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Topics - SarahVaughter

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46
(from an email)



1.I have alot of hyperpigmentation (and hypo) on body and face.

had countless procedures on face with little improvement.
 

  It depends what the cause is of your hypopigmentation. Usually, hypopigmentation is caused by a localized lack of melanin production and hyperpigmentation due to locally excessive melanin production.  Melanin is the pigment that determines the color of our skin and when our skin is exposed to the sun, the skin produces more melanin as a protection – melanin absorbs UV.
 

 Melanin peigment is produced by cells called melanocytes. They aren't very deep in the skin. They are at the bottom of the epidermis.


Hypopigmentations usually lack functioning melanocytes and that’s why they are whiter than the surrounding skin and they do not tan. (Vitiligo is a disorder in melanocytes-function just like melasma). Another reason why scars are whiter is their limited blood supply. Needling can actually in some cases induce revascularization of the scar and thus improve its color.  


Needling or rolling sometimes, but not always, restores the normal color of the skin. Needling or rolling by itself often triggers melanocyte production.  You can further increase your chance of success with hypopigmentation by attempting a "Melanocytes transfer":
 

  For hypopigmentation, first needle the areas with the single needle. Your next step will be an attempt to “transplant” some melanocytes from the normal to the hypopigmented skin!  Stick the needle many times about 0.3 mm deep (this really is very shallow - try not to go much deeper than that) into the normal-colored skin (anywhere on the body), then stick the needle several times in those needled hypopigmented areas. Repeat this “harvesting“ and “transplanting” of melanocytes. If you are lucky you may transfer some melanocytes.


  I am still researching how to optimize this procedure of melanocytes transfer, so check the forum later. After the "transfer", occluding the skin with plastic foil for a few hours will help them to "take root", and avoid washing that skin the next hours as well. I based this idea on successful melanocyte transfer experiments with Vitiligo patients. Occlusion may not even be necessary, as the melanocytes are "needled in" in our case, and they were merely topically applied in the Vitiligo patients.


Of course, the needled skin eventually needs to be exposed to sunlight in order to get a darker teint.


  The hypopigmented areas might have enough melanocytes but they are malfunctioning or dormant. In that case needling is also worth a try.


For hyperpigmentation, first needle the areas with the single needle, then apply the homemade vit. C serum (vit. C is a mild whitening agent. It also is a mild tyrosinase inhibitor. Tyrosinase is the enzyme that converts tyrosine to melanin. Do a test patch first. Keep using vit. C serum several times a week.


What you could also try is to very thoroughly clean a lemon skin. Using a fork, make the skin leak its juice and put it on your pigmentations. Cover it with plastic foil. Follow this procedure several times a week. If your pigmentation is due to inflammation, do not use the lemon peels. It would further irritate the skin. If your skin takes it well, you can apply the lemon skin juices after needling but do a test patch first. It will sting.


You can also try hydroquinone, which is a strong inhibitor of tyrosinas:


http://forums.owndoc.com/dermarolling-microneedling/How-to-treat-dermal-melasmaD/a>
   

  If your hypo- and hyper pigmentation are not localized, you cannot use the single needle.  Use just a dermaroller.
   

Post-inflammatory hyperpigmentation is usually also due to excessive  melanin.

2. Cellulite thighs and butt with minimal stretch marks.
       

Please read my article on cellulite. There is not much to do about it:
 

http://www.owndoc.com/dermarolling/what-to-do-about-cellulite/
 

3. Under chin and neck = loose skin/slight turkey neck
       

Dermarolling can improve mild skin laxity but it cannot improve significant excess of tissue.


Please read:

http://owndoc.com/dermarolling/dermarolling-microneedling-hype-realistic-results/

4. surgery and mole removal scars on back of neck and abdomen
 

    Here, needling and dermarolling will be very successful.  Surgery scars, mole removal scars, vaccination scars etc can be greatly improved (but not completely removed). The best method is needling with our single needles. Your goal is to crush the hardened scar tissue and trigger new collagen.

47
I do have a question for you though. How much blood should you see from

  Dermarolling? I think the more the better, just as long as it's not

  toooooo much? It just seems to me that, if you get more aggressive with the

  treatment you would see better results. I.E. Braking up scar tissue,

  activating more collagen, creating more blood for new; skin, collagen,

  elastin, etc..? What is your advice? I have read conflicting reports but

  am not sure which is the best or if it doesn't even matter. Hope all is well!


 

Hi [deleted],

  Mild skin injury is a nice trick to make the body renew the skin. When you injure the skin (enough to make a difference and not too much to cause scars), the body will immediately start repairing the damage. This is one of the principles behind certain laser treatments, acid peels, dermabrasion, dermarolling etc.

The advantage of dermarolling compared to those other methods is that it doesn’t remove the outermost layer of skin and there is no danger of burns and other thermal damage.

  Wound healing has 3 stages - Inflammation, proliferation and remodeling.

  Inflammation is a reaction of our body to heal the injury.  More details here:

http://forums.owndoc.com/dermarolling-microneedling/How-long-does-the-inflammation-stage-lasts-after-rolling-with-long-needles

 

During the inflammation stage, the blood vessels dilate, resulting in an increased blood flow to the area. The area becomes red and warm. Plasma fluids will flood the area and cause swelling. When the immune system cleans the area of damaged cells, the damaged cells will be replaced by new ones.

  The skin consists of 3 layers. The epidermis, the dermis and subdermis.

  The epidermis has no blood supply. The dermis has irregular blood vessels and the deeper the dermis the more blood vessels.  If you puncture a blood vessel you end up with pinpoint bleeding or even bruises.



The more damage in the dermis you cause, the more remodeling you will get. Nevertheless it is also connected to a higher risk of scarring, infection or hyperpigmentation.  For home use, it is much safer to do several rolling sessions with occasional pinpoint bleeding than one "totally bloody" to obtain the same results. Especially if you roll large areas.



