Corner-of-mouth scars

[Damo2363]

Hi, many thanks for your helpful website, can i please ask a question about dermarolling?

A few years ago i had microcanulus injections into my face, with the surgeon using the corners of my mouth as access points. Unfortunately, this has caused slight scarring - a small area of 'bumpiness' in the corners of my mouth rather than the smooth skin it used to be. The result is that when my mouth is closed, small creases form at the corners. They bother me because i feel they interfere greatly with the aesthetics of the mouth area.

It is my desire to improve this any way i can - at home if possible, or at a clinic if necessary. From my research i believe that derma rolling could be an good place to start.

The key concept is that i need to flatten the 'bumpy' scarred areas into smooth skin. Can the collagen-inducing effects of derma-rolling achieve this, do you think? I have also considered chemical peels, and various forms of microdermabrasion. However, i don't think it would be a good idea to combine treatments.. the lip area is a delicate one afterall? Thus my plan is to start with 0.25mm rolling of the area, and move up to 0.5mm once i'm comfortable.

Any thoughts or advice would be greatly appreciated!!

Regards

Damien

[SarahVaughter]

Are your bumps on the lips themselves or is it in the corners outside of the "raw red lip tissue".

   

  I recommend a dermastamp instead of a 1.5 mm dermaroller for such a localized, difficult to maneuver small area. You do not have to insert the needles fully into the skin.

  The lips and the area around them are extremely sensitive. You may need a numbing cream.

   It also depends on what kind of trauma occured during your injections. If it caused fat recession, dermarolling cannot fix it. If it is a scar in the skin, there is a chance for improvement with microneedling.

[Damo2363]

Hi, thanks for your reply.

After a closer look i have realized that the issue is more likely the result of a slow-healing split in the corner of my mouth a while back. Due to constant mouth opening, the split has closed with a slightly recessed heal-point, which is causing the creases upon mouth closure.

I have attached a pic of someone with a similar problem. Mine is less severe than this however.

Now, i realize that this is probably close to what you call 'fat recession', and microneedling may not be able to help me. Do you think a single-needle approach would cause enough collagen growth to 'fill the gap' somewhat? Or do you think i would be better off seeking out a clinical treatment such as laser resurfacing?

Many thanks for your help.

                     

Attached files

[SarahVaughter]

Single needling is the most targeted and probably the best approach in your case but needling that area will be quite painful.

   The photo you had posted is actually of Angular Cheilitis, which is a bacterial or fungal infection of the corners of the mouth.

   But I know what you mean, your lip corners look similar but it is not from an infection but it is a scar or some kind of crease left after a badly healed skin trauma.

   

I do not think laser treatment is a good idea because lasers use heat and this could burn the sensitive corners of the lips and actually make it worse.

   

Try single needling in one corner and you will see what happens. Needling will make the skin temporarily more red and the redness can last many days so it will temporarily look worse. Start with just a few pricks; do not do any aggressive or dense needling. You can needle very subtly every ten days and if everything heals OK you can slightly increase the number of pricks (extend the gap between needling) but keep needling always subtle. This is an extremely delicate area with unpredictable healing.

     

  It is really hard to say whether microneedling or anything else can help in your case because as you said it looks like your corners were basically ripped and when they healed they kind of extended.

[Damo2363]

Hi Sarah, yes basically its a small rip that hasn't quite healed all the way back.

After further reading on your forums i think single needling could help me - afterall people do use the technique for ice pick scars etc and i only need a small amount of collagen plumping to gain an improvement.

To summarize i will start with subtle needling every 10 days or so, and if everything goes well then gradually move up to more dense needling with longer gaps in between.

Regarding supporting skin care - i'm a little confused about what products should be used to 'prep' the skin, and what can be used during the healing period afterward.. prep with exfoliation, Vit C and Vit A? And then Infadolan afterward? Or should Vit C also be used afterward?

I notice that in your A-Ret cream the active ingredient is Retinoic Acid, however i was under the impression that (though the most potent) this is the most unstable form, quickly losing its potency when compared with palmitate or acetate formulations. Does your A-Ret cream therefore have a limited shelf life?

Thankyou once again.

[SarahVaughter]

The corners of the lips are mucous membranes and you should not apply any acids or exfoliation. Do not pre-treat it in any way. Take vit. C orally and buy just the single needles and Infadolan.

   Every form of vit. A has its pros and cons.

   

  Retinyl palmitate is cheap, stable, non-irritating but it is a large molecule so it may not penetrate the skin easily. Retinyl acetate is stable, easily penetrative, non-irritating. Retinol is unstable and more irritating.

  Retinoic acid is unstable and most irritating. They are all efficient and useful, some more than others in specific situations (such as directly after dermarolling, or specifically for acne etc). They are converted to Retinoic acid in the skin.

Retinoic acid is the most potent form but it has to be protected from the air (keep the jar tightly closed when you do not use it - it has an airtight inner lid) and to greatly prolong its shelf life, keep it in the fridge.

Tretinoin's shelf life is an inverse exponential function of the storage temperature.

Our tiny jars contain only 18g of Retinoic acid cream therefore it will be used up rather quickly.

[Damo2363]

Sarah, that is all very helpful, thankyou again.

When you say the corners of the lips are mucous membranes, i assume you mean right in the corner very close to where it turns red and enters the mouth?

Either way i will take your advice and avoid abrasive pre-treatment of the area.

Just to clarify, needling of a groove does generally result in some gradual 'fill-in' from the resultant collagen stimulation - correct? And if so, what is the best way to optimize this - needling directly into the bottom of the groove only, or angling the needle into the 'walls' also?

It has occurred to me that in the case of a split that has healed half 'open', what really needs to happen is the tissue re-aggravated and then brought together so that it can mesh together all the way to the top. I am guessing though that attempting this in an unskilled manner would carry a high risk of making things worse?

Thankyou again for your thoughts and advice.

[SarahVaughter]

Damo2363;3057 wrote: Just to clarify, needling of a groove does generally result in some gradual 'fill-in' from the resultant collagen stimulation - correct?

 

    We have never had a customer with this kind of problem, neither have I ever heard of a similar problem in connection to dermarolling.

   

  In general, dermaroling often fills-in or partially fills-in indented skin but it depends what is the cause of the indentation.

   Also, the tissue in the corners of the lip is quite specific and I do not know whether needling can fill in this kind of badly healed tissue or make it heal better.

   

  Do not needle at an angle. Just a few gentle straight pricks.