocytes, inadequate separation of 19
Ductal hyperkeratosis 18, 18f
Ductal keratinocytes, hyperproliferation of 19
Dyschromias 254
Dyspnea 299
E
Echelle d'evaluation clinique des cicatrices d'acne scale 44
Ectropion
development of 285
formation 161
Eczema 139
Edema 124, 161, 162, 178, 288, 289, 336
Elastolysis, superficial 45
Electro-optical synergy 324
Elliptical excision 105
Emphasis 295
Energy based devices 258
Eosinophilia 7
Epidermal growth factor 20, 21f
Epidermal heating, uncontrolled 285
Epidermal keratinocytes 255
Epidermal melanin
elimination of 295
increased 255
Epidermal necrotic debris, microscopic 147
Epidermis, dermabrasion of 110f
Epithelial tracts 251
Erbium glass laser, fractional 243
Erbium pixel laser 355
Erbium:yttrium-aluminum-garnet 145, 265
laser 145, 162f, 163f, 164f
resurfacing 148
sessions 153f, 158f
Erbium-doped yttrium aluminum garnet 331
laser 222
fractional 150
Erosions 138
superficial 161
Erythema 49, 74f, 84f, 161, 162, 178, 276, 279f, 288, 289
postlaser 356
postmicroneedling 124f
postprocedure 207, 290
prolonged 237, 261, 283, 336
reduction of 356f
temporary 356
transient 325, 336
Erythematous macular scars 158f, 160
Erythematous scars 331, 332
management of 359fc
Erythromycin 57
Estrogen 7
Ethinylestradiol 7
F
Facial acne scar 46
Facial herpes simplex, history of 203
Facial makeup, color of 316
Facial modeling device 307
Fan technique 176f
Fat
aspiration of 190f, 191f
efficacy of 195
future of 197
grafting 197f
donor sites for 189f
instruments for 185f
technique 188
types of 183f
harvesting 184, 188, 189
injection 192
placement 188, 192
preparation 191
processing 186, 188, 190
reinjection 186
survival of 195
transfer 186, 237
disadvantage of 187
Ferrous fumarate 7
Fibroblast 21
growth factor, basic 20, 21f
reactive 255
Fibronectin 21
Fibroplasia 21
Fibrous tissue 16
Fillers 169, 335
adverse effects of 288
injection techniques of 176f
substances 173
Fitzpatrick skin 253, 254, 256
phototypes 254
type 260, 334
Flotation 105
Fluocinolone acetonide 295
Fluorouracil 160
Flutamide 7, 9
Focal postinflammatory erythema 292f
Focal pustular acne 275f
Food and drug administration 5
Fractional ablative
lasers 281
technologies 144
Fractional laser 254, 283
ablation 126
resurfacing 348
Fulminant acne 50
Fulminant hepatic necrosis 6
G
Gastrointestinal disturbances 6
Glabellar area 229f
Global acne qualitative scale 43
Glycolate hypersensitivity 60
Glycolic acid 3, 10, 59, 60, 70, 241, 272, 278, 354
Glycolic peels 276
high-strength 277f
Graft
elevation of 113f
retention, minimal 196
Granuloma formation 237, 290, 298
Growth factor 124, 247
beta, transforming 20
insulin-like 22
platelet-derived 21f, 247
H
Hair
disorder 308
follicles 238
Headache 8, 299
Healing, delayed 297
Hematoma 236
formation 234
Herpes infection, active 138
Herpes labialis 81
Herpes simplex
activation of 161
active 66, 68f
history of 271
infection 175
active 269
Hirsutism 8
Homecare dermarollers 118
Hormonal agents 7
Hormonal therapy 7, 55
Human dermal fibroblasts 20
Human immunodeficiency virus 172, 235
Hyaluronic acid 124, 170, 171, 180, 207, 237
cross-linked 287
derivatives 169
filler 178f, 222, 235
Hyaluronidase 250f, 253, 258, 272
injection 237
Hydroquinone 60, 241
Hyperandrogenism 8
Hyperpigmentation 51, 82, 113f, 276, 294
postinflammatory 5, 51, 69, 76f, 88f, 99, 120, 163, 163f, 209f, 210, 218, 241, 243, 257, 296f, 321, 339
risk of 271, 333
Hyperpigmented scars, management of 360fc
Hyperplastic epithelium 24
Hyperplastic papular scars 44
Hypersensitivity 6
reactions 7
Hypertrophic scars 29f, 32, 38, 40f, 43, 45, 51, 61, 79, 148, 161, 164, 179, 246248, 253, 256, 283
and keloids, history of 69
management of 364fc
treatment of 60, 252
Hypodermic needle 222
Hypopigmentation 276, 295
postinflammatory 163
secondary 297
Hypopigmented macules 33
Hypoxia 195
I
Ice pick 36f, 201f
