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Messages - SarahVaughter

Dermarolling / Microneedling / Re: Corners of mouth
« on: September 29, 2012, 04:50:56 PM »
No, I do not think dermarolling can help release the pull because the pull is more due to dropped muscle, not skin. I believe there were some
successful fixes with Botox which releases and lifts the corner of the mouth.

Dermarolling / Microneedling / Re: 1.5mm one liner roller
« on: September 29, 2012, 04:30:57 PM »
It is not completely uncommon having skin color changes that last weeks after the microneedling session, especially if the session was intensive, such as the one liner and especially if you roll darker types of skin.  It will go away.

If the stretch marks are still red, it means the skin is still "being worked on". That is not a bad sign. There is no permanent damage.

Give your skin a rest and postpone your next rolling.

Dermarolling / Microneedling / Re: Can Tretinoin cause skin thinning?
« on: September 29, 2012, 04:12:11 PM »
The skin consists of the epidermis and the dermis. The epidermis is composed of five main layers. The dermis consists of two layers.

Tretinoin thins the outermost layer of the epidermis but thickens other layers of the epidermis and thus it thickens the total overall thickness of the epidermis and triggers collagen in the dermis (see the studies below). Of course there is a possibility there can be exceptions to this rule, but they would be very rare.

Tretinoin decreases melanin content. It means, it improves spots and hyperpigmentation but it also means it makes skin less protected from the UV radiation (melanin is skin`s natural UV filter). The darker the skin, the more naturally protected it is. So, you have to apply a sunscreen or use Tretinoin during the winter.

Tretinoin also speeds up the turnover of the skin and thus often improves acne prone skin. Initially, it sometimes make acne worse. You have to persist.

The more is not the better with Tretinoin Do not apply too much. Applying every second day is sufficient, even though daily application.

Initially, Tretinoin makes skin dry.  Wrinkles and lines are more visible on dry skin and that is why it may seem in some cases that Tretinoin worsened wrinkles but it did not. 

I do not really recommend using Tretinoin on the sensitive skin around the eyes. Our Infadolan ointment that contains Retinyl acetate is more suitable in this area.

Tretinoin has the most dramatic effect on severely sun damaged skin, pigmentations and acne, to certain extent on wrinkles and loss of elasticity.

If you are young, acne free with no pigmentations or post acne spots, there is no reason to apply Tretinoin.

Topical retinoic acid for treatment of solar damage

Twenty patients with chronic solar damage of the skin were entered in a double-blind, withinpatient trial to compare the effect of 0.05% tretinoin cream with a placebo applied once daily for 12 weeks. Sixteen completed the study. Clinical assessment of the individual signs of solar damage were recorded on separate visual analogue scales. After 12 weeks, there were significant improvements in fine wrinkling around the eyes, crease lines around the mouth and cheeks, wrinkling on the dorsum of the hands and yellow discoloration. Overall, 14 of the tretinoin treated sides were judged to have improved compared to only two of the placebo-treated sides (P=0.011). Measurement of skin thickness by pulsed A-scan ultrasound revealed that the sides treated with tretinoin were significantly thicker than the placebo-treated sides(P=0.019). Skin biopsies taken before and after treatment showed an increase in mean epidermal thickness with tretinoin treatment (P=0.019). The clinical signs of improvement persisted at the follow-up assessment performed 4 weeks after cessation of therapy.

Sustained improvement with prolonged topical tretinoin (retinoic acid) for photoaged skin
Charles N. Ellis MD , Jonathan S. Weiss MD , Ted A. Hamilton MS , John T. Headington MD, Alvin S. Zelickson,MD , John J. Voorhees MD

We performed a 22-month trial of topical tretinoin (retinoic acid) in the treatment of pho-toaging. Thirty patients participated in a 4-month, randomized, blinded, vehicle-controlled study that has been reported previously; 21 patients continued tretinoin therapy on an open-label basis, participating in the study for a total of 10 months, and 16 patients continued for 22 months. During the open-label study, the statistically significant improvement that had occurred in fine and coarse wrinkling and skin texture during our original study was sustained, despite reductions in dose or frequency of application of tretinoin. The number of discrete lentigines decreased by 71% compared with the number before therapy. Histologic findings included a statistically significant thickening of the epidermis. Side effects were limited to a cutaneous retinoid reaction that diminished as therapy proceeded.

