Dermatography

Skin discolouration
General

Introduction

A considerable number of people are born with visible discolouration of the skin. Surgery, medical treatments as well as ageing can also cause skin discolouration.

These skin abnormities and skin discolourations can very often be succesfully treated with dermatography. By injecting colour pigments permanently into the skin, the aberrant colour can be effectively camouflaged.

discolouration caused by medication (hydrochinon and loco-corticosteroide)

discolouration caused by medication (hydrochinon and depigman)

discolouration after TCA and phenol peelings



vitiligo

(blue naevus Mongolian spot) port wine stain

Klipper-Trenaunay syndrome


Haemangiomen/birthmarks

Birthmarks: Naevus Flammeus - Naevus unius lateralis - Naevus vinosus - Naevus congenitus - Naevus pigmentosus - Naevus van Unna Naevus van Ota en Rubicundus

A port wine stain is usually a congenital, benign skin abnormity, in which excessive growth of blood vessels at the surface of the skin occurs. Port wine stains are often visible on the face, usually more predominant on one side. Society and people are usually not very accepting and the patient can easily slip into social isolation because of this. Therefor the parents of a child with a port wine stain on the face are inclined to start treatment at an early age. Very young children are often treated with liquified nitrogen or with steroid injections. Especially in small cavernous port wine stains these treatments are highly effective, especially when performed by an experienced dermatologist.

Current medical therapies

Surgical removal and application of skin transplants, different kinds of radiotherapy. In the last 10 years, various kinds of laser treatments have been used, the results of which have not been necessarily effective: no results in 20% and a very limited improvement in bleaching i.e. 40% in the remaining 80% of all cases. In other words: the port wine stain will always remain visible and unattractive.

It has also become evident that treatment with general anesthesia at a young age is more burdensome and not more effective than at a later age.

port wine stain covered with skin transplant, unfortunately the port wine stain has not disappeared succesfully

port wine stain after coalgulation and laser treatment

port wine stain after laser treatment and plastic surgery

port wine stain after laser treatment



Discolouration and hypertrophic scars after laser treatment

From 1995 onward we have seen an enormous growth in beauty and anti-aging laser treatment. Commercial private clinics promoted this development with suggestive advertisements like “Without substantial risks young forever”. It seems obvious that commercial and economic reasons are more important than medical and ethical concerns.

2 patients after mistreatment with a carbondioxide laser , additional to discolouration and hypertrophic scars burning occurred



Treatment of port wine stains with dermatography

We can now safely conclude that dermography has been a very good alternative treatment since 1994, on the condition that it is performed by a physician-dermatograph (Clinic for Medical and Esthetic Dermatography). It is less burdensome for the patient and definitely not, as is said by physicians lacking any credibility or expertise, very painful. Local anesthesia is mostly unnecessary and where useful can be applied using an anesthetic ointment (lidocaine 10% in Pro-Edula).

Moreover results in dermatography are demonstrably better than in laser treatments.

In the last 15 years we have regularly seen patients still hoping for a better endresult in dermatography after having had laser treatment.

In these cases it is often easier to obtain better results when effective treatment has been performed by an experienced and skillful medical specialist using specific and well-directed laser.

Treatment is possible at 14 years of age.

More information

Medical links: http://www.birthmarks.net

before: untreated port winestain after: dermatography 11 treatments

before: port wine stain treated with radiotherapy at a young age after: 23 dermatography treatments

before: 12x Argonlaser treatment after: 18 dermatography treatments

left: histology of a port winestainafter 10 Dermatographytreatments (H.E.), amplification: 180x. Black parts are colour pigments, no inflammentary reactions can be observed.
right: Electronmicroscopy (amplification: 17.400x). Colour pigments are completely embedded in macrophages and endothelial cells, without inflammentary reactions.

before: after 40 !!! times laser treatment (Argon-laser and Pulse-dye laser). after: 16 dermatography treatments( still under treatment)

before: after plastic surgery and laser treatment
after: 7x dermatography