MEDICAL TATTOOS: Micro-needling, Scalp repigmentation, Nipple/areola tattoo, Scar Camouflage

HAIR FOLLICLE REPLICATION/ SCALP REPIGMENTATION

Hair Follicle Replication


Here at Fabulously Flawless Permanent Cosmetics we specialize in Hair Follicle Replication.   Our experts on staff are Certified Cosmetic and Licensed Medical professionals who strive to help our clients reach their goals. We are not a salon or healthcare facility that believes in shortcuts or impersonal treatments. We take our clients’ satisfaction very seriously and strive to provide the very best customer service possible.

The popular scalp micropigmentation technique which we refer to as Hair Follicle Replication for men and woman uses an advanced hair follicle technique that replicates the 3D effects of natural hair follicle. Advanced techniques, specifically-designed  needles, and specially-formulated hair color pigments are used to safely and naturally camouflage desired areas.

Hair Follicle Replication/Scalp micropigmentation is an amazing procedure and can be customized to create that natural hair look. Experience ” The Fabulously Flawless Experience” our clients are talking about! Fabulously Flawless will make sure they do what they can to give you the confidence and trust you need! Let’s make it happen!

IS YOUR HAIR AFFECTING YOUR CONFIDENCE?

  • Receding Hair Lines
  • Crown Hair Loss
  • Bald Spots
  • Thinning Hair
  • Total Baldness
  • Extension and Weave Damage
  • Stunted Hair Growth in spots
  • Head Scars/Transplant Scars
  • Burnt Scalp
  • And more!
NIPPLE / AREOLA REPIGMENTATION


Skin Repigmentation Of The Nipple / Areola
Skin Repigmentation of the Nipple / Areola Women who have reconstructive breast surgery and desire to have their areola repigmented or reconstructed.  Repigmentation to the areola or areola portion of a breast can be performed with a cosmetic permanent make-up procedure.  This service is often requested as part of a breast reconstruction after a mastectomy.  Areola colors are custom-blended and shadowing effects are used to create a natural look.  This procedure is also requested by women who prefer larger areolas after breast augmentation.  This service is typically one to two hours for unilateral and three to four hours for bilateral.
What is Areola Repigmentation?
Areola Repigmentation is a specialty area of medical tattooing that requires advanced education, training, and experience. These procedures help improve the appearance and self esteem of both women and men who have undergone breast surgery. Areola Repigmentation techniques can “create” an areola after breast reconstruction, minimize the appearance of scars, or restore an areola to a more natural looking color and shape. Areola Repigmentation may also be called Areola Tattooing, Areola Micropigmentation, Areola Pigmentation, Areola Recoloring, Areola Restoration, or Areola Simulation.
How Areola Repigmentation Helps People After Breast Surgery
The areola is part of the human breast in both women and men. It is a circular area of skin around the nipple that is often darker and thicker than the surrounding skin. The areola plays a key role in the aesthetic look of a breast. Since a woman’s self-image can depend on the appearance of her breasts, a missing areola can be psychologically devastating. A woman can survive breast cancer after undergoing a mastectomy, and she can regain her figure with a breast reconstruction. However, she may not feel “complete” without an areola. A woman can become emotionally distressed from a scarred areola as well. A man’s self-esteem can also be lowered by the appearance of his chest and breasts. Areola tattooing provides the “finishing touch” after breast surgery. Patients feel the tattooing process helps them during the last part of their recovery to look complete and feel “whole” and “normal” again.
What Causes Areola Scars?
Surgical procedures on the breast can create a scar if they require an incision at or around the edge of the areola. The scar that is left is called a peri-areolar scar. Some breast surgeries also create a vertical scar from the nipple through the lower portion of the breast that may need to be camouflaged. The following are breast surgical procedures that may create a scar: Breast Augmentation or Enlargement (Augmentation Mammoplasty); Breast Reduction (Reduction Mammoplasty); Breast Lift (Mastopexy); and Male Breast Reduction (Gynecomastia).
Post-Surgical Areola Tattooing Techniques
Areola-Nipple Complex Simulation: This procedure is for patients who have had breast reconstruction after a mastectomy or lumpectomy. Cosmetic tattooing techniques and color pigments are used to create the appearance of an areola. For a unilateral mastectomy patient, this process helps the reconstructed breast to match the natural breast. For patients with bilateral breast reconstruction, both areolas are recreated. Areola complex simulation can be achieved with or without a nipple button created by the surgeon.
Areola Scar Camouflage: Many breast operations require one or more incisions at or around the edge of the areola which may produce scarring. The most common peri-areolar scars are from breast augmentation or reduction surgeries. A scar’s appearance can be softened, blended, or reduced by tattooing the areola scar using corrective pigment camouflage techniques.
Areola Size or Color Adjustment: The color of an areola can be darkened, balanced, or enhanced with tattooing. The process helps women who have discolored or lightened areolas after breastfeeding or patients who have had areola graft surgery. Patients with skin discoloration disorders (e.g. Vitiligo) can also benefit from areola tattooing. Also, individuals who have not had breast surgery but are self-conscious about their areola color or size (too light or too small) may choose this procedure to adjust their appearance.
Waiting and Preparing For Your Procedure
Areola simulation or scar camouflage can be performed when your physician approves it. We openly communicate with our client’s surgeons and we follow all recommendations made by them. Scar camouflage can usually be performed as soon as 6 months after surgery, but you should first ask your physician. Once you have been cleared for areola tattooing, you can schedule your consultation with Stacey. During your consultation, she will discuss your concerns and recommend a treatment plan that she feels will provide optimum results. She will also provide you with specific guidelines to prepare for your procedure.
Design, Color, and Spot Testing
We have a complete assortment of hypo-allergenic areola pigment colors. We will work with you to select a color or colors that look the most natural for you. For scar camouflage or unilateral areola recreation, we recommend a spot color test before the actual procedure is performed. A patient’s skin tone and body chemistry will affect the healed color of their tattooed areas. Therefore, the spot test is the safest way to determine the formula for the closest color match to an existing areola. The color spot test is scheduled as an individual appointment. It should be completed 4 to 6 weeks before the actual tattooing procedure to allow for healing and color stabilization. Once the spot is healed and the color is evaluated, the areola tattooing sessions can begin. You should also keep in mind that a simulated or scarred areola will probably need more than one tattooing session to achieve the best looking result.
After Your Procedure
You will need to follow specific steps for one week after each areola tattooing session. We will give you an after care kit with medical grade supplies and detailed instructions. Although you will not need to take time off from work, you should keep your recovery period and after care in mind when scheduling your procedure appointments around work, social, or travel plans.