Sarah`s comment: In the study below, Tazaroten (also a potent retinoid, like Tretinoin) was used to ameliorate (lessen) skin thinning caused by Corticosteroids.

A pilot study to determine the effect of tazarotene gel 0.1% on steroid-induced epidermal atrophy:

1.   Kays Kaidbey MD,
2.   Scott C. Kopper BS,
3.   John Sefton PhD,
4.   John R. Gibson MD

Results:  The mean epidermal thickness was increased by 20% (NS) and 62% (P ≤ 0.0005) after applications of tazarotene vehicle and tazarotene gel 0.1%, respectively. Application of diflorasone diacetate reduced the mean epidermal thickness by 43% (P ≤ 0.0005). Concomitant application of tazarotene gel 0.1% with diflorasone diacetate did not entirely prevent atrophy, but was shown to ameliorate 37% of the epidermal atrophy induced by diflorasone diacetate alone (P ≤ 0.003 compared with steroid monotherapy).
Conclusions  Tazarotene gel 0.1% significantly reduces epidermal atrophy induced by diflorasone diacetate 0.05% ointment.

Treatment of photodamage with topical tretinoin: an overview
Gilchrest BA
Department of Dermatology, Boston University School of Medicine, MA 02118, USA.
Journal of the American Academy of Dermatology [1997, 36(3 Pt 2):S27-36]

Topical administration of tretinoin has proved to be effective in treating clinical signs of photodamaged skin. In large-scale, double-blind, placebo-controlled, 6-month trials, 0.05% tretinoin emollient cream (Renova, Retinova) reduced fine wrinkles and skin roughness, and it produced histologic changes such as epidermal thickening, increased granular layer thickness, stratum comeum compaction, and decreased melanin content. Smaller changes were also observed at lower tretinoin concentrations. Continued for another 6 months, 0.05% tretinoin emollient cream produced some additional clinical improvement but the histologic changes observed in the epidermis (with the exception of melanin content) regressed toward baseline, raising questions as to what was responsible for the clinical improvement. After 12 months of treatment, there were additional signs of tissue normalization including deposition of new collagen in the papillary dermis and ultrastructural evidence of dermal reconstruction with improvement in the dermoepidermal junction and correction of keratinocyte degeneration, changes that presumably relate directly to tretinoin's mechanism of action. There was no suggestion of cytologic atypia in these studies or in biopsy specimens obtained after up to 4 years of continued use. Mild to moderate dermatitis was the only common adverse reaction to tretinoin use. Percutaneous tretinoin absorption is low, raising plasma levels by amounts that are negligible compared with the normally low endogenous tretinoin levels. No teratogenic effects have been observed in retrospective studies of topical tretinoin application during the first trimester of pregnancy. Thus, topical tretinoin is safe and effective in the treatment of photodamage.

Sarah`s comment: In spite that the above study states that Tretinoin is safe in pregnancy, you should not apply it right after dermarolling/needling /stamping when pregnant, lactating or planning a pregnancy. All these microneedling tools greatly enhance its absorption. The risks are still minimal, but better safe than sorry.

Dermarolling / Microneedling / Re: What to do about lines on my face?!
« on: September 29, 2012, 09:33:57 AM »
First of all, congratulations with your weight loss. Losing weight is difficult but keeping the lost weight off is even harder. Not many people
manage. The only downside of losing weight is that the fat makes the skin beautifully plumped up and wrinkles are almost invisible. Basically, you either have to sacrifice your face or your butt. Meaning, if you want to have a naturally wrinkle-free face, you basically have to be at least
moderately obese (= huge butt).  As soon as your butt shrinks, say goodbye to the plumpness of the face. It's not fair, is it?

I am a bit confused about the lines on your face because from the photos (the photos may be misleading) the lines almost look like stretch marks. Do the lines on your cheeks differ anyhow from the wrinkles around your eyes (you do not have many)?

Also, on the photos, there seems to be something right above your lips. Or is it just an artefact of the illumination?

If the steroid injections caused the fat below the skin to recede (steroids can cause changes in the shape or location of body fat), then dermarolling will not help. Dermarolling cannot trigger new fat under the skin. Dermarolling can thicken the skin but it cannot affect the structures below the skin.