If your achieve inflammation (your skin temporarily becoming red after dermarolling), the process of skin renewal has been triggered. That is all you need and you have to regularly repeat it to get results. Your expectations must be realistic.  Currently there is no method to completely remove scars, stretch marks, significantly change the pore size or texture of your skin or stop the aging process. A lot of it is determined by hereditary factors.  You can achieve improvements though.



We provide single needles that are approx. 2 mm long for deep, intensive targeted treatment of scars or wrinkles. The scar tissue is usually hardened and has to be “crushed” by dense single needling. Single-needling may also release the anchoring of the scar or the wrinkle to the subcutaneous tissue and thus make the scar or wrinkle less indented. You do not (always) have to insert the entire length of the needle (2 to 2.2 mm) into the skin. The full needle length is intended as a safety stop.  The skin doesn’t have the same thickness all over the body, neither is the skin precisely identically thick in all individuals.



  On a limited-size area such as individual wrinkles or individual stretchmarks or scars, you can go deeper and denser with the single needle and get more pinpoint bleeding.  Always do a test patch first to learn what to expect, how much you will bleed, how it heals etc. Make your skin softer by having a hot bath, shower or steaming the face prior needling/rolling and don’t forget to stretch the skin to make it easier for the needle to penetrate.

Related forum posting:
http://forums.owndoc.com/dermarolling-microneedling/do-we-need-to-get-that-bloody-to-get-results/


48
Dermarolling / Microneedling / Dermarolling and Rosacea
« on: June 09, 2010, 05:06:39 AM »
Do you have remarks regarding dermarolling and rosacea that is, adverse

reaction to either the Infadolan ointment, Copper peptide facial mask, EMLA,

Vitamin C (did I miss anything?) or the physical puncturing of the facial

skin? What needle size would you recommend?  I am just now 60 years old,

Caucasian, female with some creping, pigmentation, but worse,  pronounced

lines around the mouth...and..."turkey neck".  I have, I suppose, mild rosacea.  


   

 

The problem is that current medicine doesn’t know the cause of Rosacea. There are many theories about its cause but none of it has been convincingly proven.  That is why it is difficult to answer the question what can have an adverse effect on Rosacea.  Theoretically it can be just about anything.

  Infadolan contains Retinyl acetate that is slowly converted to Retinoic acid in the skin. There are quite some cases in the literature reporting that Retinoic acid had an adverse reaction on Rosacea. Neither would I recommend copper peptide mask.

  You can try much diluted homemade vit. C serum and you will see.  I think that EMLA should be OK.

Instead of Infadolan, you can use a little bit of Vaseline after the rolling. The best is to buy Vaseline in a tube to avoid its bacterial contamination. Or at least buy a new jar.

   

  Dermarolling is not recommended if the skin is affected by Rosacea. Neither are dermabrasion or chemical peels.  If your case is very mild, you could do a test patch and see how your skin reacts.

   

  If Rosacea is not too much of a problem around your lips, you could give it a try. Wrinkles around the lips are very stubborn and several dense and deep rolling sessions are needed to get improvement. That area is also very sensitive. I can roll my whole face without a topical anesthetic with the exception of the areas above and below the lips.  Even with EMLA it is not exactly a pleasant experience but it is worth it.

Use a 1.5 mm roller for the face. You can use the same roller on your neck but do not push the roller too much because the skin of the neck is thinner.

  Do a small test patch first. It is really unpredictable how your Rosacea will react.  Keep in mind that you will be temporarily red from rolling.  

 

If the skin above your lips doesn’t have Rosacea, dry brush it with a new toothbrush several times a week prior to rolling. Again do a test patch first. If you feel that your skin doesn’t react well, stop using it. If the skin there has Rosacea, do not dry brush.

  Steaming the face to make it easier for the needles to penetrate (as we recommend in our instructions) is not a good idea in case of Rosacea.

 Green tea (keep it in the fridge and renew frequently) is a good skin toner for Rosacea. It has anti-inflammatory properties and a soothing effect.

49
Dermarolling / Microneedling / Copper peptides
« on: May 05, 2010, 06:40:17 AM »
I re-post the essence here after erroneously having deleted the entire thread:

We have received the copper peptide facial masks. They are non-comedogenic.

We sell the GHK-Cu facial masks for just 3 dollars, and they are excellent after dermarolling the face with needles of any length.  The facial mask is applied after dermarolling. When your face has dried, you can apply Infadolan ointment to selected spots.  Our masks contain 2000 ppm GHK-Cu/a>. [url=http://www.owndoc.com/dermarolling/copper-peptides-for-dermarolling/]GHK-Cu is the best copper peptide for skin rejuvenation and collagen regeneration.

Buy our copper peptide facial mask

<strong>Ingredient list:</strong>

          Carbomer (Carboxypolymethylene) 10 %

          TEA (Triethanol amine) 0.1 %

          Hyaluronic Acid 0.3 %

          GHK-Cu 0.1 % (1000 ppm)

          Nano Platinum 0.1 %

          Centella Extract 2 %

          Yam Extract 2 %

          Syn-Coll (PALMITOYL TRIPEPTIDE-3) 2 %

          Vitamin B3 0.2 %

          Vitamin B5 0.3 %

          1,3 Butylene Glycol 5 %

          Propylene Glycol 3 %

          Propyl paraben 0.1 %

          Tween 20 0.1 %

          Fragrance 0.01 %

          The rest is deionized water.

  It is found that in poor connective tissue conditions, the triterpenes in<strong> Centella asiatica</strong> are able to renew the collagen, in quantity and quality, and restore tissue firmness and skin elasticity, improving skin appearance and comfort. Apart from this it also has anti-psoriatic properties.

