Hypopigmentation from CO2 laser

[JD]

Dear Sarah,

I have found your site to be tremendously informative and helpful.  I am writing to make sure my proposed treatment sounds like it’s on the right track to you.  There is a lot of conflicting information about dermarollers etc. and it sounds like you have the best understanding of this process.

About a year ago, I have a dermatofibroma removed from my upper shoulder with a CO2 laser.  The procedure worked fine, however I ended up getting delayed hypopigmentation on the exact spot 6 months later.  The area does not tan and there is a significant demarcation around the edge where the laser worked.  The hypopigmentation is circular and about the size of a nickel.  There does not appear to be any scarring or scar tissue.  Just a lightening of the skin.

I purchased a dermoroller 1.5mm and was going to use it every day on the spot based on a website claim in order to “wake up” my melanocyte cells and hopefully transfer a few.   However, after reading your advice on other posts, I am having second thoughts and am wondering if a dermastamp is better.  Specifically,

1. How would you suggest I tackle this? 

2. Do I use a dermaroller or dermastamp (or both)? 

3. What thickness should I use?  Your prior posts seem to suggest 1.5mm would be optimal but I am not sure.  Again,
there is no scar tissue so I am wondering if shorter needles are preferable?

4. How often should I roll or stamp?  I seem to recall you typically suggest every 20 days (going over the patch about 8 times per treatment).  This means I would not use it daily as the dermaroller website suggests. 

5.  Lastly, to get the fully benefit of any possible melanocyte cell transfer, do you have any special techniques that I should use?  Do I roll or stamp over another part of my body first?  Or just roll and stamp in the general area?  I am not quite sure.

I really appreciate any insight you could give.  Unfortunately, the hypopigmentation spot is noticeable and it bothers me.  Hearing there is hope to correct this is such a relief!

Thank you,

JD

[SarahVaughter]

>2. Do I use a dermaroller or dermastamp (or both)? 

For the size and shape of your hypopigmeted patch, a 1 mm dermastamp would be better but you can use both.  Use a dermastamp to stamp the scar and a dermaroller (roll with very light pressure) for melanocytes transfer. A dermastamp would be sufficient for the transfer but since you have already bough a roller, use it as well.
You should stamp the white patch and also a little over the edges of the white patch to facilitate the migration of melanocytes from the surrounding normal skin into the white patch.

When the skin is healed from microneedling, expose your hypopigmentation to the sun because melanin is produced as a reaction to UV (provided there are melanocyte cells in the area to produce it).


>3. What thickness should I use?  Your prior posts seem to suggest 1.5mm would be >optimal but I am not sure.  Again,
>there is no scar tissue so I am wondering if shorter needles are preferable?


A 1.5 mm size is useful if there is scar tissue or on the skin that is very thick (a knee skin hypopigmentation etc).
For hypopigmetation without scarring, a 0.5 or a 1 mm dermastamps are suitable.


>4. How often should I roll or stamp?  I seem to recall you typically suggest every 20 >days (going over the patch about 8 times per treatment).  This means I would not use it >daily as the dermaroller website suggests. 


Stamp it every ten days.


>5.  Lastly, to get the fully benefit of any possible melanocyte cell transfer, do you have >any special techniques that I should use?  Do I roll or stamp over another part of my >body first?  Or just roll and stamp in the general area?  I am not quite sure.


You should roll over the patch, going up and down, to the areas that are normally pigmented and back to the patch. You can also roll over an area of you body that you know tans very easily and then roll on the patch. Do it many times during the same session.