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The depth of the skin itself (without the underlying fat) is certainly no more than 2 mm. Yes, inject it into the dermis. You should inject it to the bottom or slightly below the bottom of the scar to stretch and detach the scar from its anchoring.
The article doesn't say it is not working for ice pick scars but it says:
"Saline injections provide a safe, simple and cost effective solution for post-acne scarring, particularly atrophic, shallow boxcar scars."
1) You can apply vit. C before applying the A-Ret. First, let the vit. C penetrate into the skin and then apply the A-Ret. Or apply vit. C in the morning, let it penetrate and apply the other creams.
2) I think you should combine the aggressive rolling (1.5 mm every four weeks) with a 0.5 mm dermaroller (twice a week, if it is too irritating for your skin, roll only once a week). Using a dermastamp is also a good idea. Try it on your cheeks too. There is a chapter in our instructions about how to use a dermastamp:
Start slowly, with just a few stampings and if the skin heals well, increase it.
Basically, you will have to improvise a little, trying different approaches because nobody knows yet what is the absolute best dermarolling approach regarding your skin problem, especially due to the unknown origin of the quick deterioration of your skin. Every now and then, give your skin a longer break from dermarolling. The customer who allowed us to post her photos here also allowed me to give you her email addresse, have you received it?
3) You can mix Infadolan with the A-Ret. They both contain vit. A.
I have found an article where Dr. Sire who has been advocating and performing this method explains how to do it. I post here the relevant sentences:
Dr. Sire:
"During the procedure, backlighting is important for creating shadows that highlight scars' appearance. With such lighting, "You can see changes in the surface of the skin to pinpoint where exactly the scars are," Dr. Sire says.
"Usually I inject into the scar itself, creating a bleb or bolus of saline, which then expands the scar. Typically, there's only one injection into each scar," using a 30-gauge needle
Saline injection volume varies from 0.5 cc to 1 cc per injection site, Dr. Sire says. Each treatment takes about 15 minutes, and most patients see 20 to 80 percent improvement after five or six sessions.
When injecting saline for post acne scarring, the needle tip is advanced 45 degrees into the dermis and the saline injected with the objective of creating a wheal.
Dr. Sire proposes that the treatment's mechanism of action stems from the fact that stretching and physical stimuli provoke fibroblasts to produce collagen and various growth factors.13
In the eyes of peer-reviewed medical-journal editors, Dr. Sire says, the saline procedure's simplicity is perhaps a disadvantage. "I've submitted it before, and it's been ignored." Perhaps these editors believe that "something this simple can't be that great," he says, "but it actually is."
Instead of retinoic acid, I highly recommend pre-treament of the scar with single needling to re-establish metabolic activity and promote revascularisation in the scar. Needling is excellent for this. It will also soften the hard scar tissue and trigger collagen.
The saline should be injected about once every 2 weeks.
Do not buy one big bottle of saline but many small ones that you discard once opened. Keep it in the fridge.
If you buy a big bottle of saline, do not dip a used needle or anything into it - it will contaminate it. For your procedure, pour some saline into another container that you had cleaned with boiling water (do not use any sponges to clean it, sponges are bacteria breeders), and discard it when you finish injecting.
You must remove all air from the syringe before you inject.
Kelo-cote is a silicone-based cream used in prevention or improvement of hypertrophic or keloid scars. The mechanism of action is not completely understood. Several studies findings suggest it is not the silicone itself that has an effect but it is the occlusion and hydration that forms under the silicone sheets which is effective in improving hypertrophic and keloid scars.
Treatment of scars and keloids with a cream containing silicone oil
Abstract
The clinical effect of silicone cream containing 20% of silicone oil was tested on 47 patients with hypertrophic scars and keloids.
A silicone cream/occlusive dressing technique, quite similar in manner to silicone gel treatment, resulted in a remarkable improvement of scars and keloids in 9 of 11 cases (82%) whereas the simple application of the cream onto the scars and keloids of 36 cases resulted in only mild improvement in 8 (22%).
Using the chi-square test, a statistically significant difference was seen between these two treatments (p < 0.01).
From these findings, we suggest that occlusion and hydration are the principal modes of action of the silicone gel sheet method and our silicone cream/occlusive dressing technique.
Cytokine mRNA changes during the treatment of hypertrophic scars with silicone and nonsilicone gel dressings.
OBJECTIVE. To determine whether silicone is an essential factor in the treatment of hypertrophic scars and investigate the effects of occlusive dressing therapy on the expression of key wound healing mediators.