          (Reference Aesthetic Plastic Surgery, May-June 2000, pages 227-234;

          Phytomedicine, May 2001, pages 230-235; and Contact Dermatitis, October 1993, pages 175-179)

          <strong>Pantothenic acid, also called vitamin B5</strong>

          Wound Healing

          A study in 1999 showed that pantothenic acid has an effect on wound healing

          in vitro[51]. Wiemann and Hermann found that cell cultures with a

          concentration of 100μg/mL calcium D-pantothenate increased migration, and

          the fibres ran directionally with several layers, whereas the cell cultures

          without pantothenic acid healed in no orderly motion, and with fewer

          layers[52]. Cell proliferation, or cell multiplication was found to increase

          with pantothenic acid supplementation[53]. Finally, there were increased

          concentrations of two proteins, both of which have still to be been

          identified, that was found in the supplemented culture, but not on the

          control[54]. Further studies are needed to determine whether these effects

          will stand in vivo.

          <strong>Acne</strong>

          Following from discoveries in mouse trials, in the late 1990s a small study

          was published promoting the use of pantothenic acid to treat acne vulgaris.

          According to a study published in 1995 by Dr. Lit-Hung Leung,[62] high doses

          of Vitamin B5 resolved acne and decreased pore size. Dr. Leung also proposes

          a mechanism, stating that CoA regulates both hormones and fatty-acids, and

          without sufficient quantities of pantothenic acid, CoA will preferentially

          produce androgens. This causes fatty acids to build up and be excreted

          through sebaceous glands, causing acne. Leung's study gave 45 Asian males

          and 55 Asian females varying doses of 10-20g of pantothenic acid (100000% of

          the US Daily Value), 80% orally and 20% through topical cream. Leung noted

          improvement of acne within one week to one month of the start of the

          treatment.

          http://en.wikipedia.org/wiki/Pantothenic_acid

          <strong>Topical Use of Dexpanthenol in Skin Disorders</strong>

          Authors: Ebner F.1; Heller A.2; Rippke F.2; Tausch I.3

          Source: American Journal of Clinical Dermatology, Volume 3, Number 6, 1 June

          2002 , pp. 427-433(7)

          Publisher: Adis International

          Abstract:

          Pantothenic acid is essential to normal epithelial function. It is a

          component of coenzyme A, which serves as a cofactor for a variety of

          enzyme-catalyzed reactions that are important in the metabolism of

          carbohydrates, fatty acids, proteins, gluconeogenesis, sterols, steroid

          hormones, and porphyrins. The topical use of dexpanthenol, the stable

          alcoholic analog of pantothenic acid, is based on good skin penetration and

          high local concentrations of dexpanthenol when administered in an adequate

          vehicle, such as water-in-oil emulsions. Topical dexpanthenol acts like a

          moisturizer, improving stratum corneum hydration, reducing

          transepidermal water loss and maintaining skin softness and elasticity.

          Activation of fibroblast proliferation, which is of relevance in wound healing, has been

          observed both in vitro and in vivo with dexpanthenol. Accelerated

          re-epithelization in wound healing, monitored by means of the transepidermal

          water loss as an indicator of the intact epidermal barrier function, has

          also been seen. Dexpanthenol has been shown to have an anti-inflammatory

          effect on experimental ultraviolet-induced erythema.

          Beneficial effects of dexpanthenol have been observed in patients who have

          undergone skin transplantation or scar treatment, or therapy for burn

          injuries and different dermatoses. The stimulation of epithelization,

          granulation and mitigation of itching were the most prominent effects of

          formulations containing dexpanthenol. In double-blind placebo-controlled

          clinical trials, dexpanthenol was evaluated for its efficacy in improving

          wound healing. Epidermal wounds treated with dexpanthenol emulsion showed a

          reduction in erythema, and more elastic and solid tissue regeneration.

          Monitoring of transepidermal water loss showed a significant acceleration of

          epidermal regeneration as a result of dexpanthenol therapy, as compared with

          the vehicle. In an irritation model, pretreatment with dexpanthenol cream

          resulted in significantly less damage to the stratum corneum barrier,

          compared with no pretreatment. Adjuvant skin care with dexpanthenol

          considerably improved the symptoms of skin irritation, such as dryness of

          the skin, roughness, scaling, pruritus, erythema, erosion/fissures, over 3

          to 4 weeks. Usually, the topical administration of dexpanthenol preparations

          is well tolerated, with minimal risk of skin irritancy or sensitization.

50
Hi Sarah,

 

  I've contacted you before but I'm waiting for your stock of single needles to

  arrive before I order.

 

  This has got to be the most puzzling things for me - On so many sites they

  recommend the derma rollers to be rolled on the face without causing

  any bleeding so that you just get a tingly feeling - and it's not painful.

 

  Then I go to youtube and all the films show firm rolling and excessive bleeding

 

  Question - How much pressure do you use ?

 

  Do you push roller in until skin sits against roller plastic so that needle is

  in the skin by the depth of the needle - causing obvious pin point bleeding? Clearly painful though.

 

  OR

 

  Do you just run roller over skin causing tingling sensation? ( which most sites

  advise and say you can do 3 times a week  ) Isn't this a waste of time?

 

  One forum mentions that a girl pressed roller into skinn causing bleeding and was told she was doing

  it wrong as it would be too painful.

 

  I'M VERY CONFUSED as your site says for example use 1mm roller once every 2 weeks approx.

  not 3 to 5 times in a week like other sites

 

  I believe your way is the right way BUT

 



   

  Hi Julian,

 

  Skin is very tough because it is our protective layer. It is not easy to penetrate the skin, especially not with many needles in one go. You can make penetration easier if you soften the skin by taking a hot (steam-) bath prior to rolling. You should put moderate pressure on a dermaroller. Not too much and not too little. If you do not put any pressure on the roller then the needles only go superficially and you can roll more frequently. I would compare it to tooth brushing – too much pressure is not good and too little is not efficient..

 

  The thickness of the skin (epidermis + dermis) is about 0.3 mm on the eyelids, 1.5 mm on the thigh, 1.8 mm on the back and over 2 mm at the soles of the feet.  It varies depending where on the body it is and it varies between individuals as well.  Furthermore, men usually have thicker skin than women. A 1.5 mm roller penetrates about 1.3 mm into the skin, when applied with sufficient pressure.