Yes, use a 1.5 mm dermastamp on your scars (or a 2 mm if the scars are really deep). A dermastamp is really easy to use. Stubborn scars often need a more targeted and intensive treatment (such as single needling or dermastamping).

If there is no improvement of the scars after many months of rolling and stamping, adding the suction method is always a good idea because the scars may be tethered:

Dermarolling / Microneedling / Re: Microneedling of raised scars
« on: September 28, 2012, 02:54:11 PM »
Prior to stamping, try to clear your skin of acne (or at least partially) with our 0.5% Tretinoin cream. Initially, Tretinoin may make acne worse
before it gets better. Apply it every second day for several weeks. It will make the skin red and maybe peeling.

I was afraid you have a tendency for getting scars because normally, acne should not result in such raised scars. That is why you have to be very careful with rolling/stamping and you must do a test on a small area of your skin to see how it reacts.

Do you get scars easily also elsewhere?

First, try the dermastmp somewhere on your body (for example on a thigh) to see if it heals OK. Then try it somewhere on your face. Then stamp one of the scars just once and observe, whether it heals OK.  Gradually add more stampings into the scars, when the previous session went OK.

Immediately after stamping, perform the pressure massage (explained in the link I have posted here) and apply Tretinoin cream (it will likely sting).

When you stamp the scars, pull the skin upwards (away from your neck), it will make it much easier to stamp.

Buy a 1 mm dermastamp.

Concerning the allergy, you have to try. The contact with the skin is very short with stamping. Allergies are more of a problem with long term contact, such as wearing a ring, watches, earrings etc.

There is some nickel (the most common allergen) in stainless steel but it is tightly bonded so it doesn't get loose as it does in some golden jewelry.

Your question number 4 is answered here:

I am sorry it is not working out for you.

Acne scars are a difficult problem and often, various approaches are needed. It is always a good idea to add a more targeted tool to individual acne scars – such as a single needle or a dermastamp. Some of our customers combined dermarolling/needling with saline injections (the method is described on our forum).

There may be another reason why you had no success. You say you have "typical boxcar rolling type scars".  The rolling type of acne scars are often tethered to the underlying tissue by strong fibers. The fibers hold the scar down and keep it indented. Improvement can be achieved by releasing the fibers. We started to sell suction cups for it and there is a thread about it:

Until our single needle becomes available, you may want to try a dermastamp.

The reason you hear much more often that a person has problems with a treatment instead of success is that support forums inherent nature is to provide help when things don't go as hoped. Someone who achieves results usually does not bother to sign up to a forum just to say that they are happy now. This is unfortunately the way it works, and I have seen many examples of that over the years - it is the norm rather than the exception. People usually only speak up when they need something, not to "give" something. I get many positive emails every day, also how dermarolling greatly improved acne scars:

 I really am overwhelmed with questions so please excuse my sometimes being tardy in my reply or short of substance.) I've asked him to post on our forum to share the details and he promised he would do so, but just as with many others, the effort appears to be too much. If anyone wants to verify that Andy really exists, email me and I will ask him if he agrees that I give his email address to you.

This forum still contains positive feedback in regard to acne scars however:!/!-my-first-trial-attempt/

The phenomenon of not-telling-about-success is universal. It exists to an even greater extent for another product of ours, Lufenuron. We had to close the Candida forum due to too many people complaining "it doesn't work" (also for keeping to ask questions that were addressed already) but none of these people ever tested positive on any real Candida test. We hardly ever received positive feedback either. But we know that it is a very effective product for most customers, because firstly, we don't advertise - it's all word of mouth - and we sell more every year. Secondly and most importantly, we had two times that we were sold out for months due to FDA reasons and supply problems. We got inundated with emails by people saying: "Lufenuron saved my life, can you tell me where to get more just in case" and "Lufenuron is the only thing that keeps me going, when will you have more?". People even ressorted to buying Novartis' Lufenuron product for animals, paying many times more, just because it was worth it to them. That's just the way it is, people basically expect that when they pay for something that should work, that it indeed works and when it does not, they sign up to a forum and say: "It doesn't work".  When it does work, they consider that no more than normal and are not going to bother shouting it from the rooftops online. Not many are documenting their progress with pictures over a long period - let alone publish them on the Internet.

