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Always try to keep the scabs as long as possible. Never forcibly remove them because a prematurely removed scab can end up as a scar. Keep the scab very much moisturized, it will keep them longer in place. I know you did not remove the scab forcibly, I am just explaining what to avoid.
>Alright about hydrochinone. I also want to order the infadolan or the tretinoin from
>your site. Can you recommend a good hydrochinone crem, gel or serum. Could be
>also something with 2% because of my hypersensitiv skin. Can I mix it with the
>tretinoin. Even if I don't should use the roller I would try the infadolan around my
>eyes?
Yes you can apply Infadolan around your eyes.
You can mix hydroquinine with Tretinoin but Tretinoin is acidic (it is Retinoic acid). The acidic form is the most potent and the most effective but it is also the most irritating. There are many studies where Tretinoin has been successfully used to improve Melasma but again, it can theoretically also worsen Melasma in certain prone individuals. You should try it on a small portion of your face first.
>After few month with hydrochinon I shouldn't try the dermaroller again, did I
>understand that right?
No I do not think you should. It seems that in your case, melanocytes produce more melanin as a reaction to dermarolling, unfortunately.
>Just another short question which you can answer with yes or no: BPO
>(Benzolperoxyd) against acne can make the melasma worse right?
Anything that can irritate the skin (wind, acids etc) or any mechanical or other intervention (massage etc) can theoretically worsen Melasma but it is individual.
Basically any type of "activity" to the skin can in some cases provoke melanocytes into producing more melanin in Melasma sufferers. The worst thing for Melama is sun exposure. Melasma is a very frustrating skin condition.
>And AHA 10% cream twice a week or so could it make it worse too in my case?
Acids usually improve Melasma but in some unfortunate cases, it provokes the skin into producing more melanin. That is all I can say. 10% AHA is a weak acid and is should be OK but nothing is 100% sure with Melasma.
The hyperpigmentation eventually always goes away and it very rarely lasts that long. You should continue applying Retin A. I am not sure whether applying hydroquinone is s good idea, especially if your stretch marks were white prior to needling because hydroquinone reduces melanin pigment production and melanin pigment is highly desirable in white stretch marks.
It seems there is currently too much melanin in your stretch marks but it will fade. Wait a little more and if it doesn't fade, start with hydroquinone.
The moisturizing is to establish ideal condition for healing, to protect it and to postpone peeling. The longer the peeling is postponed, the better.
There is always a degree of peeling after dermarolling/needling, nevertheless it is not always visible.
The Candida forum is closed, we were getting too many irrelevant posts. Sure that will work, as long as you use ordinary gelatin or vegecaps capsules, not the special slow release ones that break up later in the GI tract.
Unfortunately, many things can worsen Melasma. Strong wind, coldness, heat, massage, creams, acid peels, dermarolling etc. However, it is highly individual. Not everybody reacts the same. Acid peels, dermarolling, laser treatments etc. often improve Melasma but in some unfortunate cases, it worsens Melasma (the skin produces more melanin pigment as a reaction to the treatment). What improves Melasma in one person can make it worse in another. Always do a test patch.
It will be difficult to find out what caused the worsening of your Melasma. Theoretically, it could have been the vit. C in spite of the fact that ascorbic acid (vit. C) has been successfully used in improving Melasma because it is a mild inhibitor of melanin (see the studies below). It could also have been the dermaroller. I think you should stop both the vit. C and the dermaroller and use only Hydroquinone cream.
A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma
Liliana Elizabeth Espinal-Perez MD, Benjamin Moncada MD*, Juan Pablo Castanedo-Cazares MD
Abstract
Background Melasma is an acquired treatment-resistant hyperpigmentation of the skin.
Methods Sixteen women with idiopathic melasma were included in our trial. After randomization by another clinician, they were instructed to use, at night, 5% ascorbic acid cream on one side of the face and 4% hydroquinone cream on the other side, for 16 weeks. Sunscreen was applied daily throughoutthe period of observation. They were evaluated every month by colorimetry, digital photography, and regular color slides. Subjective evaluation by each patient was also taken into account.
Results The best subjective improvement was observed on the hydroquinone side with 93% good and excellent results, compared with 62.5% on the ascorbic acid side (P < 0.05); however, colorimetric measures showed no statistical differences. Side-effects were present in 68.7% (11/16) with hydroquinone vs. 6.2% (1/16) with ascorbic acid.
Conclusion Although hydroquinone showed a better response, ascorbic acid may play a role in the therapy of melasma as it is almost devoid of side-effects; it could be used alone or in combination therapy.
