Worried about scarring from potential overtreatment

Hi! I’m a trans woman undergoing electrolysis for facial hair removal. I’ve been receiving thermolysis on my facial hair once a week for an hour since March and I’ve noticed some unevenness in the shape of my skin (as seen on my cheek in the pictures, same spot different lighting conditions). The images were taken four weeks after my most recent treatment in the area, but this texture has been there for several months at least. I had no acne scarring there prior either, so I’m certain it’s not that. My hairs are quite coarse so my electrologist says she has to turn it up a lot. She also says this is normal. Is she lying? I was wondering if this uneven texture (looks like an orange peel or a golf ball or something) is normal, expected, and if it’s permanent? Will it heal on its own? Is this pebbling? I still have a long way to go with treatment. Thank you so much.
(Also, apologies if I emailed any forum regulars prior to posting this. I couldn’t figure out how to post a topic with my newly created account. I don’t mean to waste anyone’s time!)


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First I’m going to say that Lfp contacted me privately before posting here, I asked her to because, well like most weeks it’s been busy around here

As I advised you briefly LFP in email, I do indeed see cause for concern here. Thereis clear evidence of pitting on the sides of the chin. This is a delicate area, and I’m concerned that in her zeal to “turn it up to deal with these big hairs” your electrologist may have caused this pitting. I like picoflash for the sides of the chin ( actually I use picoflash a lot for the WHOLE chin, because it prevents overtreatment scenarios like this one due to the energy staying very close to the probe. The chin can have up to 50000 hair follicles per square inch of skin! These tightly packed follicles will, especially if clearing this area, cause over treatment with longer duration modalities. Better yet, if you have the time and money, I love the blend on the chin. YES it takes posatively EONS to do, but wow the result is so worth it. Almost never do I see pitting like this when blend is done, mostly due to the lower thermolysis levels used in most blend treatments.

So what to so…well, nothing. You’ve done it right and sounds like you dicontinued with this electrologist a month or so ago? Lets keep it that way. She seems to be struggling. Maybe she doesnt treat a lot of transpeople? But I’m seeing a mix of pitting from seemingly both over and undertreatment simultaneously. How is this possible? Well the answer is using too much current…IN THE WRONG PLACE. I don’t think she’s getting the correct insertion depth for these hairs and is maybe just turning up the current in an attempt to compensate. In short, this isnt the right electrologist for you.
Find a new one. Proceed cautiously. Make sure they are getting good releases of the hair ( with no tugging) .

Seana

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Unfortunately the last time I saw my electrologist was last week. I have red hair (some light and some dark) and tried laser (though I don’t believe the place I tried used enough joules with their treatment because I barely felt anything) and had no results after 6 sessions so I searched for electrologists near me and the one I use is sadly the only one. Would it be safe to continue with her if I had her switch to blend instead of the thermolysis she’s doing? Also, would it be reasonable to attempt laser again except this time ensuring the levels are set appropriately high for my hair thickness? I’m kind of at a loss and feeling quite concerned for what more pitting may appear in the coming months from my previous treatment (is this a valid concern to have?). Also when she’d treat me I very rarely experienced any tugging or plucking, it almost always came out rather smoothly. Thanks.

Laser does not work on any nshade of RED hair. Sorry, itt doesnt matter what they turned up the joules to. Any Laser operator that tells you theirs works on red hair is 100% lying to you.

The results after 6 months of treatment is showing in your face as pitting. Can you honestly expect it to get better if you continue?

Sorry, I’m just desperate and I just don’t know what to do as I can’t afford to see a different electrologist. Do you know whether it will ever heal if I stop now? And would having her switch to blend reduce the chances of damage or would I be better off shaving twice a day than trusting her near my skin even with blend? Again, I’m sorry for being so desperate. It’s just a very scary situation, not knowing how much more damage is waiting under my skin right now and what to do regarding future hair removal.

unfortunately with red hair, it’s electrolysis 100% of the way. Blend work well with operators who are proficient at using blend. If thermolysis is what they first presented to you, it’s likely that’s where most of her experience lies.
The only way you will know what permanently will happen is to stop, and not get treatment for 9 or so months. Then you will see it. What I see at the moment, is not acceptable for 6 months of treatment. We wont know the final result though, for many months from now.

And being desperate, makes you do things you shouldnt or normally wouldnt do otherwise. Try and temper your frustration. Time is the best factor in your favour.

Okay, so for now my plan should be to stop future treatments, wait 9 months to see if new marks appear and if the current ones heal at all? And in the meantime, shave twice a day, cover the best I can with makeup? Also is it a good idea or a bad idea to use tretinoin on the previously treated areas, including (or perhaps especially) the areas showing pitting? My dermatologist gave me some for some acne scars on my upper cheeks I’ve had for a few decades and I’m wondering whether it’s acceptable to use it on my treated and/or pitted areas in the meantime?

