Filiberto Cedeno Laurent, MD, PhD

Thank you for your question and for sending pictures. Removing skin tags and the pigmented papules that you have on the face has to be done meticulously and with devices that minimize inflammation so that pigmentary changes of the skin can be avoided. Skin tags around the neck, under the breasts and arms are often times easily removed by snip technique. However, the lesions on your face (dermatosis papulosa nigra) are better removed with either gentle hyfrecation or with lasers with wave lengths between 532 nm and 595 nm. Alternatively light curettage can be attempted. Consult a doctor with experience managing patients with skin of color. Regards

Thank you for the question and for providing a picture. It seems like you had a somewhat intense treatment in some areas. I would recommend discussing this with your provider as he/she might need to prescribe something to prevent post-inflammatory hyperpigmentation. Regards 

Collagen induction therapy with microneedling has proven to be safe and effective in all skin tones. Multiple sessions and adequate depth is necessary depending on how deep your lines are. Complementing this with Alma skin tightening can render good results. I would recommend also complementing it with a retinoid.

Hi, thank you for posting the picture along with the question. Using a microneedling pen allows you to control the depth of penetration. Blood vessels are non-existant in the epidermis so you typically have to go deeper (down to the dermis) on the cheeks in order to see pinpoint bleeding, which is our end point when performing microneedling. You can ask your provider to go deeper next time.