  These varying skin thicknesses are responsible for the fact that some of our customers have pinpoint bleeding on the face with a 0.5 mm roller and some do not get any pinpoint bleeding with a 1.5 mm roller on the face, not even with a lot of pressure. That is why it is very difficult to give general recommendations concerning the needle length etc. - even assuming that all customers use the same rolling pressure.



  The dermaroller's patent holder doesn’t produce dermarollers longer than 1.5 mm and they state that needles longer than 1.5 mm are contradicted. Their patients do not get faces full of blood, just occasional pinpoint bleeding. That is what you get with a 1.5 mm roller. You'll see more blood spots if your roll with 1.5 mm on thin skin such as that of the neck.

 

  Studies showed that the collagen induced by rolling was not deposited deeper than 0.5 mm.

 

  Some surgeons use dermarollers with 3 mm long needles (those "bloody" YouTube videos are from rolling with needles longer than 1.5 mm and they cause a bloodbath) but there is no evidence that those work better than 1.5 mm rollers. This is not our theory - this is what the Swiss dermatologists who patented the Original Dermaroller say on their own website. And they sell exclusively to clinics and other professionals. 3 mm rollers are unsuitable for home use since they carry the risk of infection and nerve damage. We think that those rollers are a marketing gimmick, intended to persuade people not to home-roll but to pay through the nose for a "bloody treatment" instead, because that would be somehow be "better".

 

  Your goal is to produce collagen in the dermis. A 1.5 mm roller will reach the dermis. That is all you need. The epidermis has no blood supply. The dermis has irregular, small and relatively sparsely distributed capillaries in its upper part and a denser network of larger capillaries in its deeper part.  

 

  We sell a 2 mm dermaroller for thick skin areas such as the stretchmarks on the back or the buttocks.



We also now sell a specially designed single needle for targeted intensive needling of specific skin problems such as acne scars, stretchmarks, surgical scars, wrinkles etc. You will get more pinpoint bleeding with this targeted needling, but the results are worth it.

 

  Rolling with 1.5 mm needles triggers inflammation: http://forums.owndoc.com/dermarolling-microneedling/How-long-does-the-inflammation-stage-lasts-after-rolling-with-long-needles

 

  There aren't many ways to rejuvenate or remodel skin. One of the best methods is to cause mild skin damage. Our body will renew/remodel the skin by fixing that damage.

That is one of the principles of dermarolling.

That is also the principle behind most laser rejuvenation treatments. A Laser either evaporates the entire top layer of the skin or it evaporates only fractions of the skin (Fraxel laser).

Fractional lasers can be set up for going superficially into the skin or going deep – to a maximum of 1.7 mm. The reason why there is almost no bleeding is because they make holes by thermic damage - evaporating the skin (Fraxel repair). That heat coagulates the capillaries and that’s why it doesn’t bleed. Have a look how fractional laser makes holes in the skin:


http://www.youtube.com/watch?v=hHvRZ...eature=related  

 

    Our general recommendations are always on the safe side.  If you are a male with thick skin you can roll more frequently.

 

  The patent holders of the Dermaroller say that the smallest permissible interval to roll with long needles is six weeks. The longest needle length roller they manufacture is 1.5 mm and the longest needle length they sell to private individuals is 0.2 mm. So there is no concensus amongst experts, and our seemingly conservative interval guidelines are therefore considered liberal by their experts.



  If you're a woman and you roll your neck then you should roll once every two weeks.  I am just trying to explain that it is impossible to give general recommendations that would ideally suit every single area of the skin, every single skin problem and every single individual. You have to adjust based on your unique situation and the general guidelines we supply.

51
Dermarolling / Microneedling / Why vitamin D2 instead of D3?
« on: April 10, 2010, 06:14:34 PM »
Hi Sarah,

I just ordered your kit and feel that your site is very professional and thorough.  I do have a question:  why are you using synthetic vitamin D2 instead of D3.  I only take D3 internally due to all of the articles I have read about the efficacy of D3 over D2.  Thank you.


I read the articles too. AFAIK, they are based on one single study:

http://jcem.endojournals.org/cgi/content/full/89/11/5387
     

.. which is "disproved" in this study:


http://www.medscape.com/viewarticle/573613
 

My take on it: There is no hard evidence that D3 is better than D2. D2 has worked very well in the past and as soon as we find anything better or are advised of such (you're more than welcome to offer suggestions), we'll switch to it.

52
Hi Sarah

If rolling 4 times vertically, horizonatally, and diagonally give 250 pricks per cm2. Then rolling 10 to 20 times in each vertically, horizontally, and diagonally would give me more than 1000 pricks per cm2 and much better collagen placement. Do you think it's okay to roll that much?

Thanks


 

     

  Good question.

   

  The thing is that for ideal, quick regeneration there should always be plenty of undamaged skin in between the holes. Laser rejuvenation techniques where the entire top layer of skin was evaporated are gradually being replaced by fractional lasers where only tiny fractions of skin are removed because it highly speeds up the regeneration and it reduces the risk of infection.

Fraxel treatments usually have to be repeated to get the desired result.

 

Fractional lasers use the same principle as a dermaroller. A dermaroller makes holes mechanically. Fraxel makes holes thermically, evaporating small skin areas. The depth and diameter of the hole and their density can usually be set up and those parameters are comparable to those recommended with dermarolling.

Have a look how fraxel works, it's interesting. This one is set up for 400 holes per square centimeter:

http://www.youtube.com/watch?v=hHvRZ...eature=related

   

  I am not sure what the maximum density a fractional laser can be set up for. I think that 1000 holes per cm2 is too much. More intact skin should be left for regeneration - being the main factor in skin improvement. You can perhaps roll densely locally on an area of skin where you have acne scars or the like. I do not have experience with such dense rolling. The recommendations of surgeons using dermarolling are about 200-250 holes per cm2.

