Is this atrophic scarring + hyperpigmentation?

Hi there, long time lurker but only just made an account.

My partner (trans redhead, very fair porcelain skin) got her first electrolysis session and it appears to have done some damage.

Could anyone please confirm this is atrophic scarring (pitting) with hyperpigmentation? I am trying to find out the correct terminology as we might see a dermatologist for support.

My partner is risk averse and is currently not willing to continue electrolysis at this stage due to the pitting/pigmenting (which my understanding is caused because of collagen rebuilding inside the follicle causing the skin to be pulled downward/inward). I did not have this issue during my treatments.

She is currently using topical silicone to see if it has any affect but we are going to probably delay any further attempts at electrolysis for 6-12 months to see if the situation resolves before doing a full clearance.

Before we go on a witch-hunt of overtreatment, the electrologist we saw is one that I have used for my entire body clearance and had no issues with, and the electrologist is also very risk averse and has halted future sessions until we see progress of healing or a resolution as she prefers to undertreat rather than overtreat. I sat in on this first session (as we ‘talk shop’ and chat about life) and I witnessed her start at ultra-low power and work her way up to until hair removal was achieved.

It may rather be that my partner’s skin is ultra sensitive rather than overtreatment, but if it does look like too much power I’d appreciate knowing this so we could maybe arrange a few-hair experiment at ultra low current or under different pulse conditions and see what happens.

Additionally, is there any references that might suggest galvanic might be more suitable? Photos are of 1 hour of trial treatment on Apilus unit, straight thermolysis.

Any advice is appreciated, thanks in advance!

I’m unable to identify the body part. See, our skin is amazingly different in different sections … even a few millimeters between areas is a big deal. So, is that a chin, a leg or a nose? Gotta start there …

Oh, my apologies for forgetting this - this is the chin.

As a side-note, for ‘patch testing’, is there an area with similar properties to the chin/face? I have a hypothesis based on a few things that may suggest that facial hair and pubic hair are ‘similar’ in some manners (not all hair is the same in regions, even down to genetic level). Asking this because if we were to do some trials that weren’t in a visible area, would pubic area be suitable?

Looks like “under the chin” on the neck? Thing is, if you are going to an expert electrologist, she will understand how to treat each area properly. I don’t think that any particular area, vs another, would give you much of a reliable test spot.

Those dents look dreadful … almost like “ice-pick” scars from a bad acne case.

It’s on the side of the chin, right on the jawline - to get decent lighting I had to tilt her head at a funny angle. The photo is basically rotated 90 degrees from normal.

I think you’re right, it looks similar to ice pick scarring. I guess the question is though, is this really bad damage, or a just an atypical healing response - will it stay like this forever, or will it fill in? This photo is about 4 weeks after first session.

So far I’m only aware of one, possibly two places that do electrolysis in my state, so I haven’t got much reference for operators.

I did a little fiddling with your photo so others can weigh in on this. Again, this is the number 2 danger area on the face; and, right there on the chin is where I see all the dreadful results. I probably have 50 photos exactly like you are showing.
I cannot imagine that the electrologist couldn’t see the obvious over-treatment that was happening at the time of the treatment. How will this resolve? My guess is not well … but we can hope for the best.

Well, I was monitoring it and there didn’t seem to be any specific overtreatment as I was visually watching the whole time, at least compared to my treatment… this didn’t really appear until after the session.

Going forward, I’ve read a lot here on ‘overtreatment’ but not really specifics, it seems to be a bit of a catch-all phrase. Would this be related to treating too many hairs in one area, or power levels/pulse sequence? Trying to find a solution going forward, since it’s going to be difficult to find another electrologist in this area, so we might have to work with her to find a solution.

Seems like you’re on the right track and have a game plan.

Thanks Mike for the different perspective with the photo.

I’m curious about a few things, servavitae. Did big scabs develop a couple days after treatment? Was there any oozing? Did the skin look angry as she worked? How many times did she insert for each hair follicle? If there were scabs, were they picked off before the wounds healed? Do you know what modality of thermolysis was used? Was an insulated probe used? What was the size of the probe? All these factors make a difference for a good outcome verses a shaky outcome.

You described your electrologist as being extra careful and gradually working the energy level up , which is excellent adherence to basic concepts, but I agree that this is not a desirable outcome and I hope it fills in and heals well. Time needs to pass.

And thank you too Dee. (BTW, did you get my silly email?)

So, I was skeptical that the poster said “she didn’t see any over-treatment happening” or words to that effect. I seriously don’t think a layman can see over-treatment happening … without magnification … And, I always get a little perplexed with such an assessment.

It’s sort of like looking at a car crash scene and then wondering who or what caused it: the car, the driver, the conditions? Frustrating.

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I will check later today, Mike.

There wasn’t any big scabs or oozing, the skin did not generally look really inflamed. My partner tends to take really anxious care of her skin, so she definitely didn’t pick or touch the area except for general aftercare.

I will talk to the electrologist next time we have an appt to get her modes/figures, that may be a while since we need to wait for the skin to perhaps heal first, could be 6-12 months.

I could perhaps persuade my partner to go back for a test patch elsewhere, but that would appear to not be an ‘apples to apples’ test, though if it did crater that much it could rule out one variable, ie, location on body.

@Bono - I’m not an electrologist. I’m also not a pilot, but I know when a plane is crashing. As stated prior, I’d prefer for constructive comments, not ad-hominem remarks/witch-hunts. Even if the electrologist skill is the issue, if I have the ability to help her be better at what she does, and get better results, then I’ll take whatever advice I can get, but not if the pitchforks come out.

My point was that looking at such an aftermath is not really a mystery. There are only a few possibilities, but there is nothing out of the ordinary with such an unfortunately common problem in that area.

We will be seeing a dermotologist for options for recovery of the existing situation, but regardless of this I’m still looking for something more ‘concrete’ than ‘overtreatment’. If this is a common issue, there should be some documentation or technicality for reason(s) behind ‘overtreatment’?

For example, we could talk about density of removal (too many follicles in one area being treated per session). Or the effect of pulse length/sequence/current and cases of overtreatment with one specific element of this. Or whether neither of these matter independently, but overall power level or core temperature is more of an indicator.

What are these ‘possibilities’? I am sure that you could appreciate that from our perspective, we have limited hair removal options (basically electrolysis only), and we can’t at this stage confirm that simply switching electrologists would solve the situation if it is ‘common’. Regardless of whether or not we switch electrologists or work with the one I used, it would be useful to go in to a potential next session armed with something tangible.

I’m a scientist, and so I’d rather not leave this an unknown. I’m here to learn.

Dee Dee gave you a great list of possibilities, all of which produce an over-treatment issue.

I would go back to the electrologist and have her evaluate the skin … and potentially give you some idea of what happened. I would ask a couple key questions such as needle diameter (sizes are usually 3-4-5 etc.), insulated needle or not and was she trying to clear all the hairs in one treatment. (A size 3 needle would be a definite red flag.) I just completed a 51-hour back (almost) clearance and I used seven different types of needles. Too often, electrologists get lazy and use a “one size fits all” needle. BIG mistake.

I think if you ask those questions, she won’t get defensive? Good luck; and I know this is very upsetting. I have seen this exact injury for 45-years and it still upsets me (actually makes me sick) … because it did not have to happen.

I have a video on this that might be helpful “dents on the skin” or something like that … In most cases, these “dents” will either completely resolve or become much less visible. That exact spot on the chin is a very problematic area.