Camouflaging / Scar Revision

 
Skin or scar camouflage is tattooing of the skin with different colors of flesh tone pigments. Its purpose is to disguise a scar or skin area that is missing pigment or color. It is a specialized area of permanent cosmetics that falls under the category of Medical or Paramedical Tattooing. This process is also called Corrective Pigment Camouflage (CPC), Corrective Camouflage, Skin Repigmentation, Scar Camouflage, Skin Camouflage, Camouflage Tattooing, and Skin Color Tattooing. The science behind pigments and the physiology of human skin and tissue must be understood by the specialist performing these procedures. These procedures require advanced knowledge, training, skills, and experience in permanent cosmetics as well as an artistic eye for color and skin tones.
Are You a Candidate for Skin Color Repigmentation?
Even if you have a scar or skin abnormality, you may not be candidate for skin repigmentation. You might be a candidate if you meet the criteria below. Your scar should be:
Healed and no longer pink or changing color: Your scar should be at least 9 to 12 months old with stable color. If it is red or pink or still changing color, the tissue may still be healing. A reputable, experienced medical tattooist will not work prematurely on scar tissue because it may cause further damage to the skin. (Note: If you were under a physician’s care for the condition, ask him/her if you may undergo skin color tattooing before contacting our office.)
Smooth and relatively flat: Camouflage tattooing cannot disguise or correct extreme changes in skin texture. If your scar or skin area is bumpy or raised, the process may not be effective. (Note: If you have any skin surface irregularity, please consult with a Dermatologist or Plastic Surgeon first to see if any type of medical treatments can first improve the skin texture.)
Without dark edges: Dark edges or borders around a scar indicate Post Inflammatory Hyper-pigmentation (PIHP) from the initial trauma or surgery. It is possible that the camouflage tattooing process may increase the hyper-pigmentation and create a wider, darker border. (Note: The risk of this happening is usually greater with darker skin tones.)
NOT one of the following: Port Wine birthmarks; spider veins; freckles; age spots; under eye circles; hyper-pigmentation; or unstable Vitiligo (not in remission). These can be improved with non-tattoo medical treatments such as lasers, sclerotherapy, or chemical peels. Please consult with a physician regarding the best course of treatment for these conditions.
 