  I recommend using dense needling – needle abrasion (with a single needle) on specific skin conditions - on stretch marks and surgical scars to crush the hardened collagen. Use less-dense needling for wrinkles and acne scars.

53
Dermarolling / Microneedling / Dermarolling after Sculptra
« on: April 01, 2010, 01:39:03 PM »
>I'm scheduled for my 4th sculptra treatment next week . My dermo

>Is not familiar with dermarolling , how long do you think I should  

>wait to roll for the first time ?






  Wait at least one month if you use needles longer than 0.5 mm.



Sculptra is injected into the deep dermis or subcutaneous layer.

A dermaroller with 1.5 mm long needles doesn’t reach that deep but ask your doctor approximately how deep the Sculptra is injected.

  A 1.5 mm dermaroller penetrates about 1.3 mm into the skin. If they inject Sculptra to a shallower depth than 1.3 mm then do not use a 1.5 mm dermaroller at all.



  The principle behind dermarolling is to renew the skin by causing mild skin damage. Our body repairs that damage and thus the skin gets renewed/remodeled.  A dermaroller mechanically makes tiny holes into the skin and that damages some skin cells. Our immune system immediately starts removing those damaged skin cells, which are replaced by new cells.



  My concern is that if you roll as deep as Sculptra has been deposited, those tiny wounds will be cleaned up by white blood cells and Sculptra might be partially removed as well as a side effect.  That means that your Sculptra longevity would be affected.

 

If the Sculptra has been injected deeper than your dermaroller can reach, then there is no problem and you can use it.

 

In any case - if you roll over an area with Sculptra underneath, do not push a long-needled roller in too much.

54
Dermarolling / Microneedling / How to treat dermal melasma?
« on: March 27, 2010, 08:45:49 AM »

>Dear Sarah,

>What can you recommend, if anything, for dermal melesma?

>I worry about creating added inflamation and yet I need greater penetration for my skin care products.

>Thank you in advance for any information you can provide


Melasma is one of the most difficult skin conditions to treat. It is caused by hyperactive melanocytes (pigment producing cells) resulting in the overproduction of melanin pigment. The origin of this hyperactivity is not fully understood, it’s believed to be a combination of genetics, hormones (estrogen) and sun exposure. High estrogen levels (due to hormonal contraception or pregnancy) usually triggers or aggravate this condition.         

Currently, doctors don’t know how to stop the overactivity of melanocytes. Thus they cannot treat the cause, only the symptoms.



Nevertheless, acid peels ( for examle  Jessner's solution)   can help. Melasma is frequently present in both the epidermis and the dermis ( Wood`s lamp can determine the depth of the pigment) so acid peels have only a limited effect. Old melanocytes will be replaced by new ones that are again over-active. Sometimes repeated stimulation induced by acid peels of the new melanocytes makes the melasma even worse - although this is highly individual.       

Tyrosinase inhibitors such as hydroquinone is currently the best treatment for melasma. They inhibit the enzyme that converts tyrosine to melanin. It occurred very rarely but in some individuals prolonged or/and excessive use of a high percentage hydroquinone (above 3% for 6 months) in combination with extensive sun exposure caused exogenous ochronosis – bluish black pigmentation.     

Tretinoin (Retinoic acid) usually improves melasma by increasing the turnover rate of new skin.     

Avoid exposure to sunlight as much as you can and use high factor sun blocks, preferably with zinc oxide or titanium dioxide (they block the entire UV spectrum). The downside is that they are reflectively white and will make your face whitish. Nowadays though, you can buy a sun block with nanoparticles of zinc oxide (micronised zinc oxide). This sun block is not white but transparent. There were some concerns about the safety of zinc nanoparticles since they, contrary to ordinary zinc oxide, could potentially penetrate deeply but after some studies showed it also stays on the surface, micronized zinc oxide was approved and it is considered safe.   

Alternatively you can add skin tone makeup to your zinc oxide sun block cream to make it less white.       

If you wish to stay in the sun for a long time and do not care how you look, buy a baby diper rash cream containing a high percentage of zinc oxide and totally cover the melasma with it. That will make your skin very white but it will totally or almost totally block the sun. Zinc dries up the skin so first apply some moisturizing cream and after that the zinc cream.

If you use hormonal contraception, consult your dermatologist and gynecologist whether it would be suitable to switch to non-hormonal contraception such as IUD, due to your melasma condition.       

Melasma creams typically contain a combination of a tyrosinase inhibitor, acid peels, tretinoin, sunscreen and sometimes a corticosteroid - which is an anti-inflammatory.     

A dermaroller for skin care product penetration (0.2 mm needles) should not cause any skin inflammation. If it does in your case, then use even shorter needles. There might be some short-lasting redness (just as it happens when you rub the skin) but that should disappear very quickly.

Dermal Melasma is in the dermis part of the skin and that is very deep. Anything acting superficially is not going to work. You have to get the products deep.

You can use a 0.2 mm dermaroller to enhance the penetration of hydroquinone to the dermis but do not do it for a prolonged time. The best protocol is  3 month on, 1 month off. You can use other skin lightening products with dermarolling.

Vit. C is a powerful antioxidant and in concentrations above 5 %, it acts as mild skin whitener. However, it can irritate the skin.

Apply tretinoin (Retin-A) once or twice a week on your melasma after dermarolling. Do it in in the evening because Tretinoin is light sensitive. If your skin becomes too irritated, apply it without rolling and less frequently.Be warned however that in some people this actually makes the melasma worse, because melanocyte activity can be increased by the skin stimulation from the tretinoin. This seems to be a genetic factor and unless you try it once, you won't know whether it applies to you. The same applies to laser treatment in melasma. Always do a small test patch first.



Lightening agents can't affect the existing pigment, it can only reduce the formation of new pigment. That is why it sometimes takes months to see effects.

Ablative procedures (such as microdermabrasion, acid peels etc) remove existing pigment but they cannot prevent the formation of a new one. They cannot go very deep due to danger of scarring and hypopigmentation. Dermarolling is not an ablative procedures (a dermaroller does not remove skin layers, it only make temporary microinjuries in the skin).



