temporary hypopigmentation or dermis scarring?

Hair Removal Methods Professional Electrolysis
#1

I’m a trans woman pretty far in the process of beard removal. I’ve been receiving multi-needle galvanic treatments for the past six months or so. My skin’s response has been pretty mild, I believe. There is some redness and some swelling in the first few days. Sporadic scabbing occurs, although the scabs at most a millimeter in diameter, and always fall off in six days or fewer.

A few months ago, I noticed in the car mirror some white spots along my chin and jawline. Some of these spots join up to form lines that run along my jaw. They become a little fainter as I move up the cheek. My skin in relatively fair, so they aren’t immediately visible unless you know where to look. They become very visible if I stretch the skin taut so that it blanches. I do not believe that I had these before, although I cannot be 100% sure. I had cystic acne when I was younger and underwent several rounds of Accutane (over 10 years ago). My acne became rather mild as I entered my late 20s/early 30s, but only fully cleared up on estrogen therapy. I’ve fiddled with the contrast on one of the attached images so you can see the general texture of my skin. My skin texture doesn’t look nearly this bad in person, but on the other hand, the white marks are more visible with the naked eye than through the camera lens.

Should I be worried about these marks? How common is hypopigmentation? Does it typically clear on its own? These have yet to fade, and they don’t really look like the other images on this site of post-treatment hypopigmentation. My fear is that there has been overtreatment resulting in columnar scars that extend into the dermis. My electrologist claims that this is temporary hypopigmentation that will resolve over a year. I don’t intend to throw my electrologist under the bus. (I like her! I’m pretty sure she browses this forum, and my face is very recognizable.) I ask because I’m starting an electrolysis program next week, and want to soak in as many opinions from working professionals as I can, even if they differ.

my jawline: https://imgur.com/6mt6ywd
some of the white marks designated in red: https://imgur.com/ZMI3nuB
high contrast image: https://imgur.com/YOpvvtb

#2

I cant see anything in those images out of place ( unless you count the multiple ingrown hairs on the neck) , certainly nothing I can determine a cause from, sorry.

#3

Well, I suppose this is the best response I could hope for.

#4

That is tough, tough hair. From what I see, all looks good.

I take before pictures. It’s amazing how many natural flaws people have before we even remove the first group of hairs. The flaws were not noticeable until the hair was cleared away because the eye and brain “focused” on the hair, not the orange peel skin or freckle or the hypopigmentation or the acne scar.

What your electrologist is doing is very challenging work that requires a delicate balance of getting enough energy down to the bottom of the follicle, in order to disable the follicle for good. Sometimes you will think your skin look like a mess and there will be some down time, but it all leads to good outcome. Small scabs that are gone within 7-10 days is very good.

The ingrowns look very surfacing and should be easy to shoot and remove next time. I don’t see anything to be concerned about.

#5

Yes indeedy Dee Dee!

#6

I started seeing a new electrologist and showed her these white spots. She claims that they are indicative of work where the previous electrologist zapped the hair and ripped it out. Each white spot is follicular debris which has plugged the pore, and sebum which has filled it up. These may or may not clear on their own.

She demonstrated plunging a probe into a few and flushing out the follicle with lye. A lot of material with the consistency of library paste comes out, occasionally along with a dead hair. Additionally, the uneven texture of my upper lip is also due to embedded debris. Since she started cleaning up my upper lip, the bumps have started going away, and the wrinkles which I’ve had since May have greatly softened. I do have a couple of scars on the upper lip, but they are now pink and flat, rather than dark and puckered. A “freckle” which I thought was uncovered by removing the mustache turned out to be embedded hair, which she removed.

I have on the order of hundreds of these things. I’m pretty angry that I paid a previous electrologist money, only to have to go back over my skin a second time to clean it up the mess.

#7

One thing you might consider is scar mitigating options like silicone sheeting. Many people have had acceptable reduction of scarring by using silicone sheets as directed. If you’re concerned about it you should also speak with a cosmetic dermatologist about additional options including fillers, microblading, dermabrasion, and laser.

#8

Hi Andrea!

I first came across tsroadmap back in the 90s when I was in middle school! I should’ve done this long ago, but a multi-year timeline and spending tens of thousands of dollars both seem impossible when you’re a child.

Well, the hope is that these aren’t actually little scars, but plugged follicles. The only thing I can say about them is that they are white, and if I catch one under my fingernail I can feel that it has some body to it. In fact, while the skin looks smooth at first glance, if you take a light and shine it at an angle against the skin, my former beard area looks rather rough, and the surrounding skin smooth. My current electrologist zapped a couple of these bumps and got some material out. They both have little scabs on top, so I don’t know what they look like underneath.

That being said, Fraxel laser in the perioral area is probably in my future regardless just for general skin smoothing. I’ve already had some on my cheeks and sideburns with good results. My skin type runs the risk of pigmentation changes with dermabrasion, and I don’t appear to have much volume loss for a filler.

#9

Glad I could help with that, regardless of the time frame!

If they look like tiny pimples, those are normal and resolve in a couple of days with proper care. If sebum or other material comes out when they are gently squeezed, they might be blocked pores. But based on the info, it looks as if it may be tiny scars in the treated follicles. Are they colored the same as other scars you have?

It would be worth going to a dermatologist, but if you can’t afford that, going to a skincare expert at a local salon for a consultation can often be free and they may be able to give you more information.