You might be a candidate if you also meet the criteria below. You should:
Have realistic expectations: Camouflage tattooing will not completely restore skin to the way it looked before it was injured. The process will not “erase” a scar or skin abnormality so it appears completely gone and the area looks “perfect” again. It improves color differences to help disguise the scar or anomaly and make it less noticeable to other people.
Not spend time tanning: A scar camouflage tattoo will not be a “perfect” match to the surrounding skin color. This is due to the constant changes in skin tones from blood flow, body temperature, and tanning. The pigment in the tattoo will not darken if it is exposed to sunlight or tanning booths, so the tattoo may appear lighter if the surrounding skin tans. When the tattoo color matches tanned skin, it may appear darker once the surrounding tanned skin fades. Therefore, if you spend time outdoors, you will need to adjust your lifestyle or decide to match the tattoo to “winter” or “summer” skin and live with the changes in between.
Not expect results in one session: Camouflage repigmentation is a process, not a one-time “cure”. It is performed on “unhealthy” skin that has been damaged or altered. Its response cannot be predicted—a scar or Vitiligo patch may have areas that absorb pigment, reject it, or both. The area will look dark and red immediately after a tattooing session, and then it takes several weeks to show the healed color (or not). This requires time and patience.

Camouflaging Cleft Lip – Lip Liner / Color

Cleft Lip Camouflage, Lip liner and Color 
A cleft lip is an opening in the upper lip. Normally the lip is formed by the union of two tabs of tissue that grow in from the sides of the face with a central tab that grows down from the lip of the nose. This fusion should take place in the fourth to sixth week of pregnancy. If the union is not complete, the baby is born with a cleft lip. If the cleft extends up into the nostril it is called a “complete cleft lip”. If the nose is not affected it is called an “incomplete cleft lip”. The amount of treatment required for a child with a cleft lip depends on how severe the condition is at birth. A small cleft lip may need only one surgical procedure in the first months of life. A child with a complete cleft lip may need several surgical procedures and ongoing care. After all surgical procedures micropigmentation restoration camouflage can help create a more symmetrical lip line and fill in with a natural lip colour suitable for the client’s skin tone.
A lack of symmetry or lip definition is often found in clients with a cleft lip. By micropigmentation we are able to reconstruct a new lip contour creating balance, symmetry and color to the lips.
After cleft lip surgery, a patient is often left with scarring, uneven peaks and without a vermilion line.  Permanent make-up can recreate the appearance of a natural look around the nose and mouth and define the Cupid’s bow.


MICRO NEEDLING

What is Dry Needling?
Dry Needling has been in practice since the late 1980’s, but has gained in popularity in the last two years. Needling treatment is the preferred method for 100% natural scar and wrinkle reduction. This technique promotes the body’s natural collagen production and also melacantis (pigment producing cells). Needling will relax and smooth out scars, wrinkles and can help to tone skin discoloration (hypo- and hyper- pigmentation). Needling has also shown to be promising in the reduction of stretch marks. Most commonly used in UK hospitals for post-surgical scar reduction.

How does it work?
Needling has often been referred to by some as an acupuncture, but the Needling treatment does not involve acupuncture at all. Needling doesn’t involve pigments. A high-speed digital machine (150 to 230 punctures per second) places thin needles in the lower and higher dermis skin layer, breaking the already formed old collagen chain. The brain receives messages to repair the trauma to the existing collagen chain. The effect is an immediate response of the dermis. The skin starts to immediately produce and generate new collagen and form new bonds. The exterior effect of Needling is that your own collagen is forming and pushing the skin up, which will smooth and reduce up to 80% of scars and plump up the wrinkles and erase fine lines.