Since dermarollers speed up the skin's turnover it should improve Melasma by speeding up the sloughing off of skin including the pigmented skin. A short-needled dermaroller is useful for Melasma in the epidermis. A long-needled dermaroller could be an interesting option for dermal Melasma. The turnover of the epidermis is much quicker than the turnover of the dermis and ablative methods can't easily reach the depth of the dermis due to the risk of scar formation, so a dermaroller that can reach the dermis (> 0.5 mm) could be theoretically very useful for deep Melasma. However I'm not very keen on recommending it for Melasma because it causes short-term inflammation and it is likely that Melasma will reoccur and dermarolling will have to be repeated over and over for maintenance. If you decide to try it, do a test patch first.

  More details:  http://forums.owndoc.com/dermarolling-microneedling/Melasma-cure-and-dermarolling

     

Because inflammation seems to play a certain causative role in melasma and dermarolling might make it worse, I would be cautious using long needles (longer than 0.2 mm) due to the fact that they induce inflammation. There is not enough data available yet to make an informed judgment about using long needles on melasma.

 The problem with long lasting hyperpigmentation in Melasma, café-au-lait spots and other melanin related pigmentation is that the root cause of the pigmentation is unknown. It is caused by local overproduction of skin pigment melanin by pigment producing cells (melanocytes) but nobody knows why melanocytes produce an excessive amount of melanin in certain individuals. Thus, you cannot treat the cause but only the symptoms. That is why fighting hyperpigmentation is so difficult.

 You will manage to lighten your spot with melanin inhibitors, however it is likely that your melanocytes will keep on producing excessive amounts of melanocytes in that area. The reoccurrence of the hyperpigmentation does not always happen, however it is not uncommon.

     

There is a new skin lightening topical called Elure that works in a different way than hydroquinone.

   Elure contains an enzyme (  lignin peroxidase) that breaks down existing pigment. Hydroquinone prevents formation of a new pigment.

The results with Elure were disappointing in many cases and successful in a few. I don't want to comment on its efficacy because I truly can't say anything else about it except that it's extremely expensive.



When you use a sunscreen (I hope you do), use one that has only physical blockers and no chemical blockers.

    Physical ones reflect UV whereas chemical ones absorb UV and convert it to heat, which can make melasma and other pigmentation worse.

To read about the difference between physical and chemical filters, read this:

http://forums.owndoc.com/dermarolling-microneedling/Sun-protection-with-dermarolling

Pharmacies often sell a sunscreen with physical filters for people who are allergic to chemical filters.

55
> I am a 25yr old female with stretch marks from a pregnancy in 2003. I have

  > two types of stretch marks : the silvery thin ones (buttocks, back of

  > calves, top thighs, and front of abdomen) and the deep indented ones (

  > hips and sides of waist). I would like to make a kit purchase and was wondering

  > which of the two sizes would you recommend? I would assume the egukar

  > 1.5mm and NOT the narrow line 1.5mm ?

 



  I believe the regular 1.5 mm would be best, especially if you have a lot of stretch marks.

          When you become proficient in dermarolling, and if you find out that 1.5 mm causes absolutely no occasional pinpoint bleeding, you can even opt for 2 mm long needles with your next purchase but such long needles should be only used on the areas with thick skin.  If your 1.5 mm roller does cause occasional pinpoint bleeding, then stick with that one, no need for longer and more painful needles.

 

 

>How long does each kit last?


 

    This   a hard question even to give a general answer to. (It is as difficult as answering the question  of how long a knife will remain sharp, or how long a piece of string is.)

 

    It depends how often you roll, how tough  your skin is and how big the rolled areas are.

      You can soften your skin before dermarolling by taking a hot bath or long shower. It will make the skin easier to penetrate for the needles. It should make the rolling easier for you and it will make the needles remain sharp longer.

 

   

>When should the dermarollers be replaced and how do I dispose of them?

 

        It should be replaced when the needles do not penetrate the skin as easy they used to. Simply, when it has become blunt. Keep in mind that the skin is a very tough organ (it has to be because it is a protective barrier) and it is in fact very difficult to penetrate the skin even with sharp needles.



Skin toughness and thickness varies - depending where on the body it is.

  Try to roll the soles of your feet, you will likely not manage..

 

  A good way to dispose of a dermaroller is to  wrap  tape around the needles and throw it away in the ordinary garbage. A dermaroller contains only plastic and a little bit of steel.





> Also, do you recommend any special creams or products to purchase that can

  > help me along my journey to rid my stretch marks?

   

 

    I wish I could recommend you a miraculous cream that provenly and significantly helps with stretch marks but I do not know of any.

 

      Try to apply creams indicated for striae (stretchmarks) and roll them in up to 3 times a week with a dermaroller intended for skin product penetration enhancement (0.25 or 0.5). No guarantee it will help though.

 

        You should supply your skin with vit. C and A because they are needed for collagen production. Copper peptides may be worth trying but I do not have experience with them neither I received sufficient feedback from our customers to guarantee you they will help.

The only available research  on Copper peptides has been done by the same people that patented them and are selling them. We wrote a little about that research, but it is certainly not sure that they will make a big difference. We gave them the benefit of the doubt, based on the little data available.



  Also unfortunately there is currently no way to completely get rid of stretch marks (unless they are very shallow and that is usually not the case).  However you can greatly improve their texture, color and even their depth and thus make them much less visible. It is a long journey and a lot of patience is needed.

 

                  The best improvement of stretch marks so far achieved by our customers was to manually needle them with the single needle that is a part of our dermaroller kit. It is laborious and you have to do it several times before you will see results but it is worth trying. A single needle will crush the hardened collagen bundles and that will soften the striae and improve their taint and texture. It will trigger new collage production and that can make the scar slightly less indented after repeated needling. You might be lucky and achieve melanocyte production - which means your stretchmarks will start to tan or partially tan.


