7 Thirteen trials involving 559 people, aged from 2 to 81 years were included in the review. The trials compared adhesive silicon gel sheeting with control; non-silicone gel sheeting; silicone gel plates with

added vitamin E; laser therapy; triamcinolone acetonide injection and non-adhesive silicone gel sheeting. In the prevention studies when compared with a no treatment option; silicone gel sheeting reduced the incidence of hypertrophic scarring in people prone to scarring (RR 0.46, 95% CI 0.21–0.98) but these studies were highly susceptible to bias. On the effectiveness of established scarring in people with existing keloid or hypertrophic

scars, silicon gel sheeting produced a statistically significant improvement in scar elasticity, (RR 8.60, 95% CI 2.55–29.02) but these studies were also highly susceptible to bias. Thus, the poor quality selleck products research means a great deal of uncertainty prevails regarding the effectiveness of silicon gel sheeting in the prevention and treatment of hypertrophic and keloid scars. A more noteworthy outcome is reported from a study that compared the characteristics of microscopic treatment zones induced by ablative fractional CO2 laser and by microneedle treatment in ex vivo human breast skin.8 While both methods induced minimally invasive sites needed for autologous cell therapy, the CO2 laser resulted in superficial, epidermal Adriamycin supplier papillary dermis defects of 0.1–0.3 mm covered by a thin eschar coated with denatured collagen. In contrast, the microneedle intervention produced thin vertical skin fissures reaching up to 0.5 mm into the mid-dermis and injuring dermal blood vessels but without surrounding tissue necrosis. Both technologies created small epidermal defects

which allow delivery of isolated cells such as melanocyte transplantation for vitilago, with microneedle treatment Chlormezanone having the advantage of lacking devitalized tissue and enabling vascular access for transplanted cells. The visible inflammation phase (erythema) lasts on average about 48 hours. The redness on Caucasian skin decreases by 50% 4–6 hours after the treatment. Chilled silk layers (Cool Mask) soaked in hyaluronic acid are extremely helpful in reducing erythema by at least 50% in 30 minutes. Visible edema is unusual after microneedling. There may be a general slight swelling that fades within 48 hours. In chronic wounds progression toward healing often stalls in the inflammatory phase. At the wound edge, when re-epithelialization is arrested, microneedling of periwound skin may serve to induce a mild inflammatory response which may stimulate epithelial migration to occur.