How deep does the needle penetrate the skin?
During the Needling procedure, the needle penetrates the skin only 0.5-1mm deep.
Are the results for wrinkles similar to those after receiving Botox?
YES THEY ARE!!! After the Needling procedure, patients report difficulty to wrinkle the treated area as similar to Botox. The difference is that NEEDLING IS 100% NATURAL!!! It’s your own collagen and nothing else, and no poison is injected! The Needling effect even last longer- not 6 to 8 months but 3 to 8 years. Needling is also much less expensive!

How old can the scar be?
In general, the scar should be at least 1 year old. In some cases, 6 months is long enough. The older the better! Can an “old scar” still be treated with good results? Definitely yes!!! They are usually soft and even easier to work on than new scars.

How soon can I expect results?
Most people see and feel results immediately after the needling procedure. After about a week the process of collagen forming slows down, but strongly speeds up from 4 to 8 weeks when you can really see the difference and the results. Needling has similar effects as laser treatment, but often works faster, is much less expensive, and doesn’t damage the epidermis to get the desired effect. There are some differences between scar and wrinkle healing abilities. The individual’s age and immune system can also support or slow down the healing process from procedure. After the Needling procedure, wrinkle lines may not disappear completely but will be more shallow and smoother. Clients feel a similar difficulty to wrinkle the treated area (similar effects as Botox, but 100% NATURAL!!!).
How long does each procedure take and how many do I need?
Most procedures take 1 to 3 hours. However, each procedure varies person to person. It depends on how big the scar is, how many you want to treat during one session, and how large or intense the wrinkles are. The number of procedures you will need depends on your own unique body regeneration abilities. The average is 2 to 4 Needling procedures. You will have complete control over how many Needling procedures you want to have done. After about every 4 to 6 weeks you will know if you need another procedure or if you are completely satisfied with your results.

What is the percentage difference after each treatment?

Scars – a visible change in appearance is 50-80%! Wrinkles – 40- 80%!

How long does the effect last?
Each case is different, and so is everybody’s skin regeneration. In general, after Needling for scars, they will get smoother, softer and be reduced for the rest of your life. It not only depends on your skin type, but also on muscle structure and your habits of facial expressions. After Needling, your results will depend on you regeneration process but also on your genetics, and how much and how often you wrinkle your skin (forehead, area around your eyes). The habits of facial expressions vary in every person. There is also huge impact from how you treat your skin on a daily basis. Sunscreen, Vitamin A, E and C will definitely help your skin appearance in all cases! In general, the effect after Needling for wrinkles much longer, so call for additional information.

Is skin needling natural and safe?
Each case is different, and so is everybody’s skin regeneration. In general, after Needling for scars, they will get smoother, softer and be reduced for the rest of your life. It not only depends on your skin type, but also on muscle structure and your habits of facial expressions. After Needling, your results will depend on you regeneration process but also on your genetics, and how much and how often you wrinkle your skin (forehead, area around your eyes). The habits of facial expressions vary in every person. There is also huge impact from how you treat your skin on a daily basis. Sunscreen, Vitamin A, E and C will definitely help your skin appearance in all cases! In general, the effect after Needling for wrinkles much longer, so call for additional information.

Does the Needling Roller give the same effect?
Using a professional Needling machine will allow one to focus on the exact places that need to be treated. With acne or chicken pox scars, precision is everything. A roller may help you on large areas (stretch marks,etc) or can stimulate successful scalp hair growth. To get the right results in Needling treatment, it’s extremely important how deep and how frequent the needle will penetrate the skin. The experience and education of the person who will provide the Needling service for you is extremely important. If the needle goes too shallow, that will leave damage on the top layer of the skin without any results. If it goes too deep and hits muscle, that will leave a scar. Imagine going to reduce scars or wrinkles… and getting deeper scars instead– all over your face or another area that was treated!!! Pick the right person for this procedure.

Can just anyone do the procedure?
Definitely no!!! Needling is a very advanced technique and therefore, specialized training is required. Spend some time to find the right person, who knows how to successfully apply the Needling procedure so you will see positive effects. This can be a very helpful procedure giving you amazing results! But if somebody uses Needling without the right education and skills, it can leave even deeper scars than you had to start with. Wrinkles, if treated too deep and with the wrong speed, can become scars!

Does it hurt?
For all Needling procedures like Permanent Makeup, it is preferred to use topical anesthetics to minimize discomfort. In the beginning of the Needling procedure, some patients don’t feel any pain, and some feel only discomfort. During the procedure, after applying additional anesthetics, most patients don’t report pain or discomfort at all.

