Microneedling
Microneedling is a relatively new minimally invasive procedure involving superficial and controlled puncturing of the skin by rolling with miniature fine needles. Microneedling was initially introduced for skin rejuvenation, but now it’s used for a wide range of indications, including acne scars, acne, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, stretch marks, and many more. It is very safe for dark skin types, where risk of postinflammatory pigmentation is very high with other techniques that damage the epidermis. Traditionally, it’s used as a collagen induction therapy for facial scars and skin rejuvenation, but it is now widely used as a transdermal delivery system for therapeutic drugs and vaccines.
The standard medical dermaroller has a 12 cm long handle with a 2 x 2 cm wide drum-shaped cylinder at one end studded with 8 rows and 24 circular arrays of 192 fine microneedles, usually 0.5–3mm in length and 0.1–0.25 mm in diameter. The microneedles are synthesized by reactive ion etching techniques on silicon or medical-grade stainless steel and pre-sterilized by gamma irradiation. Rolling with the standard dermaroller over an area of skin for 15 times results in about 250 holes per square cm up to the papillary dermis depending on the pressure applied. Each pass produces 16 micro punctures in the stratum corneum per square cm without damaging the epidermis significantly.
Micro punctures are created using microneedles to produce a controlled skin injury without actually damaging the epidermis. The micro injuries lead to minimal superficial bleeding and set up a wound healing cascade with release of various growth factors such as platelet derived growth factor (PGF), transforming growth factor alpha and beta (TGF-𝛂 and TGF-𝜷 ), connective tissue activating protein, connective tissue growth factor, and fibroblast growth factor (FGF). The needles also break down the old hardened scar strands and allow it to revascularize. Neovascularization and neocollagenesis is initiated by the migration and proliferation of fibroblasts and laying down of intercellular matrix. Another proposed hypothesis explains that resting electrical membrane potential of cells is approximately -70 mV, and when needles come near the membrane, it increases quickly to -100mV, triggering increased cell activity and the release of various proteins, potassium, and growth factors from the cells into the exterior leading to the migration of fibroblasts to the site of injury, which causes collagen induction. The needles do not create a wound in a real sense, just fooling the cells in believing that the injury has occured.
Consumers can buy at-home microneedling rollers over the counter. But for best results, microneedling should be administered by a dermatologist using more advanced equipment. The dermatologist can adjust the device depth according to the area of the skin and deposit medication, such as topical tretinoin or vitamin C, deeper into the skin. At-home microneedling devices only superficially affect the skin, penetrating just the outer layer, the stratum corneum or epidermis and reaching 0.25 mm deep. Professional devices can go deeper (2 mm to 3 mm deep), reaching the dermis. Professional devices are also electrically powered and evenly pushes the microneedles into the skin. Home versions rely on manually rolling the barrel over the skin to create small punctures.
References:
Singh, A., & Yadav, S. (2016). Microneedling: Advances and Widening Horizons. Indian dermatology online journal. Retrieved March 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/
Yale Medicine. (2021, June 23). Microneedling. Yale Medicine. Retrieved March 21, 2022, from https://www.yalemedicine.org/conditions/microneedling
Micro needling is also known as percutaneous collagen induction therapy. It is performed using a handheld, drum or pen shaped device that is usually electrically powered with tiny needles that make precise, microscopic punctures to the skin. This process creates microinjuries that are not visible to the skin and does not leave scars. Essentially these microinjuries work by helping to stimulate the skin to repair itself naturally through a process called dermal remodeling. The main purpose is to produce collagen production. The production of collagen and elastin starts the skin process, creating firmer skin. It is a popular cosmetic procedure which is used to reduce scars, acne, and wrinkles. In addition, micro needling is used to aid with alopecia and skin rejuvenation.
Although often seen as just a beauty enhancing tool, micro needling does aid in the skin conditions of acne scarring, surgical scars, enlarged pores and burn scars. A major benefit to the use of micro needling to treat these conditions is that there is not heat involved in the process. Micro needling benefits over its counterparts such as laser treatments are in its more limited side effect profile. People with dark patches of skin on their face, melasma or hyperpigmentation can undergo micro needling without the possibility of worsening the pigmentation and discoloration of their skin. Micro needling in skin treatments continues as a form of better penetrating medications into the desired skin area. For instance, people who are using minoxidil for alopecia treatment of hair loss can micro needle prior to the application of the medication.
Although, micro needling has a better side effect profile than other treatment options, there are several issues that may be experienced. Most of these side effects are temporary and go away with time. Micro needling can cause short term swelling, redness, and skin flaking. The usual duration of these side effects are a few days post- procedure. Micro needling can worsen active acne outbreaks. Therefore, it is advised that you should not undergo the procedure until the inflammation of the outbreak is gone. It is also safe practice that once you finish micro needling, your skin will be more sensitive to sunlight, so sunscreen application is extremely important.
During the process of micro needling, often the skin will bleed. This is dependent on each situation, like the area being treated, the length of the needles, and the pressure being applied. Although the thought of bleeding during a procedure is not usually a good, in microneedle it shows the beginning of skin rejuvenation. When the microinjuries occur, the skin will then go into the healing process. This process includes the formation of epidermal growth factors, and fibroblast. This is the beginning of treating those unwanted hyperpigmentation and the creation of new collagen in the skin.
Micro needling is a procedure that is best done by a professional who is trained in administering this procedure. A lot of beauty stores carry over the counter versions of micro needling equipment. However, if not done properly skin damage can occur. In addition, the concern of proper sanitation is something that is a risk when done at home.
References:
Gowda, Asha et al. “A Systematic Review Examining the Potential Adverse Effects of Microneedling.” The Journal of clinical and aesthetic dermatology vol. 14,1 (2021): 45-54.
“Microneedling.” Yale Medicine, Yale Medicine, 24 Sept. 2022, www.yalemedicine.org/conditions/microneedling.