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grandor

RF microneedling grid marks

About a month ago, I did RF microneedling, and have generally had good results. However, I do notice some faint grid or track marks from the microneedles. If you look closely, you can see the grid where the needles went in, and there are pinpoint shallow scars (not hypertrophic raised papule scars). They are not huge, but you can tell they are like small icepick scars or pores in a patterned grid formation

I'm wonder if these resolve over time? And is there any way to improve healing to avoid this, or get this to heal faster after future treatments? Thank you

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Yes they will. You are most likely a slow healer. You can try to get some retin a, tretinorin, or Differin OTC at Target. Apply nightly. The body after Infini takes 6 months to stimulate collagen. Please be aware whatever the DR Told you is bullshit with no down time. Laser has down time as well. Some just take longer than others. Those grids will heal and make new skin with time, if you can heal normally doing other procedures. 

Turn down the settings of the Infini Level 4 is fine. Make sure the needles are insulated by asking. If you have ethnic skin, pre treat with hydroquinone or albutin bleaching creams and retin a 3 weeks before. You can tca peel after your microneedling but I would wait for 3 months after. 

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Thanks for the quick reply BA, your presence is much appreciated here :)

Re: settings, the device was Intracel at Level 5, and my guess is that the .8 mm pass was too shallow for the bonier parts of the face. As such, the energy may have hit the epidermis and created the grid marks. Glad to know they will fade though.

Should I continue to expect improvement over the 6 month timespan? Also by tca peel, do you mean cross? or just regular low % peel on the affected area?

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Collagen can be stimulated up to six months after treatment, so hopefully the scar will looks better. Have you been on Accutane before? That can impact your healing abilities, especially if you have been on it recently. 

You said you had good results with your treatment? How much % improvement did you see? You can use something like dermablend to cover your track marks. 

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Never done accutane, my acne was not severe enough (imo) to warrant the risks of the drug. Although, I was on retin-a for several years, and I think that really damaged / thinned my skin, and feel like it may have ruined my healing at the time. I have been off for over 3 years now though, so it shouldn't be affecting my healing at this point.

Tough to say %... maybe 10% or 15% tops. The reason I think it has given good results, is that it has improved the overall texture of the skin, especially with the shallow rolling scars. The icepicks and boxscars haven't changed much, but now it seems like all scars are returning to the same "plane" so to speak. I think more treatments will help, but I am discouraged by these grid marks - if not for this, I would be overwhelmingly ready to continue.

 

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Mainly due to the purging effects -- I had never had cystic acne prior to going on tretinoin, but it made me breakout like nothing else, scarring my skin more drastically than my normal acne had before. I also felt that I was more predisposed to scarring on it, hence the feeling of "thinned" skin. But you may have a point -- I have ethnic skin and did not use sunscreen regularly unless I knew I was going to be exposed in the sun for an activity or something. 

Anyway, that's all in the past -- now I have to figure out if I should continue RF microneedling procedures, or if it has side effects (eg. track marks) that are not worth it. Would love to hear other folks perspective on any negative effects from RF microneedling, especially for folks who have had it months or years ago, and seen long-term effects

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"Intracel at Level 5, and my guess is that the .8 mm pass was too shallow for the bonier parts of the face. As such, the energy may have hit the epidermis and created the grid marks."

There are not side effects, you have a incompetent operator, this is how you have issues, they must know hot  to use the device. Why would one goto level 5 at that low depth, ....Sure if you turn up the power and go deep you can get fat loss or low depth with high power, this is incompetence. This treatment needs someone skilled at how to use the device, as anything can hurt you if done improperly. Regarding grid marks. I have gotten them before and they really are not a big deal, ... they go away with time. This treatment takes 6 months to heal from just like laser. Your low down time is just that, minimal down time. IF you need the marks gone sooner you can do a peel 3 months after, yes TCA regular peel. You seem to heal poorly though, since I see your above experience with Retin A / Tretinorin. This may be also a reason for slow healing, it's not a standard response.   

This treatment Intracel for you takes 3 total treatments, ... it gets worse before better. You will see no magical results. Again 6 months after each treatment. It stimulates collagen. If you cannot heal properly it may not be as effective, time will tell.




 

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On 2/28/2018 at 1:22 PM, grandor said:

...but I am discouraged by these grid marks - if not for this, I would be overwhelmingly ready to continue.


From my own experience, grid marks can last up to 3 months on certain areas of the face. But they do fade with time, so no worries. If you can't take the heat, I suggest you buy yourself a BB cream from Amazon. These are tinted moisturizer that helps cover the blemish.

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Thank you guys for the advice. I will hang tight for a couple months and see if the marks fade! As a follow up question, who are the best doctors for RF microneedling on the west coast? 