What kind of scars can be treated?
Needling can be used to treat any kind of scars except: Keloids or raised scars, red scars, ans scars the are too fresh after surgery or an accident. The Needling 

procedure works great for:
Acne scars
Chicken Pox scars
Burn scars
Post-surgery scars
Tummy Tuck
Breast Augmentation
Face Lift
Post-Cancer surgery scars
Hair Transplant scars
Stretch Marks
How about enlarged pores?
Needling is great for face, neck, and hand wrinkles. The procedure works great for large pores and age spots.



MICRO-NEEDLING TREATMENT PRE AND POST INFORMATION It is through the use of a safe, natural, holistic alternative for resurfacing of the skin using micro needles without an aggressive machine, to produce optimal results. There may be some bleeding during the treatment for which I understand is temporary. There may be some mild discomfort during the procedure. Topical coolness or anesthetic cream may be used if needed for tolerance. Treatment achieves: 
• Helps to build collagen
 • Smoothes fine lines and may help fill in pitting or areas lacking structure • Smoothes acne scars
 • Stimulates growth factors 
• Post care includes no aggressive products for 48 hours after treatment and SPF of at least 30 shall be worn when outdoors. Pre-Treatment Instructions
  Avoidance of Accutane for the past 6 months 
 Avoid retinoids, topical antibiotics, exfoliants, hydroquinone, sunburn, and benzoyl peroxide 3 days prior to procedure 
 Recommended skin care system for preconditioning for 4-6 weeks for optimal results 
 Avoidance of IPL/Laser procedures for the past 7 days prior 
 No waxing, depilatory creams or electrolysis 5-7 days prior to the peel. 
 If use of a peel was recommended in conjunction with the micro-needling, No topical agents that may increase skin sensitivity, reaction to the peel, or dryness 3-4 days prior to the peel (topical retinoid or hydroquinone products). No acids or defoliants that may be drying or irritating to the skin (such as alpha hydroxyl acid (AHA) beta hydroxyl acids (BHA), exfoliating masks, hydroquinone, or benzoyl peroxide acne products). If no peel, 24 hours without irritating products. 
 No shaving the day of the procedure
  No significant changes in the skin recently reported including breakdown of skin or excess dryness or sunburn 
 Skin is clean without lotion, oil, makeup, deodorant, powder, perfume or sunscreen
  Antiviral agent for 2 days prior to and day of treatment if history of cold sores 
 Patient denies today: active cold sores, herpes simplex, or warts in the area to be treated, open sores, sunburned, or excessively sensitive skin within the application area, pregnancy, dermatitis or inflammatory rosacea within the peel application area. Reports no allergies to salicylates Day of Treatment Instructions
 • Omit lotions, creams, make up or deodorant in area to be treated 
• Arrive with clean washed skin 
• Inform provider of any changes in medical history and of all medications you are taking Post- Treatment Instructions Immediately after your Medical Micro-Needling procedure, your health care provider may apply moisturizer and sunscreen topically. Do not take any anti-inflammatory medications such as ibuprofen, Motrin or Advil. Continued on next page These agents will interfere with the natural inflammatory process that is critical and responsible for your skin rejuvenation. Avoid sun tanning and prolonged exposure to direct sunlight. When exposed to sun, always use sun screen SPF30 or above. You may clean your face with a gentle cleanser before bed. 
• Redness or sensitivity might be present (and last up to a few days) after peel 
• Use Tylenol only as needed for any soreness 
• Peeling may start 3-5 days after peel. Do not pick or scratch at treated skin but instead keep moisturized 
• Eat fresh pineapple to optimize healing
 • Avoid strenuous exercise or sweating for 24 hours due to open pores 
• Treat skin gently washing with a gentle cleanser, cool water, using hands only and pat dry no earlier than 4 hours after peel
 • May use cool compresses after peel if excessive discomfort, burning, redness, or swelling
 • Follow post peel instruction sheet if indicated 

