Wendy Lewis explores the buzz surrounding skin needling | Plastic Surgery Practice July 2014
By Wendy Lewis
Skin needling, also called microneedling therapy, collagen induction therapy (CIT), and percutaneous collagen induction (PCI), is a minimally invasive skin-rejuvenation procedure that involves the use of a device that contains fine needles. The needles are used to puncture the skin to create a controlled skin injury. Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin. Through the process of neovascularization and neocollagenesis, there is improvement in skin texture and firmness, as well as reduction in scars, pore size, and stretch marks.
Among the earliest proponents was Michael Pistor, the French doctor who is credited with having developed mesotherapy in 1952. In the 1990s, Montreal plastic surgeon Andre Camirand, MD, experimented with using tattoo guns without ink to treat postsurgical scars. South African plastic surgeon Des Fernandes, MD, founder of the Environ™ skin care range, introduced skin needling using a roller for treating vertical perioral wrinkles at the International Society of Aesthetic Plastic Surgery (ISAPS) congress in Taipei in 1996.
There has been a recent proliferation of devices and systems on the market in this category that vary in the diameter and length of the microneedles, generally ranging from 0.5 to 3.0 mm. Essentially, there are two basic categories of devices: battery- and cord-powered systems. Each design has some advantages, and personal preference determines operator selection. There are also flat-edged tips versus beveled tips. Current devices range from mechanical to manual models with shorter needle lengths designed for home use to rollers or stamps with longer needles designed for skin professionals only.
PCI has proved to be a simple and fast method for safely treating wrinkles and scars. Because the epidermis remains intact, the procedure can be repeated safely and is also suited to regions where laser treatments and deep peels are not typically performed.1 PCI therapy is now becoming widely used as a treatment for photoaged skin to improve the skin’s appearance and quality, and to improve or even prevent scarring.2
Microneedling can be performed in an office setting and does not require extensive training or costly equipment. Single-use systems are available for up to a few hundred dollars, with multiple-use devices costing roughly a few thousand dollars, depending on the model. It is cost-effective, and can be done on areas of skin that may not be suitable for peeling or laser resurfacing, such as around the eyes and mouth, hands, and chest. The procedure is well tolerated by patients with minimal downtime, and can be easily personalized by going deeper on some areas where skin damage requires a more aggressive approach.
Topical anesthetic cream is used to keep the patient comfortable during the procedure. Patients should be advised that multiple treatments will be necessary. The number of needling sessions depends on the individual skin condition. Three or four treatments may be recommended for mild to moderate acne scarring, whereas deeper scars and stretch marks may require upward of five treatments. An interval of 4 to 6 weeks between treatments is typically recommended. Many practitioners are also doing maintenance treatments at intervals of 6 to 12 months. When utilized for generalized skin resurfacing, products such as topical growth factors and antiaging serums are better absorbed in the skin as an adjunct to treatment.
“Microneedling is a safe, chemical-free method that triggers new collagen production,” says Beverly Hills, Calif, nurse and aesthetic trainer Sylvia Silvestri, RN. “Because it can be performed on all skin colors and types, it is sometimes the preferred treatment over laser as there is no risk of burning the patient.”