A Randomized, Double-Blind, Placebo-Controlled Trial of Vitamin C Iontophoresis in Melasma
Huh C-H, Seo K-I, Park J-Y, Lim J-G, Eun H-C, Park K-C
Abstract
Background Vitamin C is known to both inhibit melanin formation and reduce oxidized melanin. However, vitamin C does not easily penetrate the skin. In this study, vitamin C iontophoresis was employed in order to enhance vitamin C penetration.
Objective: The purpose of this study was to evaluate the efficacy of vitamin C iontophoresis for melasma patients. Methods: Twenty-nine females with melasma were enrolled. For iontophoresis, a vitamin C solution was applied to one side of the face, while distilled water was applied to the other side as a control. The L (luminance) value was measured by a colorimeter to obtain an objective pigmentation parameter.
Results: Twelve weeks after iontophoresis, the colorimeter of the treated site showed a significant decrease in the L value (from 4.60 to 2.78, p = 0.002), compared to that of the control site (from 4.45 to 3.87, p = 0.142).
Conclusion: Vitamin C iontophoresis may be an effective treatment modality for melasma.
Both a 2 mm roller and a 2 mm dermastamp are effective for deep scars. A dermastamp is perhaps less painful (it has less needles) but much more laborious. You can combine the two in one session. Roll over the whole area with your roller and then stamp the deepest scars with either a 1.5 or a 2 mm dermastamp. A day or two later, start the suctioning.
You can also use just the dermastamp if you prefer.
Severe acne scars can take up to 5 to 10 sessions, spaced 4 to 6 weeks.
This therapy to eliminate severe scarring caused by acne, is done by taking a small amount of blood from the patient to produce platelet rich plasma (PRP), then applied to freshly dermarolled acne scars.
The Dermaroller creates microscopic channels that allow PRP to penetrate deeply into the skin affected by acne scars and starts its healing. The PRP stimulates the proliferation of fibroblasts and keratinocytes, forming new skin.
In addition to correcting acne scars, the procedure also improves the texture and vitality of the skin by creating new blood vessels (angiogenesis). These provide essential nutrients to the skin, maintaining a healthy skin.
Dr. Kalieska Arroyo of the Clinic for Surgery Surgery and Estetic Medicine said the procedure is simple and convenient, with minor discomfort. Occasionally, anesthetic cream or ice packs are used to make the treatment less painful.
Usually, there is little or no downtime associated with this treatment. Some redness, and sometimes bruising in the treated area may last a few days after treatment. Makeup can be applied immediately after treatment.
Surgeon Gaby del Rio said acne scars look better within days after the first treatment and continue to improve for the next month. Severe acne scars can take up to 5 to 10 sessions, spaced 4 to 6 weeks. The procedure takes around 30 minutes.
Your burn scar appears to be hyperpigmented. Buy our 0.1 % Tretinoin cream and apply it on the scar every day or every second day if the scar is too irritated by it.
Do not use Tretinoin if pregnant or breastfeeding.
Use the 1.5 mm dermastamp also on your acne scars that you mentioned.
The main "contributor" to the color of our skin is the pigment melanin. The more melanin, the darker the skin. If melanin is not completely evenly distributed in the skin, the skin tone/color is uneven. Hypopigmentations are areas where there is less melanin than elsewhere and hyperpigmentations are areas where there is more melanin than elsewhere.
Melanin is produced upon sun exposure because it is our natural protection – melanin absorbs the ultraviolet rays and thus prevents DNA damage by the sun. Dark skinned individuals are much better protected against sun damage.
Melanin is also often produced as a reaction of the skin to an injury (even without sun exposure). Such as post-inflammatory hyperpigmentation in acne, burns etc.
Melanin is produced by melanocyte cells. The cells are at the bottom of the epidermis, which resides approx. 0.2 mm into the skin.
If the hyperpigmentation is shallow, it is relatively easy to solve it.
If the membrane between the epidermis and the dermis is damaged, melanocytes or melanin gets deep into the skin and that is very difficult to solve (such as in dermal Melasma).
In some cases, the uneven production/distribution of melanin is hormonally related. For example in Chloasma, which typically appears in pregnancy.
Pigmentations also tends to re-occur upon sun exposure. You must avoid the sun as much as you can and always use a sunscreen.
You should definitely use Tretinoin cream (we sell it). It evens out the color of the skin.
Start using a 0.5 mm regular dermaroller, twice or three times a week. On the days when you do not roll, apply Tretinoin.
If you get no improvement in 6 months, it means that the pigmentation is deep and you should use a 1 mm regular roller and a Hydroquinone cream.
You can use a dermaroller to enhance the penetration of hydroquinone into the dermis but do not do it for a prolonged time. The best protocol is 3 month on, 1 month off.
Concerning the hypopigmentation, dermarolling/needling often "wakes up" the melanocytes, increasing their activity or enables the migration of melanocytes from the surrounding skin into the hypopigmented spots.
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