• Avoid sun exposure for 3 days and if possible 10 days. Apply a minimum of SPF 30 every 2 hours 
• May use mineral makeup after 24 hours
 • Restart regular skin care regimen in 48 hours and Retin A in 72 hours 
• Recommend follow up and repeat treatments in 4 weeks and for best results a series of 3 – 5 treatments Day 1: On the next day, you may clean your face as usual and apply makeup, lotions and other topical products as usual. Stay away from exfoliants or glycolic acids that are present is cleaners as these can make your skin very dry after the procedure. Be sure to use an approved SPF30 or greater sunscreen! Days 2-7: Within two (2) days following your Medical Micro-Needling procedure, you will notice skin dryness and flaking. This is due to an increased turnover of skin cells. During this period, you may apply your regular skin moisturizer. Follow the instructions given to you by your medical professional. If your medical professional used the roller around the eyes, you may have a little micro bruising that may exist for three or four days. This can easily be covered with makeup. Days later, your skin will start shedding. These are skin layers that would regularly shed a week later, but the Micro-Needling brings this skin to the surface sooner. During this temporary process, your skin will shed and be dry. You may use your regular skin care products once your skin is not irritated. Days 7+: A week after the Medical Micro-Needling procedure, most patients notice that their skin is smoother and more radiant. Continue with sun protection every day and reapply every 2 hours if outdoors. 



Micro needling after care

Micro-Needling Post Procedure Immediately after your Micro-Needling procedure, do not take any anti-inflammatory medications such as Ibuprofen, Motrin or Advil. These agents will interfere with the natural inflammatory process that is critical and responsible for your skin rejuvenation. Follow these simple steps: Day of procedure: No lotions, makeup or other topical products on your face before your procedure. After your procedure your medical provider may apply a lipopeptide booster, skin moisturizer, and sun screen. You may clean your face with a gentle cleanser before bed. 
Day 1: On the next day, you may clean your face as usual and apply makeup, lotions and other topical products as usual. Stay away from exfoliants or glycolic acids that are present is cleaners as these can make your skin very dry after the procedure. Be sure to use an approved SPF30 or greater sunscreen! POST  TREATMENT:
 
After the treatment, take precautions against sun exposure. Do not apply sunscreen for 12 hours after the Dermapen treatment due to the skin’s channels being open for a period of time and due to the toxic nature of some sunscreens on the market.
Do not perform any vigorous exercise for at least 12 hours after treatment.
Do not apply make-up for at least 12 hours after the treatment. We recommend Lira BB cream for use post procedure versus other foundations.
Dermapen needling may trigger a cold sore response in patients and a prophylaxis medication should be recommended to those who are prone to breakouts.
Wash the face thoroughly a few hours after treatment. Gently massage the face with tepid water, and remove all serum and other debris such as dried blood.
For the first 1-3 days the skin will be very dry and feel tight.
After 2-3 days patients can return to regular skin care products or as soon as it is comfortable to do so.
Avoid alcohol based toners 10-14 days.
Avoid direct sun exposure for at least 10 days

Day 1: Erythema and red appearance and severity will depend upon how aggressive the treatment.

Days 2-7: Within two (2) days following your Micro-Needling procedure, you will notice skin dryness and flaking. This is due to an increased turnover of skin cells.  If your medical professional used the roller around the eyes, you may have a little micro bruising that may exist for three or four days. This can easily be covered with makeup. Days later, your skin will start shedding. These are skin layers that would regularly shed a week later, but the Micro-Needling brings this skin to the surface sooner. During this temporary process, your skin will shed and be dry. 

Days 7+: A week after the Micro-Needling procedure, most patients notice that their skin is smoother and more radiant. Results vary, but usually a course of 1-3 treatments (maximum of 5, depending on the condition being treated) is typically recommended. If you require MORE procedures than this, you may have an unrecognized underlying medical condition and should consult with your provider. Of course, results may vary from patient to patient. Keep in mind that the healthier your body is, the better will be the results you achieve from a Micro-Needling procedure. Your body’s function and overall health are reflected in your skin.

Dermapen Microneedling—Before and After Care
PRIOR TO TREATMENT:
No Retin-A products or applications for 12 hours prior to treatment.
No Auto-immune therapies or products for 12 hours prior to treatment.
No prolonged sun exposure or sun burns to the treatment area 24 hours prior to treatment.
Skin should be clean and make-up free.
If an active or extreme breakout occurs before treatment, evaluate on a case by case basis.
 