acne scars 79, 85, 206f
Ice pick scar 26, 32f, 35, 42, 81, 93, 200, 201, 210, 331, 333, 351
deep 32f, 202, 202f
depth of 201, 203f
management of 361fc
mild superficial 202f
moderate 202f
treatment of 203
typical 36f
V-shape epithelial tract of 201f
worsening of 209f, 298
Immunocompromised status, history of 159
Infection 76, 178, 290, 292
active 214, 223
Infiltration anesthesia, discomfort of 234
Inflammation 19, 174, 178, 246
active 214, 223
phase of 20, 21
reduce 258
secondary 18f
Inflammatory acne 5, 19, 269
Inflammatory disease
chronic 16
multifactorial chronic 11
Inflammatory disorder 1
Inflammatory infiltrate 269
Inflammatory lesions, active 81
Inflammatory mediators destroy 26
Inflammatory papules 57
Injectable fillers 287
Instruments 131, 184
Insulated needles 323f
Insulated wire electrode 240
Intense pulsed light 160, 359
devices 157
treatment 161b
Intralesional corticosteroids 57
Intralesional radiofrequency 239, 242f, 244f, 249
Intralesional steroids 104, 105, 248, 250, 364
Intralesional triamcinolone acetonide 250f
Intra-treatment vigilance 273
Iontophoresis 59, 62
Iris scissors 104
Irritation 290
Ischemia 187, 195
Isotretinoin 9, 10, 54, 249, 271, 327
therapy 10
J
Jasmonic acid 67f
Jessner's solution 65
modified 70
Jewelers forceps 104
K
Keloid 27, 79, 138, 179, 246, 248, 252, 297
acne scars 313
formation 297
frequency of 255
risk of 256
scars 39, 40f, 43, 51, 164, 248, 253, 261
management of 364fc
tendency 81, 269
treatment of 60, 249
Keratinocyte growth factor 21f
Kojic acid 241, 278, 295
L
Labile melanocyte responses 255
Lactic acid 67f, 70, 354
Laser
abrasion 342
beam 203f
complications of 161b
devices 144, 258
energy, melanin absorption of 285
exfoliation, post-fractional resurfacing 284f
parameters, selecting appropriate 274
resurfacing 280
therapy, contraindications of 159b
treatment 254, 346
Lens
contact 72
reflex camera, single 305
Lesions
healing 269
nodulocystic 57
removal of pigmented 254
Levomefolate 7
Light devices 144
Light-emitting diode 118
Lightening agents 272
Lignocaine 106, 184, 188
Linear acne scars 228, 231f
lipoatrophic 230f
Linear atrophic scars, narrow 229f
Linear scars 26f, 37, 38f, 229f, 231
hypopigmented 231
management of 363fc
narrow 232
subtypes of 228
treatment of 228
of narrow 231
Linear threading technique 176f
Lipoatrophic acne scars 174f, 228
Lipoatrophic linear scars 229, 232f
Lipoatrophic scars 29f, 38, 39f
Lipoatrophy 223f
Lipografting, technique of 184f
Liposuction cannula 185f
Local anesthesia 106, 234, 339
infiltration of 341
lignocaine 104
Lumenis 342
Lumpiness 290
formation 298
Lupus
drug induced 7
erythematosus 139
Luteinizing hormone 2
M
Macular acne scars 67f, 152f
Macular atrophic scars 42
Macular erythematous acne scars 66
Macular scars 33, 332
Macules acne scars, hyperpigmented 65
Magnesium oxide 133
Makeup 317
fixing 317
setting 317
Mandelic acid 3, 10, 53, 59, 60, 69, 70, 277, 332, 354
peel 70
Matrix metalloproteinases 20, 53, 61
Maturation, phase of 20
Medical therapy 52
Melanocytes 295
Melanosomes, larger 255
Melasma 259
Menarche 8
Menstrual irregularities 8
Mesosolutions 323
Metallic crystals 136
Metalloprotein, tissue inhibitor of 21f
Metalloproteinases, tissue inhibitor of 247
Methyl alcohol 81
Microdermabrasion 130, 275, 281
advantages of 142
causes 131
crystals 131, 132, 136
diamond tips suitable for 137f
effective 142
erythema after desired endpoint of 141f
machine 132, 137f
types of 133
tips 136, 137f
Microfat 197
Microneedle 115, 128, 280, 281
after three sessions of 126f
delivery systems 119
endpoint of 122f
instrument 117f
principle of 116
radiofrequency 239, 288, 321, 322, 322f, 331, 333
fractional 321
treatment 324f
Microthermal zones, density of 259
Milia 161, 178, 275, 294
Minipunch grafting 202
Minocycline 57
Mitogen-activated protein 247
kinases 20
Moisturization 315, 343
