Thank you for your question.
You submitted several good photos of what you appear like the same day you underwent
a microneedling procedure.
And you state in your question and you’re asking is it normal to have hyperpigmentation
after microneedling.
And in the details of your question, you described that the practitioner went aggressively in
the cheek area because of pigmentation and you also state that you feel like there are
stripes in your forehead afterwards.
Well, it’s clear that you want to have some guidance.
To just give you a little bit of background in how I help patients like yourself in my
practice, a little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained
oculofacial plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Microneedling is a significant part of my practice as one of the many solutions we offer
in addition to the many lasers and other options.
In addition, we often do combine microneedling with platelet-rich plasma or PRP and I’ll
explain why as I describe for you the thinking behind this kind of treatment.
So to begin with, I think it’s interesting that you’re asking a question like this
because from my perspective, the total treatment plan very much requires an aftercare plan
and an explanation for you as to the aftercare that’s necessary.
So first of all, to understand what microneedling is, it’s using these fine needles that are
adjusted to different depths anywhere from a half a millimeter to 2.5 millimeters to
go through the skin first to create micro injuries to stimulate new collagen and improve
skin quality and it can address fines lines, wrinkles, sun damage and pigmentation.
Now when we do microneedling in our practice, we actually do it for the same issues including
fine lines and wrinkles and sun damage but we combine it with platelet-rich plasma (PRP).
And the basis for that is related to your question about hyperpigmentation.
Skin types like yours are at a higher risk for hyperpigmentation whether it’s the slightest
pimple to a laser procedure.
Anyone who has a darker skin or what’s called type 3 skin is at a higher risk for hyperpigmentation.
So when we use platelet-rich plasma (PRP), as an explanation, platelet-rich plasma (PRP)
is a concentration of the wound healing factors derived from your own blood that is used for
assisting in improving the rate of wound healing but has a very specific benefit on hyperpigmentation.
And so, I use platelet-rich plasma (PRP) topically after microneedling as well as laser.
In fact, we use platelet-rich plasma (PRP) as an injection to help with sun damage, brown
spots as well as dark under eye circles.
So with that understanding, the point of that is that I’m trying to be proactive when
I treat my patients for hyperpigmentation.
Now I’m not saying that your practitioner did something wrong.
But with that thought process in mind, I hope that there was counseling for you regarding
the use of sunblock which you can pretty much start wearing starting the next day because
the skin would have healed over, the epidermis would have healed over and then you apply
the sunblock but you also want to ask your practitioner about any topical aftercare that
includes whether it’s a topical anti-inflammatory or steroid, a topical therapeutic ointment
or cream, whether there’s even a role for a bleaching cream prior to or afterwards.
When you do any dermatologic treatment, it’s very important to also manage the healing.
Unlike surgical procedures, for example, if I take out bags under someone’s eyes, there’s
a very specific aftercare that’s recommended for the first 24-48 hours and then for 1 week
etc.
Well, for dermatologic care, there are many things that can be managed to try to mitigate
the skin’s natural response to injury and the natural response to injury in darker skin
types is to create something called post inflammatory hyperpigmentation.
So, if you didn’t get clear information as to what to do after this treatment which
is maybe why you’re asking this question, contact your practitioner and ask this question
because if you go to the sun unprotected, your skin will get darker just by nature of
the behavior.
The darker skin tends to attract more sun.
It absorbs more sunlight.
And in your situation, you have temporary darkness that can become long-term darkness.
Not necessarily permanent but it is very important to manage that.
As far as the broad question, is this a normal appearance after microneedling?
Yes, it is a normal appearance.
Those stripes on your forehead are reflective of just the pattern that the practitioner
was using to ensure uniform coverage and that pattern should fade as long as it doesn’t
get too dark.
If it does get dark, there are ways to manage that with bleaching creams and other modalities.
So make sure that you have these instructions clear.
And I would say, most importantly, protect your skin with sunblock and allow the skin
to heal.
So I hope that was helpful, I wish you the best of luck and thank you for your question.