HOME PREPARATION:
 
Preparing the skin for this procedure will ensure optimum results. Healthy skin will respond better and results will last longer. Skin cells need nutrients for best function and a Dermapen recommended anti-aging regime should include:
 
Oral Supplements (omega-3, glucosamine and multivitamins)
Cleansers and Toners
Topical Vitamin A (avoid high dose)
Topical Vitamin C
Topical Antioxidants
Topical copper peptides
Topical Growth Factors
Sunscreen ( natural, no chemical recommended)

Other resources: http://www.mcdonnelldermatology.com/docs/Pre%20and%20Post%20Microneedling%20for%20non%20acne%20conditions-for%20web.pdf

Chemical Peel—Before and After Care
It is crucial to the health of your skin and the success of your peel that these guidelines be followed: 
 
*Chemical peels are a superficial treatment designed to improve the texture and appearance of the skin.
* Benefit: minimize wrinkle,  and acne  scar,  dark spot,  aged spot,  lighten freckles... improve overall soon appearance. 

PRE-PEEL PRECAUTIONS

The pre-peel precautions to be taken to prevent complications include identifying the patients at risk by a detailed history and examination as detailed above. Other precautions include the following.

  1. Adequate priming of the skin for at least 2-4 weeks prior to peel and discontinuing 3-5 days before the procedure is of vital importance.[5] Priming is done by application of depigmenting agents such as hydroquinone or retinoic acid and use of sunscreens.
  2. Patient should be instructed not to bleach, wax, scrub, massage or use depilatories or scrubs, or schedule any important event 1 week before the peel and to stop retinoid 3 days before the peel.
  3. In patients with active lesion or H/o herpes simplex, a prophylactic antiviral such as acyclovir 200 mg, 5 times a day, or valaciclovir 1 g, 3 times a day, should be given, beginning 2 days prior to the peel and continued for 10-14 days after peeling, till re-epithelialisation occurs.
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INTRA-PEEL PRECAUTIONS

  1. While doing a chemical peel, it is very important to select the right peeling agent at the right concentration.
  2. It is always better to under peel than over peel in the initial stages.
  3. Sensitive areas like the inner canthus of the eye and nasolabial folds should be protected with petroleum jelly.
  4. The neutralising agent must be kept ready to terminate the peel if required before the scheduled time.[2]
  5. A syringe filled with saline should be kept ready, in case of accidental spillage into the eye to prevent ocular complications like corneal damage.[8]
  6. If trichloroacetic acid or glycolic acid enters the eye, normal saline should be used to flood the eye, and in case of phenolic compounds, mineral oil should be used.[1]
  7. When peeling the periorbital area, a dry swab stick must be kept ready to absorb any tears. If there is watering of the eyes, the peel can trickle up or down.
  8. When doing medium and deep peels especially in darker skin, peeling agent with lower concentration should be feathered at the edges to merge with the surrounding normal skin to avoid lines of demarcation.[1]
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POST-PEEL CARE

Good post procedure care ensures early recovery with minimal complications.

  1. In the immediate post peel period, mild soap or non-soap cleanser should be used.
  2. If there is crusting, topical antibiotic ointment should be used to prevent bacterial infection and enhance wound healing.
  3. Sun exposure should be avoided and broad spectrum sunscreen should be used meticulously.
  4. Calamine lotion in a moisturising base can be used for stinging sensation.
  5. Peeling agents like glycolic acid and retinoids should be avoided till desquamation is complete.
  6. Patients should be strictly warned against picking, peeling, scratching, rubbing or scrubbing the skin.
  7. Patients should be clearly informed to recognise complications like excessive redness, swelling, burning or pain, crusts, oozing, pus formation or blisters and to report immediately, so that preventive actions can be taken promptly.
 
Cliens should NOT be treated with the following: 
Active cold sores or warts
Open wounds or lesions 
Sunburn
Excessively sensitive skin
Inflammatory rosacea
Untreated skin cancer
Recent surgery in peel area
Recent permanent makeup in peel area
Rashes, allergies or sensitive skin reactions
Allergic to chemical peel components or salicylates (aspirin)
Accutane use in the past 12 months
Radiation or chemotherapy in the past 12 months
Pregnant or breastfeeding




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