Molluscum contagiosum 68
Mometasone 295
Monocytes 21f
Monopolar radiofrequency 323
Monotherapy 67f
Multifactorial disorder 1
Myocardial contraction 278
Myocardial infarction 8
N
Nail disorder 308
Nanofat 197
Nasolabial fold, lipoatrophic in 230f
Needle
abrade 115
holder 104
selection 94
Negative pressure 141
Neodymium:yttrium aluminum garnet 331, 332
Neodymium-doped yttrium aluminum garnet 254, 352, 360
laser 155
Neutral pH balance 135
Nicotinamide 53
Nodular keloids 297
Nodular lesions 351
Nodules 1
Nokor needle 93, 95f, 235
Nonablative fractional erbium glass laser 154
Nonablative laser 154, 239, 281, 285
fractional 156f
Noninsulated needles 323f
Nonsurgical conservative therapy 248
Norethindrone acetate 7
Norgestimate 7
Normal skin 146
O
Obesity 2
Office procedure, simple 127
Oily cysts 195
Onion extract 61
Oral antibiotics 159
Oral contraceptive pills, combined 7
Oral zinc 11
P
Pain 178, 292, 336
management 283
mild 326
Papillary dermis 141, 154
Papular acne scars 239f, 244f
hypopigmented 239f
Papular postacne scar, typical 229f
Papular scars 28f, 39, 41f, 238, 240, 240f, 243
Papules 1
raised 32f
visible 237
Papulopustular acne 244f
Peel
combination 70
complications 278
superficial 69
timing of 69
Peeling agent 69, 276, 278
Peeling area, open wounds on 68
Percutaneous collagen induction 231
Persistent edema 276
Persistent erythema 161, 162f, 226
edema 275
Persistent erythematous macules 34f
Persistent hyperpigmented
macules 35f
scars 51, 332
Persistent keloids 250f
Petechiae 163
Phenol peels 236, 269
deep 261
Phenolization 57
Photodynamic therapy 11, 57
Photorejuvenation 254
Photosensitivity 6
Photothermolysis
fractional 146
principle of selective 146
Phytic acid 354
Pigment 6, 68f
Pigmentary disorders, prevalence of 255
Pilosebaceous follicle 19, 53
obstruction of 18, 18f
Platelet-rich plasma 195, 289, 323, 329, 331, 334
Polyacrylamides 172
Polycystic ovarian syndrome 2, 55
Poly-L-lactic acid 235
Polymorphonucleocyte 18, 18f, 21f
Poor skin texture 333
Postablative laser skin
dermabrasion 81
resurfacing 81
Postacne scars 339, 346
linear 237
treatment of 355
Post-carbon dioxide laser
immediate post 293f
resolution 293f
Postprocedure care 87, 99, 109, 123, 126
Povidone-iodine 104
Prednisolone, low-dose 9
Pregnancy 60
Progesterone 7
Proliferation, phase of 20, 21
Prophylaxis 294
Propionibacterium acnes 1, 17
Pros and cons 114
Proteoglycan 21
Pruritis 294
Pseudotumor cerebri 7
Psoriasis 139, 269, 308
active 159
Psychosocial distress 312
Pulsed dye laser 154, 160, 248, 359
Punch closure 107
Punch elevation 105, 107
principles of 108f
Punch excision 114, 217f, 286
and grafting 105
at recipient site 110f
complications of 112
of donor grafts 110f
techniques 103, 104, 114, 219, 220
Punch flotation 217, 286
Punch grafting 107, 109f, 112f, 286
abraded 107, 110f
cobblestoning following 113f
Purpura, delayed 161
Pustules 1
Pyruvic acid 60, 61, 70
Q
Quantitative scale 44
R
Radiofrequency
devices 254
fractional 321
machine 240, 242
wire electrode of 241f
Reactions, irritant 52
Reflectance confocal microscopy 308
Relaxed skin tension 236
line 104, 251, 362, 363
Remodeling, phase of 20
Renal failure 186
Retinoic acid 60, 142
receptors 4
Retinoid 2, 60, 253, 272
dermatitis 4, 53b
topical 4, 52, 224, 241
Ribonucleic acid 22
Right peel, strength of 273
Ring scars 111, 111f
Rolling acne scars 227
Rolling scar 25f, 36, 37f, 221, 223f, 331, 333, 346f
complications of 226
contraindications of 223
deep 32f
depressed 93
indications of 223
instruments of 222
limitations of 223
management of 361fc
postprocedure care of 226
precautions of 224
treatment of 221, 223
Rosacea, active 138
S
Salicylic acid 2, 3, 5, 10, 53, 67f, 69, 70, 276, 298, 332
peels 54f, 56f, 74f, 267
Salicylic peels 269
Salicylic-Mandelic acid peels 75f, 278
flare after 279f
Scalp rollers 118
Scar 16, 238, 250, 252, 257, 312, 350