Just as with our product Lufenuron, we do not advertize our dermaneedling products. We don't need to - satisfied customers tell others about their successes in more informal ways. If dermaneedling was ineffective, we would not see such explosive growth and mainstream media exposure of the phenomenon. But as I said, acne scars are hard to treat and success depends on using the best techniques that suit the particular type of scar. Would you mind posting a photo of the affected skin? (well-lighted, high-resolution and in perfect focus, this is best done by someone else photographing your face. Use lighting from the side to bring out shadows to highlight the scars.)

Dermarolling / Microneedling / Re: Microneedling of raised scars
« on: September 26, 2012, 05:24:34 PM »
Could you tell me how did you got those scars?

For the time being, read the below link and I will add to it after you have answered me:

Dermarolling / Microneedling / Re: 1.5mm one liner roller
« on: September 25, 2012, 05:26:40 PM »
Please email me so we can refund you for that roller. Our home-brand occasionally has that problem but when someone gets a bad roller like that, we always send a replacement or refund.

You can use the roller and the stamp during the same session or you can stamp the bumps later. The same with stretch marks.

OK, then buy just a 1.5 mm dermastamp and "crush" the bumps with it. Roll the whole area with your 1.5 mm roller every three weeks.

If you have uneven skin tone – post acne redness and spots or an overall uneven skin texture, a 0.5 mm regular roller is very useful. If you have just the bumps, you may not even need it.

Yes, the 0.1 % Tretinoin is also OK.

The skin must be dry before applying Tretinoin.  You do not have to wait half an hour to apply the moisturizer.

Dermarolling / Microneedling / Re: 1.5mm one liner roller
« on: September 24, 2012, 11:06:37 AM »
A one liner is much easier to use on long scars or stretch marks than on short ones. The scratches will certainly disappear and honestly, any type of very mild skin damage, be it pricks from dermarolling or even for example scratches, will trigger skin remodeling. The stretch marks will remodel into their previous state or they will remodel into a better state (in fortunate individuals) and become less visible. Scratches are too superficial to make any difference in stretch marks but they will certainly not make them worse or anything.

Using the one liner on your abdomen will be likely easier. If you have many stretch marks, having various dermarolling tools is certainly advisable. You can add a 1.5 m dermastamp (preferably the small one) and target individual stretch marks on the breasts or elsewhere.

In stretch marks, the best combination is a regular 1.5 mm dermaroller (or a regular 2 mm dermaroller) and either the single needles or a 1.5 mm or 2 mm dermastamp or a 1.5 or a 2 mm one liner roller. Tretinoin cream is also useful for stretch marks:

To Purple Butterfly:

Needling with a single needle is very effective for stretch marks but the skin on the upper arm is unfortunately too thin for this treatment and
needling often causes bruising here. Bruising is harmless but unsightly. You would do better in using a 1 mm dermastamp on the stretchmarks on the upper arm.

Dermarolling / Microneedling / Re: How deep should I go and how do I know?
« on: September 24, 2012, 11:03:25 AM »
You can roll and stamp the scars during one session but always add stamping or single needling to your dermarolling sessions for scars because it is more targeted and intensive and it crushes the hardened collagen bundles of surgical and other scars.

Dermarolling the whole area will slightly improve skin sagging so both rolling and stamping/needling are useful.

I recommend the same combination (a 1.5 mm roller and a 1.5 mm dermastamp) for your skin puckering. Dermarolling cannot completely reverse skin sagging (surgical skin lift is often necessary in these cases) but it can improve it.

The lesions are centered around the hair follicles and there is a loss of elastic fibers. The lesions will eventually disappear by themselves but it can take years. You can speed it up by rolling the whole area up to three times a week with a 0.5 mm regular dermaroller and by stamping the individual lesions with a 1.5 mm dermastamp - apply a 0.5 % Tretinoin cream (we sell it) right after stamping. On top of the Tretinon, apply a moisturizer. You do not have to stamp all the lesions in one session if you have very many. Divide your area into several parts and stamp one or two parts per session. It will take some time for the bumps to disappear and it may even look temporarily worse because stamping and Tretinoin will make it red for a while. It will subside.