Advice and products for treatment of hyperpigmentation and hypopigmentation

[dayzee76]

I am new to the website and hoping beyond hoping that I can find some help for my skin issues - I have explored all around the website and feel very hopeful! I was wondering if I could get some advice on where exactly to start and what products would be beneficial for my particular issues. I am dealing with areas of hypo pigmentation and hyper pigmentation - all kind of mottled together. My cheek areas are particularly uneven in their coloring, with lots of brown spots with white spots mixed in.....mottled is the best way to describe it.

Would single needling be the best way to treat or would a roller be a better approach to evening everything out??

What size needle or roller would be the best???

What type of products would be the best for pretreatment and post treatment??

How often should I needle or roll and for how long???

I just need someone to tell me what to do and what I need - please help Thank you so so so much .....it is wonderful to feel hopeful - I am so ready to not feel self conscious about my skin

[SarahVaughter]

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.

[dayzee76]

just to clarify....should i roll the whole uneven area with a 0.5mm roller?? My trouble areas are such a messy mix of brown and white spots if I roll the area I will be treating both hypo and hyper pigmented together.

[SarahVaughter]

Yes, roll the entire area.

   

  The Tretinoin cream should also be used on the whole area. It evens out the skin tone.

[webs]

Hi Sarah,

I have pigmentation problems similar to dayzee76.

I started using some whitening serums some  time ago, but it seems like I got 'white' spots from this + the dark spots didn't really fade or dissapear, so now my face (only forehead) is a big mess of white and dark areas.
It seems to have gotten a bit worse by time, which confuses me as I very rarely go to the sun (because of this) and use spf 30 in winter & spf 50 in the summer.
I'm actually wondering if it would be an advantage for me to get some sun for the white areas ?

Any advice on what the best treatment should be? Im male 33 years old.

Currently Im using a 0,5 mm dermaroller 2 times a week on the whole area.
What product, do you recommend I use right after needling?
And what product do you recommend I use on days where I don't needle?

I have bought A-Ret cream 0.025%, but have not used it yet as Im afraid my skin will get too sensitive to the skin. Do you just apply this product directly?

Thanks

[SarahVaughter]

Sorry for the very delayed answer. We were on holidays and I have been overloaded with questions recently.

To be honest, I do not have any better advice for you than what you are already doing (a 0.5 mm dermaroller). If a whitening substance made it worse, it is not a good idea to advise you for example to apply it right after dermarolling for better penetration.

You may have dermal melasma. You can search for melasma on this forum.

Try the A-Ret cream but start using it in winter. A-Ret helps with hyperpigmentation but it also makes skin more sensitive to the sun.

Sunshine would be beneficial to your white areas but it will likely worsen your dark areas so it doesn't seem to be an option.

Have you noticed any change after rolling it with your 0.5 mm dermaroller?

[webs]

Hi Sarah,

I haven't noticed any changes yet, when using the 0,5 mm dermaroller, but it haven't made it worse (which is the most important for me). This is summertime so the spots always get a little darker, but actually Im satisfied with being able to keep them down to a acceptable level of darkness using spf 50+.
Heres some question I hope you will answer:
- What product would you recommend I use right after dermarolling ?
- Regarding  A-Ret cream 0.025%, should it be applied directly or mixed with another lotion ? Will it only make the skin sensitive for the sun for a certain period (while using it) ?
- What product do you recommend I use on days where I don't needle? vit c ?

[SarahVaughter]

These questions are answered in our dermarolling instructions:

https://http://dermaroller.owndoc.com/dermaroller-instructions.pdf

[webs]

Hi Sarah,

I think I noticed that the difference between the white and dark areas has become more noticeable, which off course is not good. Is this naturally in the beginning or would you recommend I stop dermarolling?
Or maybe switch to 0,2 mm in order to get better results with Infoldan, a-ret, c-vit etc?

[SarahVaughter]

Sorry for the delayed answer.

No, the increase in contrast is not natural after dermarolling but are you sure it is not due to the summer season? Even if you always apply a high factor sunscreen, the melanocytes will still manage to get stimulated by the sun and produce the melanin pigment. They will produce much less than if you do not use any sunscreen but there is no sunscreen that can provide a 100% sunblock.
 
You can continue with dermarolling but roll only a small part of your face to see what happens long term. It will help you deciding about the rest of your face.
 
If you have Melasma, it is very unpredictable condition and everybody reacts differently:

https://http://forums.owndoc.com/dermarolling-microneedling/should-i-stop-dermarolling-for-my-melasma
 

[webs]

Hi Sarah,

Thanks, Im almost absolutely certain that i have melasma, which is a big pain. I have been avoiding the sun all summer and it still got significantly worse.  I have also used the incorret skin products, for instance a chemical sunblock instead of a physical, so it could be due to many things.
I will try to continue to dermaroll on an area and keep you udpated.

[barebcy]

Should we be applying hydroquinone on a daily basis for the 3 out of 4 months?  Or is only immediately following each stamp/needling?

Thank you!

[SarahVaughter]

Apply it daily and every now and then after dermarolling for greatly enhanced penetration. For example after rolling with a 0.5 mm dermaroller.
 
The studies using a dermaroller to enhance depigmenting products have been successful:
 
https://http://forums.owndoc.com/dermarolling-microneedling/malazma/

[fusion]

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