56
Dermarolling / Microneedling / 2.0 mm rollers in stock now
« on: March 17, 2010, 06:16:58 AM »
We have a limited supply of 2.0 mm dermarollers in stock now, because a few people have asked for those.

It is suitable for use on very thick skin, deep acne scars, deep stretchmarks, wrinkles and sagging skin on the body. Not to be used on the neck. Can be used once every six weeks.

Link to buy the 2 mm dermaroller

57
> I just ordered the derma roller 1.5 kit.  Can you do chemical peels
> between treatments on the face?  Also, I would like to use the derma
> roller on my stomach and outer thighs for stretch marks and lose skin
> after having a baby.  I read your review and that a longer needle may
> be needed for those areas, but I did not see that you sell a 2.0mm kit.



I would advise you to do the chemical peels before dermarolling. If you are prone to acne or clogged pores, then Beta Hydroxy acids such as Salicylic acid are better since they get deeper into the pores than Alpha Hydroxy peels. Salicylic acid is fat-soluble and it is a mild antiseptic. It is effective in penetrating sebaceous pores and keeps them unclogged.

DERMAROLLING AFTER A PEEL - WHEN CAN YOU DERMANEEDLE AFTER A PEEL?

When the skin has fully recovered from a peel, you can start with dermarolling.

How to know that you skin has fully healed?  When it is still red, tender, dry or flakey then it has not.
Before doing dermaneedling after a peel, your skin should be 100% back to its natural state how it was before you got the peel.
How long that is, is totally individual and depends on the type of peel performed.


GETTING A PEEL AFTER DERMAROLLING - WHEN CAN YOU DO A PEEL AFTER DERMANEEDLING?

When the skin has fully recovered from dermaneedling, you can do a peel.

How to know that you skin has fully healed?  When it is still red, tender, dry or flakey then it has not.
Before getting a peel after dermaneedling, your skin should be 100% back to its natural state how it was before you did the dermaneedling.
How long that is, is totally individual and depends on the needle length and how much you needled.


I do not advocate using  frequently deeper acid peels or any other relatively aggressive treatments in between rolling with long needles. The more is not always the better and the skin should be allowed to regenerate and remodel in between various treatments.


Classification of chemical peels:


Exfoliation - can be used daily

-AHA 5-10%
-Retinoids

   
Very superficial peels
   
-Alpha-hydroxy acid (AHA) - glycolic acid and lactic acid up to 50%
-Beta-hydroxy acid - (BHA) - salicylic acid (excellent for acne prone skin since it cleans pores)
-Trichloroacetic acid (TCA) up to 10%


Superficial peels - reach the epidermis - usually performed every 4-6 weeks

-TCA up to 30%
-AHA - up to 70% (left from 2 to 20 min)
-BHA
-Jessner’s solution – (contains 14% resorcinol, 14% salicylic acid, 14% lactic acid and ethanol)


Medium depth peels - reach the papillary dermis - usually performed once in 6-12 months

   
-TCA 30% to 40%
-Glycolic acid 70% + 35% TCA
-Jessner’s solution + 35% TCA
-Glycolic acid 70%


Deep peels - reach the reticular dermis - Can be performed once every few years or once in a lifetime

-TCA 50% or more
-Phenol

 
The depth of penetration depends on many variables:

-The concentration of the peel
-The pH of the peel
-Thickness of the skin
-How many layers of the peel are applied
-How long it stays on               


It is very difficult to give general advice concerning the needle length for skin conditions due to the fact that the skin thickness varies depending where on the body it is. The thinnest skin is on the upper eyelids and the thickest is on the palms of the hands and the soles of the feet.

When people want to roll against lost elasticity of their neck, they should not use 2 mm needles because the skin of the neck is quite thin. On the other hand the skin on the back or buttocks for example is rather thick and 2 mm needles may be appropriate to address stretch marks in that area.

The proper answer to the question how long the needles should be to address loose skin is: They should be able to reach the dermis. 1.5 mm needles are often totally sufficient - but it depends how thick and tough your skin is. If you never get any pinpoint bleeding (occasional pinpoint bleeding is a sign that you reached the dermis), you could try 2 mm needles. But even just reaching the very upper dermis (no pinpoint bleeding) is enough to trigger new collagen production. If your skin turns red after rolling, you triggered the desirable processes.

We will have 2 mm rollers for sale in just a couple of days from now. We'll announce it on the forum.

2 mm long needles might be too painful for you to roll and not even necessary so if you are a dermarolling "beginner" then 1.5 mm long needles are better to start with. A dermaroller will eventually get blunt and has to be replaced anyway so you can buy a 2 mm dermaroller the next time.

I believe that dry brushing the area, accompanied by the external application of vit. C as well as massaging it with a mixture of fine salt with oil is beneficial to prepare the skin for dermarolling. In combination with a healthy diet, of course.

You could also target individual stretchmarks with our single needle to crush the scar tissue. It is laborious. Nevertheless, you can needle just a couple of stretch marks every day (even while watching TV). Do not forget to disinfect both needle and skin beforehand.

Buying a 0.2 roller for skin care product penetration enhancement is a very good idea as well and such a roller can be used up to 4 times a week.

Apply a tightening cream, stretch mark cream (or the skin care product of your choice) onto the area and roll it in.

It is difficult to find time for exercises when you have a baby but toning your muscles will usually make any skin problem look better.

58
> hi,i am just writing to ask for some advice,i purchased some

  > dermarolling items from you a few weeks ago,really happy with everything

  > i got and was absolutely desperate to try it and also got some emla

  > cream to,was just wondering if you could help me with a few thing-i

  > did the roller last nite for 1st time and all so far seems well-got my

  > friend to roll for me while i tightned my skin and lay under the

  > light,i have the 1.5mm and although i did go red afterwords and feel

  > tingley-i wasnt sure wwhether the needles are just touching my skin or

  > fully penetrating it as there was no blood spots at all and i dont

  > think the needles are long enough to penetrate there full length-what

  > do you think does this sound ok?