after stretching skin, effacement of 240f
atrophic 32, 44, 66, 143, 306f, 333, 353
mild superficial 65, 66
bigger 176
bottom of 212
bridging 27f, 41, 41f, 246, 251, 251f
broader 237
clinical acne-related 46
cobblestoning and ring 220f
correction, principle of 170
counting 42
deep 212, 214
depressed 35, 219, 339
development of 248
distribution of 265
edges of 343
elevated 38, 112f
excision of 233f
hyperpigmented 331, 332
in acne 228
ineffective for 267
intervention, stage of 268
irregular depressed 212
marking of 113f
mild 265
narrow 237
permanent hypopigmented 256
predominant 265
revision techniques 286
right 217
severe 264, 265
shallow depressed 173f
shouldering 344f
size, smaller 176
skin 251
tissue 195
treatment of 177, 196
types of 160, 221, 230, 265, 331
medical makeup for 313
wide 177
worsening of 89f, 282, 298
Sebaceous duct, hyperkeratinization of 19
Sebaceous secretion 18f
Sensitive skin 332
types 277
Serial puncture technique 176f
Sex hormone-binding globulin 7
Shallow rolling scar 32f
Shallow scars 212, 213
Shamban acne scale 45t
Shamban scale 45
Silicon
based products 248
gel 61, 249
implants 170
sheets 249
Sinus tracts 41
Skin 131
ablation, partial 141
atrophy 250
cleansing 315
color 253
contact, amounts of 132
dry sensitive 266
dryness of 283, 342
injury 282
irritation 76
lightening agent 203, 332
needling 115, 309
phototypes 253
products, deep 170
smooth 313
stretching 28f
suture 6–0 prolene 104
texture 236
tightening 254, 344
tightness of 283
tumors, malignant 138
type 198, 253, 265
Skin scar 150
chemical reconstruction of 72, 79, 89, 125, 201, 205, 206f, 214, 222, 231, 268, 329331, 340, 361
technique 79
chemical reconstruction of 77f, 79f, 81f, 87, 88f, 100, 160, 208f, 209f, 210
Smallpox 352
Sodium
bicarbonate 133
microdermabrasion crystals 135
chloride 133
Soft tissue augmentation 237
Spirit 81, 104
Spironolactone 7, 8
Staphylococcus aureus 10
Stem cells 190
Stereoimage optical topometer 307
Sterile
abscesses 288
hypodermic needle 93
Steri-strips 104
Steroid
mild topical 62
potent 290
superpotent 50f
topical 249, 266
Stratum corneum 60, 62, 147
Stretch test 222f
Stromal vascular fraction 195
Subcision 91, 106, 197, 231f
adequate 224
after four sessions of 225f
danger areas of 98f, 98t
modified 92f
principle of 92f
Subcutaneous incision less surgery 91
Subcutaneous tissue 212
loss of 237
Sulfamethoxazole 6
Sun control 271
Sun protection, adequate 236
Sunscreens 59, 224
Surgical glue 104
Surgical marking pen 104
Surgical scar 93
revision techniques 263
Surgical therapy 55
Systemic antibiotics 1, 5, 57
T
Tattoo removal 254
Tazarotene 4, 272
Test patch 272
Tetracyclines 5
Thermal injury, columns of 146
Tinnitus 6, 298
Tissue
connective 286
destruction, excessive 243
Tools 314
Topical nicotinamide 5
Topical retinoic acid 60
Toxic dose 188
Toxicity 298
Traditional glycolic peels 277
Traditional laser 258
Traditional liposuction 196
Traditional subcision 95f
Tram-track appearance 127
Tranexamic acid 124
Transitory reactions 288
Transplanted fat, zones of 195f
Traumatic scars, depressed linear 93
Tretinoin 4, 142, 272
binding 4
iontophoresis 62
Triamcinolone acetonide 237, 249
Trichloroacetic acid 65, 79, 80, 81f, 125, 160, 205, 222
peels 279f
Trimethoprim 6
Triple laser technique, combination 336
Tumescent anesthesia, amounts of 186
Tumescent fluid 188
U
Ulcers 138
Ultrapulse laser 343
Ultrasound, high frequency 305
Ultraviolet
A 271
B 271
Unrealistic expectations 174, 269
V
Vaginal candidiasis 6
Varicella scars 118
Vascular endothelial growth factor 247
Viral warts 68
Vitamin
C 124, 295
topical 142
D level 2
E 93
Vitiligo 159
unstable 269
W
Warts 138
Wooden toothpick, sharpened 82f
Wound 138
healing, phases of 20, 21f
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Chapter Notes

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