Q. Will Sculptra injection cause an acne flare-up? I worked very hard to keep pretty clear for the last 2-5 yrs. I read a few reviews where women had very bad flare-ups after getting the Sculptra injections. I have a consult coming up to get injections for the first time ever. I have never done anything cosmetic like this before and I am now very concerned. I was getting it to help my aging process for I am going on 36 and due to my past acne problems my pores and skin looks a bit aged. Have you had any patient complaints about it? I truly appreciate your honesty. Thank you!
A. Sculptra is a very interesting drug. It is safe and effective in my experience and performs differently than the majority of fillers in the same category. Sculptra induces a cellular action directly or through a controlled inflammatory response. The following fillers have very little if any reactionary activity.
- Hyaluronidase fillers Juvederm, Restylane, others) attract water within its molecular lattice, growing in volume like “jello”.
- Inert fillers such as calcium hydroxylapatite (Radiesse) and polymethyl methacrylate (Belafill) provide static volume
Sculptra, made of poly-L-lactic acid in some way stimulates adjacent cells to up-regulate its productivity of anabolic or reparative structural molecules. All the manufacture will provide is that it produces collagen but my experience shows a skin enhancement greater than simple production of collagen.
My personal experience is that within 6-12 weeks of a serial injection of Sculptra, the overlying skin exfoliates, improves pigmentation evenness, reduces oil production. There is increased firmness and thickness to the skin with resistance and greater elasticity. Initially there is blushing or increased circulation to the skin which when optimized provides a more youthful appearance, less sensitivity and less irritation of the skin. Folds diminish because of the firming resistance to the skin, fine wrinkles and lines diminish due to the exfoliation, reversal of senescent epidermal aging, thickening of the dermis with filling in of the dermally injured wrinkle. It acts very much like a topical retinoid injected under the dermis.
If allowed to coalesce, there appears to be a “tipping point” of Sculptra mass that develops a nidus of collagen to a granule to a nodular growth. When tiny as a granule, it has responded to the anti-inflammatory effects of dilute triamcinolone injection. When nodular, it must be excised or tolerated. Sculptra must be well diluted and very well and consistently massaged following its injection so the suspension of Sculptra molecules will not coalesce.
Adding topical (tretinoin, retinol, others) or oral retinoid (iso-tretinoin) further synergizes in stimulating skin rejuvenation.
I do believe Sculptra could reverse the improved acne response you have achieved if your skin is not already primed and optimized with retinoids. In other words, like topical retinoids, you can expect to go through a transitional period of acne flare-up until the up-regulated skin cells are functioning at peak and the acne process has been suppressed with proper epidermal exfoliation and sebum production controlled.
Use of Sculptra is an advanced technique. Please select an injector who has great skill and experience and is Board Certified in Plastic Surgery or Dermatology. I wish you well.
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This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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