Paul M. Graham, DO
Microneedling, also known as, collagen induction therapy (CIT), is a non-invasive, in-office skin rejuvenation procedure with minimal downtime and excellent results. Microneedling can be used to treat a variety of skin conditions including fine lines and wrinkles, acne scarring, stretch marks, skin texture irregularities, hyperpigmentation, large pores, and facial rejuvenation. This procedure is becoming widely available at many medical spas, plastic surgery offices, and dermatology practices. Microneedling treatment cost roughly $250-$700 depending on the location and operators level of training. It can be used in areas that are not suitable to laser resurfacing or chemical peels such as areas around the mouth and eyes, the hands, and the chest. It is also suitable to be used in darker skin types with very little risk of hypopigmentation, as opposed to laser therapy.
Microneedling treatment is performed every 4 to 6 weeks for a total of 2-6 treatments, depending on the skin condition being treated. Anti-aging maintenance therapy can be done at intervals of 6-12 months allowing for good retention of collagen when used in combination with sunscreens, vitamin A, and antioxidants. During the procedure, pinpoint bleeding, mild redness, and slight swelling are the desired endpoints of a successful treatment. Adverse effects are limited to mild redness and swelling following the procedure with resolution typically within 24-hours.
How does it work?
The 30-32 gauge needles on the device work by creating controlled skin injury allowing each micro-wound to fill with serum and endogenous growth factors, initiating the production of new collagen and elastic fibers. The microneedling treatment leaves the top layer of the skin intact, allowing for quicker healing time, and a lower risk of side effects. The micro-wound columns created by each needle are separated from each other by normal columns of skin. These columns act as stem cell reservoirs for the migration of skin cells and regeneration of new collagen and elastic fibers under the direction of various endogenous growth factors. By sparring areas of normal skin, the healing process is expedited, allowing the remodeling and reorientation of old collagen and elastin fibers to occur over a 4-6 week period. Each microneedling treatment is thought to stimulate the production of new collagen and therefore should be utilized until the desired result is obtained.
What Are the Types of Microneedling Devices?
Microneedling devices come in many forms including rollers, electric pens, and single needle applications. Over the past 10 years, electric and battery-powered devices have emerged, demonstrating superior results over manual devices. This is thought to be due to the limited depth of penetration with these devices. Electric and battery-powdered microneedling pens work by penetrating the skin at a 90-degree angle, creating vertical micro-wounds with limited damage to the top layer of the skin. Rollers enter the skin at 45-degree angles creating a more triangular-shaped injury with more superficial damage and minimal penetration into the deeper layers of the skin.
The majority of powered microneedling devices have adjustable depths of penetration ranging from 0.15 millimeters to 2.5 millimeters in depth. Ideal treatment occurs when the depth of the microneedles reach the upper reticular dermis. The upper reticular dermis contains an abundance of collagen producing cells called fibroblast and when stimulated or stretched, these cells function to secrete collagen producing enzymes while simultaneously breaking down old, devitalized tissue. Different regions of the face have varying skin thickness and require specific treatment depths to limit the development of adverse effects. For example, the skin around the eyes is much thinner than the skin around the mouth and will require less depth penetration as opposed to the thicker skin around the mouth.
What Should You Expect?
Before the treatment, the face is cleaned with antiseptic solution and topical numbing cream is applied and left on for 15-60 minutes depending on the strength of the anesthetic. The skin is then wiped clean and dried prior to applying the topical hyaluronic acid gel. This gel acts as a lubricant, allowing the device to slide over the treatment region with ease. Typically, 4-6 passes with the device are performed with a combination of horizontal, vertical, and circular motion for the best results. Following treatment, additional hyaluronic acid gel is applied followed by application of a barrier cream. Sun avoidance is imperative to prevent hyperpigmentation from occurring. Redness and swelling typically resolve over the course of 12 hours and the collagen remodeling process is usually completed by week 6.
To view a short microneedling procedural video, click here: Video: Microneedling
In a Nutshell!
Microneedling therapy is a safe and effective treatment modality for anyone seeking a non-invasive therapy for the treatment of fine lines, wrinkles, scars, and facial rejuvenation with minimal downtime and excellent results. Not all dermatology offices do this procedure so make sure to call prior to scheduling a consultation.
I would like to thank Dr. Tina Alster for her continued support and commitment in teaching me the principles and procedural technique with the use of microneedling. Dr. Alster is a pioneer in microneedling therapy and has been a strong proponent to the development of my passion for this revolutionary procedure.
Photo Credit: Clinica Dr. Campos, Luxe Laser, Sedora Spa
1. Aust MC, Fernandes D, Kolokythas P, Kaplan HM, Vogt PM. Percutaneous collagen induction therapy: an alternative treatment for scars, wrinkles, and skin laxity. Plast Reconstr Surg. 2008;121(4):1421-1429.
2. Aust MC, Reimers K, Gohritz A, et al. Percutaneous collagen induction: Scarless skin rejuvenation: fact or fiction? Clin Exp Derm. 2010;35(4):437-439.
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