Experiencing PIH after Dermapen for many months. What should I do?

Dear Deli,Thank you for the inquiry.Not all hyperpigmentation is equal.So, although microneedling can be helpful with hyperpigmentation in many cases, it is not helpful for you.See a specialist to evaluate your skin and discuss alternatives.Wear spf 30 daily to protect from worsening hyperpigmentation.Best. Dr Brecht Seattle, Wa

The very first step is to determine the LEVEL of pigmentation. If it is dermal, there are other methods to resolve deep pigmentation. Modulators such as T.acid po. maybe viable. Additionally lasers such as pico or nano may offer faster resolution. Woods light 365 nm can assist specialist in the diagnosis of dermal vs epidermal pigment. 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