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Agree with BA and @Sirius Lee regarding treatments and all. Few other points -
1. With insulation timing is everything. If one delivers the pulse in timing at deeper depths all good. But if the Specialist pulses as the needle is coming out or entering skin, collateral epidermal damage occurs.
2. All the aspects covered regarding the 3 months or even longer of grinding, and topical methods to reduce PIH. Time and sun protection is your friend. 
3. Another excellent method is with the 1927 wavelength ( C and B or Fraxel), pre treat with HQ, post treat with HQ but at say 5 mj max with C and B or say 15 mj 1927, the amount of passes (more than 10) can also speed up recovery and add to collagen production, decreasing pore sizing. If in no hurry, just wait it out. 
4. BA is correct, with any microneedling RF there has to be multiple adjustments throughout the entire procedure. Example - forehead area, one only has 1 mm to work with so anyone competent would turn the energy right down (10-20% of max power), slow down the interval rate (so less mistake), decrease PD or pulse duration, hence less total energy and go vvvvvv superficial 0.25- 0.75/ 0.8 maximum in this area. Energy based microneedling is very complex, as combinations are infinite. Spring and solenoid rates and device limitations, loss of insulation, skin type and many many variables need to be taken into consideration, including facial anatomy and even amount of facial fat. Belittled by many specialist, RF microneedling is more complex than 99% of lasers. I stand by that comment as a laser technician. 

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@Obi wan thanks for the detailed advice.  I think I'm happy to wait it out, as I'm not in enough of a hurry to have another procedure to fade the grid marks.

Re point 4 - how does one go about finding a qualified specialist / doctor wrt RF microneedling? Afaik, it's a fairly new treatment (at least in the USA), and only now is it gaining mainstream adoption. Specifically in west coast USA, is there a consensus recommended doctor? (Similar to Dr. Weiner in Florida or Lim in AUS)

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Wanted to report back with my progress 3 months in -

Grid marks have faded a good amount, and noone else would be able to notice them, even 1 foot away from my face. But I can still see there is some textural difference if I really scrutinize my face - safe to say, it doesn't bother me very much anymore.

There is still some irritation on my skin, where it feels like burned skin trying to recover. This includes hyperpigmentation still remaining and some general irritation in the form of red inflamed skin (not acne) under the eyes where the skin is thin. My skin never reacted like this pre RF-microneedling, so I'm guessing this is still the lingerning effects post treatment.

Overall, I notice some improvement 5-10%, and certain scars are softened or a bit more plumped up. Did nothing for the ice picks though. I don't regret doing it, but don't really think it was worth the expense, given the long healing process. Will report back again in 6 months to document the healing.

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Could you please update about your grid marks? How are they now? Thanks so much

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@Ctk This is a old post. Grids are very common as ethnic patients often have longer time to recuperate, sometimes a few weeks to a few months. The biggest issue with this complaint is the following. The Dr lies (sooooo common) and says this is a no down time procedure where you will only have a day of down time. The truth is any treatment has healing time unless it's worthless and does nothing. The types who have perfect skin go on sites like Real Self to complain after doing this procedure. They were told no down time and not they have to heal for several weeks. Rail road tracks are simply the body healing, just like would happen after laser. Now it also can be a very poor operator who choose to raise the needles during the procedure and messed up the skin or put the thing on blast at top energy settings and caused the energy to creep up, creating longer healing times. New settings are much lower actually given to the Dr's who use the machine because of the things they learned during the initial years of treatment. IF you heal poorly or are overly sensitive then you could take longer to heal or have side effects. Please consult with a expert Dr who has done thousands of these procedures and can evaluate your skin before using such device. There are some nurses who have more experince than the Drs on the unit, ask lots of questions.  

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Hi...what about if my red pinpoint dots from neddles Secret RF since 16 Juny 2017?i still have them.The plastic surgeon was told me"isn't a big deal,just do some make up"...I went to my dermatologist and i did 2 fraxel and 2 times with vvein laser but nothing.Still i healling 20 months now?sorry if i have errors in my message

Hi...what about if my red pinpoint dots from neddles Secret RF since 16 Juny 2017?i still have them.The plastic surgeon was told me"isn't a big deal,just do some make up"...I went to my dermatologist and i did 2 fraxel and 2 times with vvein laser but nothing.Still i healling 20 months now?sorry if i have errors in my message

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@sofaki90greece This is a common condition for those with sensitive, thin skin, or poor operator of the rf needling making the energy engage before it's in the skin. By two years it could be hyperpigmentation. But I have seen some patients with just wounding this long. The doctor does not sound experienced in treating you. 