Hi Lfp, Thanks for your private email on this issue. Seana has it covered for you and what she said is good solid information and advice. Best Wishes on this!

Thank you, Mr. Bono. Your videos are very informative and are what helped tipped me off to something being wrong with the treatment I’d been receiving.
Do you know whether it would be helpful or harmful to use retin-a products like prescription tretinoin on my on my treated areas in the coming months as I wait and see the extent of my damage in order to hopefully heal it along the way?
Also if I were to find a better electrologist in the coming months, would it be safe to pursue treatments again or should I simply continue waiting for my face to heal/reveal the extent of the damage beneath? At this point I’ve dropped my current electrologist and am just trying to formulate a plan for the future to ensure an ideal outcome.
Thank you for taking the time to read my post. I appreciate everyone’s helpfulness.

At this point, whether you wait or not to resume with another Electrologist is up to you. What has happened, happened. We cant do anything about that.Whether you are able to see the damage lready done and distinguish it from other treatment performed, well in that case if you need to know that my advice is to wait.If the dysphoria from hair presence is the overwhelming concern ( and I undersand that from a transgender perspective, then go ahead and have the hair removed responsibly. Modality is up to you. If you let me know what area you are in, there’s a chance one of us might know a really good electrologist in the region.

I’m near Athens, Georgia (east of Atlanta) and am very financially and time restricted, which makes finding new electrologists a challenge. A new place just opened in my town, so I may attend a consultation to gauge my confidence in their understanding and technique, but I will likely choose to wait for six-ish months before starting with a new electrologist and assess the extent of the damage that may appear during that time.
In your experience, has damage like in my photos ever cleared up or decreased over time or is it truly permanent? Is there anything I can do to reduce its appearance outside of applying makeup? Thanks.

The appearance may become more diminished. Time is your greatest friend in such cases.
Edit: as an aside,its possible David ( Hairadicator) may be close enough to help you. I’n not good with southern geography and it appears quite a piece, but he may know someone near Atlanta who is good.

I think that using Retin-A would be fine (I would on myself). That is the one cream/drug that actually works … causing increased collagen-turnover and causing the skin to produce more and better-quality collagen. That’s why you were using it on the acne scars. People mostly stopped using Retin-A because the skin gets pretty tender, flaky and can’t be used if you’re in the sun (without protection). But YES, I think it will be helpful.

Since those areas are now “thinned out” you will not have the problems that probably happened because the areas were cleared-off with high HF output (i.e., treating all the continuous hairs). So now, there is less potential for over-treatment … and, having proper treatments on those areas might actually make the area better!

See, electrolysis will cause the healing process to start-up again in those areas … and that will get the collagen turn-over started-up in the scars you already have … and potentially improve the area (but no guarantee). So, I say, yes go for it … however, don’t be aggressive … take it slow-and-steady.

Again, the two areas that show damage are in the exact areas I like to call the “danger zones.” There are three “danger zones” on the face, and you got “nailed” in two of them. The other is where the sideburns would be located; although that is less of a danger zone than the pad of the chin and outer corners of the upper lip.

Finally, when you are totally hair-free and the skin is calm, try to find a dermatologist who will take the time to properly administer Kenalog “Triamcinolone Acetonide Injectable Suspension, USP.” Injected into the scar area itself. There are various types and your dermatologist will know the right one to use for scar remodeling.

Proper usage is not a one-time thing, but must be administered in a series of injections at the proper time. I have seen virtual miracles with this drug, even the near elimination of deep acne scars … So, maybe start your searching now? Most doctors will give you one shot and forget about it … No, you need a series!

We preferred to use a 30G needle so the injections are almost painless … however, the medication is thick and usually a fatter needle is used. With the 30G needle, we thinned it out using lidocaine with epi … this way the medication is also held in the area longer. Still, just using it straight is fine too. Most derms don’t seem to want to “fiddle” with this and prefer a one-time treatment or prescribing something. However, if the derm has a nurse … that is usually a ticket for getting more treatments.

SORRY FOR THE LONG-WINDED POST.

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So do you think I should actually consider starting with a new, better quality electrologist in those (and other) areas, just be conservative and slow with it, instead of waiting until say March? Because if further treating those areas (just more conservatively and slowly) has the capacity to actually HELP heal it, I am on board. But if you think it would be a better idea to wait, I can do that too and in the meantime use Tretinoin.
Am I able to use tretinoin on treated areas while in the process of regular electrolysis treatments or is it best to wait until I’m hair-free and done with electrolysis in the coming few years?
I will definitely make note of the Kenalog injections for the future once I’m hair-free.
Thank you for the detailed post. I appreciate it very much. Sorry for asking you and Seana so many questions. I’ve lurked on these forums for many months and it’s clear that you two are very knowledgable so I am very thankful to have the opportunity to ask these things.

If you were my client, I would work on you on all the areas. Retin-A use is okay during the process; just not a few days before and after. Definitely not after for a few days. Best Wishes,