 

Some people get pinpoint bleeding on their face from rolling with a 0.5 mm roller and some do not bleed even with 1.5 mm needles. It depends where on the body you roll and how thick and tough your skin is. If you were red afterwards it means the micro-damage and subsequent inflammation happened as it should.  

  A 1.5 mm roller penetrates about 1.3 mm into the skin and that certainly reaches the dermis of the face.

 

  Next time you can try to soften your facial skin with steam. Boil some water in a wide pot, take it off the stove and put your face above the pot for about 10 minutes to get the steam in your face. You can use a towel like this:









It should not be scaldingly hot, just hot and it will soften the skin and make it easier for the needles to penetrate. If you roll on your body, have a hot bath before that. The skin is in fact a very tough organ because the outer layer, the Stratum Corneum is our protection barrier against the outside world. This outer skin layer contains dead cells containing Keratin, the same material that hair and nails are made of and is therefore very hard to penetrate, especially by dozens of needles simultaneously. This is also how someone can lie on a bed of nails because the pressure is divided over many nails.



   

  > i numbed my right cheek alover firstly,wiped that off with alcohol

  > then single pricked with the smallest single needlle in the kit! i

  > have done a fairly ok job i think-but i was just wondering-the needle

  > didnt actually go the full way in-it was really quite tough and i did

  > prick in but id say only about half way in i got with that needle-i

  > got ALOT of bloodspots

 

    The skin consists of 3 layers: The epidermis, dermis and the subcutaneous layer.

 

  The epidermis has no blood vessels at all and the dermis has a sparse capillary blood vessel network. If you got some pinpoint bleeding, you know that you reached the deep dermis. The dermis is your target when treating scars. Not every prick should lead to a bleeding spot because the capillaries are irregularly and sparsely distributed in the dermis. The depth of your single needling was correct.

   

  >please get back to me and thanks for great quality products and service!

  Thanks :-)

                      Attached files  

59
Dermarolling / Microneedling / Botox or fillers after dermarolling
« on: March 03, 2010, 09:18:37 AM »
>If i do the Derma roller in my face, how long after can i have done

>Botox and Derma filler. I’m 31 years old and my first concern is my

>wrinkles under my eyes. Do you sell the small derma roller,

>to use it in this area?





If you roll with needles longer than 0.25 mm, you should wait about five days with using botox or fillers.

We sell a narrow 0.5 mm roller for under they eyes. You can buy it here: 0.5 mm "3-liner" dermaroller for under the eyes.


60
>I would like to know if it is safe to use a dermaroller if you have had

>Botox or some kind of filler.



First four weeks,you should only use < 0.3 mm needles. Don't use long needles when fillers have been freshly injected, wait about four weeks before rolling over the areas with longer needles than 0.3 mm because the rolling might speed up the breakdown of the filler.

You can roll around it, just do not roll for four weeks directly over the areas that were injected with a filler.

Do not perform any kind of microneedling over the botoxed area for the first two weeks. It can take up to two weeks for Botox to maximally paralyze the muscle (by blocking the receptors on the muscle).


>If you have bottox on your forehead and coaptite filler (radiesse) in your cheeks, does rolling with dermaroller interfere and reduce their duration or is it safe?

 

No problem with dermarolling after Botox but do not roll for two weeks directly over the Botox area and for four weeks over the fillers area with needles longer than 0.3 mm.

 Radiesse or other fillers are applied to the bottom of the dermis and the layer immediately below it (subcutis) and this is too deep for a dermaroller.

 If you want to be absolutely sure, stop using needles longer than a 1.5 mm and do not deep single needle the cheeks, directly over where the filler is. The needles of a dermaroller never penetrate the skin to their full length so there should be no problem even with a 2 mm roller.

 In the Botox area, you can use any size of needles and deep needling (after two weeks).

 There were two studies done on whether laser therapy, radiofrequency or IPL negatively affect dermal fillers and they both found it did not have any negative effect on the fillers (in spite of the fact that radiofrequency penetrates really deep). At the moment I only found one study of those two:

 

Randomized Trial to Determine the Influence of Laser Therapy, Monopolar Radiofrequency Treatment, and Intense Pulsed Light Therapy Administered Immediately after Hyaluronic Acid Gel Implantation

BACKGROUND Hyaluronic acid-based dermal fillers, such as hyaluronic acid gel (Restylane, Q-Medical AB, Uppsala, Sweden), are widely used for tissue augmentation of the nasolabial folds. Additional dermatologic treatments using infrared light, radiofrequency (RF), and intense pulsed light (IPL) are also important tools for facial rejuvenation. This study was designed to evaluate whether these therapies could be safely administered immediately after hyaluronic acid gel treatment without compromising the effect of the dermal filler.

OBJECTIVE The objective of this study was to confirm or refute any possible subtractive effects of augmentation of the nasolabial folds when followed by 1,320-nm Nd:YAG laser, 1,450-nm diode laser, monopolar RF, and/or IPL treatments.

METHODS Thirty-six patients with prominent nasolabial folds were treated with hyaluronic acid gel implantation on one side of the face and hyaluronic acid gel followed by one of the nonablative laser/RF/IPL therapies on the contralateral side of the face.

RESULTS There were no statistically significant differences between wrinkle severity or global aesthetic scores for hyaluronic acid gel implantation alone and hyaluronic acid gel with laser/RF/IPL treatment at any time point. In a small sample, histologic changes were not apparent after laser/RF/IPL treatment.

CONCLUSIONS Based on this small pilot study, laser, RF, and IPL treatments can safely be administered immediately after hyaluronic acid gel implantation without reduction in overall clinical effect.



 

>And, do you know any "home made" method to fill the cheeks other than the expensive filler by the dermatologist?

 

No, there is unfortunately no DIY method. You can have it filled with you own fat in a surgery and supposedly, if well done, it lasts very long.

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