Red spot won't go away after microneedling w/ PRP. Is it scarring/hyperpigmentation/blood vessel? What can I do?

Question

I had microneedling at plastic surgeon who did my subcision (her assistant did the microneedling). On 2nd treatment, I bled a lot. Now I have a red spot on my cheek that won't fade. It's 4mm at its widest. No bump or hardness underneath, and nothing about it has changed in 40 days. Looks like acne hyperpigmentation (I had a lot of hyperpigmentation after 2nd treatment, but most has been fading except for this spot). Been using 2% hydroquinone and it's done nothing.

Michelle Cabret, MD, DDS · Answer

It is normal for the skin to be pink or even red like a sunburn after treatment, but this all depends on how aggressively the treatment was performed, i.e. how deep the needles are penetrating the skin in different areas of the face, how many times the skin is passed over, etc. Usually this redness fades after 12-24 hours. If you have sensitive skin, rosacea, underlying redness, or if the treatment was overly aggressive more stubborn areas of red can appear. These should fade, but at this time frame it could be appropriate to try IPL to treat underlying pigments/vessels. If you have any concerns, speak to your doctor.

Davin Lim, MBBS, FACD - Account Suspended · Answer

OK, you can wait 3 months and use sunscreen, or see your plastics or dermatologist for a close examination under magnification. Now, if its RED, the use of a vascular laser can help. 1-2 sessions can fade this within 2 weeks. BBL or IPL in the CORRECT settings can also assist. Above all use SPF - sunscreen between now, and 3 months. Microneedling has come a long way over the past few years and can help skin via several methods. Firstly it releases cytokines and growth factors in the epidermis and dermis- the top and bottom layers of your skin. This in turn remodels scars and the dermal layer of the skin. Additionally needles can break up scars themselves. This leads to new collagen formation, and in practice can provide limited skin rejuvenation.

Microneedling is both user dependent and method driven. Simple needles can be used, growth factors can be added after the procedure, including PRP, or controlled heating during the procedure. This controlled heating is delivered via RF, and is called RF microneedling. RF can then be delivered via insulated or insulated needles. Even the energy level, depths, density, pulse duration and so many other variables can be controlled. This together with the added benefits of growth factor infusion makes this one of the most complex procedures in procedural dermatology. I use everything from Dermapen, though to newer generation insulated and non-insulated devices including INFINI micro-needling radiofrequency, Intensif and others. Newer generation devices can provide an added advantage in some, but not all patients. In my practice, I combine microneedling with many different forms of energy devices, depending on the expectations of the patient. Tailored microneedling combination will always give the best results.

Like most procedures, its 80% skill level of the specialist and 20% dependent on the brand of the energy device- microneedling system. All the best, Dr Davin Lim. Brisbane. Australia. Realself Advisory Board Member

Red spot won't go away after microneedling w/ PRP. Is it scarring/hyperpigmentation/blood vessel? What can I do?

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Red spot won't go away after microneedling w/ PRP. Is it scarring/hyperpigmentation/blood vessel? What can I do?

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Everything you need to know about Microneedling

Our mission is to create a world where every investment in modern beauty is Worth It.