Could microneedling correct linear indentations on my forehead? (Photo)

Question

I have a series of linear indentations on my forehead that appeared 4-6 months post laser resurfacing. I have been told by some that it is vascular. Others have said it is volume loss due to too much energy being used on those passes. Almost everyone just wants to use more lasers, and I’m unsure. They are not very deep. Are not visible from the front but can be seen from the sides and from the top like attached image. Is this something microneedling could fully correct?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I'm really sorry that this has happened to you. I have been cautioning my regular followers for years to be cautious when evaluating the heavy marketing hype and social media buzz that surrounds the expensive "bells and whistles" gizmos, like fraxel lasers and RF devices. The hard science to support the use of these unfortunately continues to lag well behind the media hawking. Sorry. Professionally performed manual microneedling (no need for the added expense and risks of RF microneedling) has a long track record of safety and efficacy (I personally have been performing it for nearly 25 years) for treating all kinds of superficial, surface color and textural irregularities. Ideally, scars treated between one and twelve weeks following their formation respond the best and most optimally. This is certainly beyond that time frame, but it would seem reasonable that the sooner proper treatment is performed, the better. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Microneedling is a dermatological procedure that can help with issues like scars, wrinkles, and uneven skin tone. It works by creating tiny punctures in the skin, which triggers your body to produce more collagen and elastin to heal the wounds, ultimately rejuvenating your skin.
However, whether microneedling can correct the linear indentations on your forehead depends on several factors, including their depth and cause. If the indentations are due to volume loss, treatments that restore volume, such as dermal fillers, might be more effective. If they're due to vascular issues, other treatments may be required.
Remember, it's essential to consult with a professional dermatologist or a cosmetic surgeon who can examine your skin and provide a more accurate assessment. They can offer you the best treatment options based on your skin type, the nature of the indentations, and your overall health.

Randal Haworth, MD, FACS · Answer

Based on your photo, I would recommend filler to correct the indentations. It would be the best course of action.

Best of luck !

J. Renee Booth, MD · Answer

Microneedling is unlikely to help in this situation. The first step I would recommend is platelet rich plasma (which has growth factors) or nanofat (which has stem cells and requires harvesting fat). Off label use of exosomes is another option that can be considered. These treatments help the tissue heal itself. Filler was mentioned in another response. It could help some, but the tissue formed during the healing period will affect the behavior of the filler since it will likely resist stretching. Also, filler dissolves in about 1 year possibly sooner if intense exercise is a part of the patient's regimen.
If PRP, nanofat, or exosomes do not achieve the desired improvement, either dermabrasion or a laser provider who has treated many acne scar patients would be the next step. For acne scars, a combination of profractional, contour TRL, profractional XC, and/or microlaser peel are often used. In general, laser is very precise and removes an even layer of skin. Spot laser treatments are often used when the skin texture is uneven.

Could microneedling correct linear indentations on my forehead? (Photo)

Answers (5)

Answer: Indentations

Answer: Indentations

Answer: Indentations

Answer: Indentations

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Could microneedling correct linear indentations on my forehead? (Photo)

Answers (5)

Answer: Indentations

Answer: Indentations

Answer: Indentations

Answer: Indentations

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Everything you need to know about Microneedling

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