Hello! Great questions and thank you for your inquiry! I think sadly that there have not been that many microneedling studies and unfortunatlely to date, no randomized clinical controlled trials. We typically say microneedling is to be reserved for patients that do not have sensitive skin--a lot of times, sensitive skin means they have increased inflammatory markers like Cathelicidin. This is increased in patients with rosacea as well. I also think that microneedling should be used with caution in patients with darker complexion because their is an increased risk for post inflammatory hyperpigmentation. Needless to say, do your research when you go to a practitioner--go to somebody who does these procedures often and will spend the time to go over what to expect before, during, and after the procedure. I hope this helps!
Hi! Good for you for making the first step! Acne that happens in our 30s and 40s can be very stubborn! Accutane, or isotretinoin can really, really help with more treatment-resistant deeper cysts. The photographs you've taken really help with seeing that you still have some deep cysts as well as lots of hyperpigmentation too. You're right isotretinoin does not help with hyperpigmentation, but it does give you a "cure" in terms of stopping cyst formation...which will lead to more hyperpigmentation. I often work alongside with my patients and their psychiatrists. 99% of patients don't ever notice a change in their depression or anxiety while going through the 6 month course of isotretinoin. There are other options too but perhaps you've already exhausted them--sometimes taking out your IUD and switching to a combination pill can help too!
Hi! First of all, congratulations! I think you will really enjoy your new lips. From my experience, there is always a lot of swelling in first week. Usually when there is an obvious asymmetry that you can feel or see that is usually from bruising and swelling. I usually reassess patients at 2 weeks for touch ups because by then the swelling has gone down (although the product my still be palpable!) and I can make sure my patients are completely satisfied!
Hi Alicia, Thanks for your question. Isotretinoin, or accutane is a fantastic treatment to "Cure" acne including hormonal acne. It prevents further scarring but it wont help with the scarring that you already have. That being said there is so much that your board-certified Dermatologist can do for acne scarring. I agree that birth control is not a permanent solution, so it makes sense for you to go through the 6 month treatment with isotretinoin. Good luck and hope you experience the clearest skin!
Hi! Topical tretinoin is negligible when looking at systemic absorption, so you do not need to worry about growth being stunted. I hope you love your treatment! Good luck! If at any point you're not satisfied with your treatment, be sure to see a board certified Dermatologist--there is a lot we can do to prevent scarring, blackheads and whiteheads!