Some suggestions:

1) Find a better aesthetics Dr, I hear that is hard in Greece

2) Press on them if they go away even for a microsecond and turn white they are wounding or PIE, if they still stay there they are PIH or hyperpigmentation

3) Buy a cream with silicone in it this is shown to work on wounds and new scars

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___________
Disclaimer: Information and support is not meant to diagnosis, treatment, or cure any health or mental condition and is not a substitute for professional face to face medical care  (consult with a few Dr's and pick your favorite one). Posts are for informational purposes only, please consult your personal health care practitioner before engaging in anything discussed. 

Edited by Vincci
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@beautifulambition i will try again to ask you because i so comfused and i see that you helped so many people.i will post photos too to see what exacly i mean but my phone camera isn't toongood to catch them.

My question is:

Who can fix them if in Greece is hard to find spesialist Dr ?

This is from December 2018

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20190122_111817.jpg

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Hi, I’m not sure about lasers in Greece but I did have filler for my acne scars there with a plastic surgeon who seemed to do the job. I’m not sure if he now does subcision as this was a few years ago but I can send you his details when I’m home...

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Between my eyerbrows are blisters.My dermatologist tryied only here an diode laser to fix the color but nothing,because the vein laser dodn't help either..But if you look too close these blisters gave me scars too.

I will go in two days to plastic surgeon who dod the secret rf the summer of  2017 and i will ask for the details that you wrote me.But i don't think that he hold my settings.I wish to be wrong.

Never changed doctor...i have olny my detmatologist since 21 while i was in  cystic acne for 1 year.Never trust someone else to touch my face and yep i did it once.i went to plastic surgeon and now more scars.

 

The doctors from Greece are too in FAQ's.You mean to be contact with the woman?

And you wrote that i need 8  sessions of subcision.You mean in my atrophy scars in cheeks?or in the forehead?i thought i had only rolling scars.

And who are you?Do you have an office?so manny thanks that you answer me 

 

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@sofaki90greece

I am not denying that you have scars, ... if anything I am trying to help you now with the aftereffects. I can only go by the partial picture of the data points I am given, and there is always more I don't know or perhaps can't get the full view in one picture (eg. eyebrows).

Ok they are blisters? How long have you had these "blisters" it sounded like you have had them for a very long time. Hence hypertrophic scarring. I don't know when he tried the diode laser. 

It really sounds like a mess, ... Lots of terrible Dr's out there. I am told in Greece this is common by several patients and the standard are not as strict to do these procedures or just be a general clinic who does these things. The Greek patients I know end up traveling to other Drs in Northern Europe for treatment sometimes. 

Your going to need several treatments. There is a lot of scarring and damage that has been done. I believe I have two female Dr's in Greece. One is trained by Dr Chu actually to do manual methods of scar revision and she works in the UK/Greece. https://www.xo.gr/profile/profile-911203240/en/ (For some reason my update did not take on her contact). I would consult her and the other female Dr and see what you think. 

 

I am not your Dr or responsible for your care, please see a Board certified practitioner closer to you. You can find out who I am by my track record helping thousands with acne scars as a subject matter expert. Everything else is private as we do not advertise, or allow Dr's here. 

 

 

 

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First of all i want to ask sorry because i can't write right as good as i can read and uderstand english.

Yes there were blisters.These blisters gave me scars too.The dermatolist gave me the blisters.The aftercare about blisters was the fusicort cream and then cicaplast from la roche poshay. I had the blisters one week.They caused by the diode laser for the red nedlles holes.In the same day that i had the nd lang laser for the red holes.(date:6 December of 2018)My dermatologist wanted to see if can improve the color  of those holes  that secret rf(the secret was from plastic) gave me.

The plastic doesn't touch my face since secret rf.I went only two times to him.For procedure of secret rf and then after 5 months because he said to me i will be fine,i did not need him for something else.And i went after 5 months becuase i saw the red holes in a mirror with white light and i said:whatttt are these?

Now i feel hope that i found this site.Before i was lost and i said i'm quit.Becausei did not where to look for help. Special thanks to you @beautifulambition really.

It a mess i aggree with you.

Hope to understand my english.

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@sofaki90greece Your doing fine. Better than I can speak Greek ;-)

Blisters sound like the settings were too high or administered incorrectly. You sound like you have very sensitive skin. The settings are high and they should do test spots. That is terrible, ... they do not do the laser the same day as the rf needling! That is placing to much energy or heat in the skin. This can cause scars. So he did make the rf needling to high, ... damaged, and then tried to use a laser afterward!

You don't worry about color on these things until a few months after, ... you may need to wear concealer or makeup while healing. Now if they went to high and caused burns, yes this is a permanent problem.

I would do the manual subcision and some filler, this will help (many sessions). Then worry about energy devices. Let them know your sensitive, the Dr's we spoke of above and what happened. 

 Your Welcome!

Take it slow.

Ba

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