CONCLUSIONS. This study demonstrates that silicone is not a necessary component of occlusive dressings in the treatment of hypertrophic scars. The pathogenesis of hypertrophic scars is further elucidated by demonstrating that there is molecular evidence for extensive connective tissue remodeling occurring during occlusive dressing therapy.
Hydration and occlusion treatment for hypertrophic scars and keloids.
Sawada Y, Sone K.
Department of Plastic and Reconstructive Surgery, Hirosaki University School of Medicine, Japan.
Abstract
In 31 patients with hypertrophic scars or keloids, a side by side test was carried out to check the efficacy of an occlusive dressing technique using cream which did not contain silicone oil, versus a simple application of vaseline, used as a control. In all cases, the cream treated areas of scar and keloid demonstrated a remarkable improvement over that of the vaseline treated area. These findings strongly suggest that the mechanisms of hydration and occlusion are the main basisof the therapeutic action of this method in treating hypertrophic scars and keloids.
BTW, Infadolan ointment that we sell for dermarolling aftercare is a semi-occlusive ointment that prevents water evaporation from the skin and thus keeps it extra moisturized (just like silicone). Adding "water creams" or glycerin to the skin does not moisturize it for more than several minutes. Topically added water actually increases the evaporation of water from the skin. The skin contains enough water. The top layer of the skin works as a barrier that prevents evaporation from the skin. If this barrier doesn't work properly or is temporarily compromised, the skin becomes dry. Adding water does not solve it. Establishing a barrier that prevents water evaporation solves it. That is why oils are much better moisturizers than any light moisturizing cream because oils form a film on the skin that prevents the evaporation of water. The film however can be a problem with acne prone skin.
You can wrap your scar into food wrap to enhance the occlusive effects of Infadolan or other products.
The best approach in your case is a 0.5 mm dermaroller (used twice a week on your entire face) and a 1.5 mm dermastamp (used once every three weeks on your scars and indentations). Dermastamping is more laborious but you do not have to do both cheeks in one go. It is better to stamp one cheek thoroughly and the next day or any time later the other cheek.
Yes you can do that, but you should not reuse the solution, so you can't soak the rollers directly in the litre of solution but have to poor it first into a glass for example.
How much Chloramine you need depends on the volume of the container you use to put the roller in. If you use a longdrink glass, you'll need very little.
How long the redness lasts is individual but on average, the initial redness that looks like a sunburn is gone within a few hours. There can be some residual redness, lasting for a day or two but this is not very noticeable.
Some of our customers with sensitive skin are still quite red a day after dermarolling with long needles. That is why it is better to do the first roll without planning an important social event the day after - or do just a small test patch first.
It also depends on what kind of product you apply afterwards. If you apply a cream that contains an acid (glycolic acid, lactic acid, retinoic acid, salicylic acid etc), it will make the skin redder.
Single needling redness lasts longer and aggressively and deeply needled stretch marks or scars can stay red for a week or longer.
No, dermarolling will not help with these lines, because they are not wrinkles. You have a wrinkle-free face.
The line at the outer edge of your eye is not caused by aging. It is a normal part of the area around the eye. When you look at the photo of the baby in this link (forum posting #3), you will see that even babies have them. The line is especially pronounced in his left eye. The baby has lines under its eyes but also at the outer edge (the same line you are referring to):
We are born with skin folds. As we age, the folds deepen due to the drop down of the skin and the underlying skin structures. A mild skin laxity can be improved by dermarolling and tightening the skin by dermarolling can slightly improve the depths of skin folds deepened by aging.
Your skin however doesn’t have any laxity and other signs of aging. There is nothing dropping and in my opinion, nothing to improve.
The skin on the arms is thinner that the skin where the stretch marks routinely are - the hips, buttocks, thighs etc. Single needling thin skin deeply can unfortunately cause bruising. If you send me an email with your address, I will instruct our dispatch center to send you shorter needles for free. We have some in stock. It could also be that you received some that were a little too long.
We have ordered a new batch of single needles that are shorter.
Have you needled vigorously? (with the single needle on the inside of the arms, that's a no-no - I'll add that to our instructions ASAP.)
Skin thickness varies. The thinnest skin is on the eyelids, the thickest on the footsoles. Skin thickness also varies individually. It is possible to use needles on the eyelids, for example in permanent make up procedures but I really cannot recommend "homerolling" the eyelids and taking the risk of
pricking the eyeball.
I advise consulting a dermatologist or perhaps a plastic surgeon.