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Complete Guide to Microneedling

 

What is Microneedling?

Microneedling is interchangeably called skin needling, collagen induction therapy (CIT), percutaneous collagen induction (PCI), or more commonly dermarolling. This skin rejuvenation procedure uses a device which contains fine needles. Dermaroller has grown in popularity due to favourable media coverage and has few serious side effects. During the microneedling treatment, thin needles puncture the skin's surface creating micro-wounds. The wound creation triggers the body’s natural defences, and it begins to produce new skin cells, capillaries and collagen to repair the damage. This natural repair process caused by microneedling eventually leads to the younger-looking skin which is also firmer and plumper. The youthful appearance of the skin is mainly the result of collagen growth. A certified skin care specialist usually carries out this treatment in a clinical setting. The micro-needles differ in their size, length and construction and are chosen based on the type of skin condition to be treated. There are many microneedling device brands such as Innopen, dermarollers, Dermapen, and Dermastamp. At-home devices are less-effective as the shorter needles provide significantly less penetration. People who want a younger-looking skin or who want to treat various skin conditions are turning to this treatment due to its numerous benefits over other procedures that address similar issues.

 

A brief history of microneedling

The earliest form of microneedling, acupuncture, traces its roots to the Chinese centuries ago. The significant milestones in the development of microneedling are:

  • Among the earliest proponents was the French doctor Michael Pistor, who developed Mesotherapy in 1952.
  • Dr Philippe Simonin, a Swiss-French dermatologist, published the results of his Electroridopuncture (ERP) technique in 1994. His study examined 600 patients, split into two patient groups – Skin Ageing and Old Scars. After ten treatments on all patients, 40% of the Skin Ageing group showed significant improvement and 22% moderate improvement. In the patient group with Old Scars, 60% improved with 5-6 treatments. The best results were obtained for old fibrous and depressed scars.
  • Dr Des Fernandes, a plastic surgeon and founder of the Environ skincare range, pioneered the treatment of wrinkles by skin needling using a roller. He presented his findings at the International Society of Aesthetic Plastic Surgery Congress in 1996.
  • In 1997, Andrea Camirand, a Canadian surgeon, used tattoo-guns to treat scars caused by plastic surgery. He reported a remarkable improvement in texture and colour of facial scars after camouflage tattooing done on scars. The insertion of tattoo gun needles led to the breakdown of scar collagen tissue and stimulated the synthesis of new healthy collagen leading to improvement of scar texture. This microneedling technique soon disappeared from the operation rooms because it was tedious.
  • The German inventor Professor Horst Liebl sought a new and considerably faster way of microneedling. He integrated nearly 200 non-traumatic micro-needles of medical grade into a drum-shaped device. This design transformed the “static” into a “dynamic” needling process which could more quickly treat larger skin areas. This invention was patented and trademarked as Dermaroller in the year 2000.
  • In 2006, Dr Des Fernandes developed Percutaneous Collagen Induction (PCI) therapy with the Dermaroller. Dermarollers gained popularity in the treatment of acne scars, stretch marks, and post-surgery scars. 

 

How does microneedling work? Is it safe?

Microneedling relies on the principle that growth factors are released once the needle pierces the stratum corneum (the outermost layer of the epidermis). These growth factors are believed to be responsible for the treatment of various skin conditions. At a microscopic level, specific skin cells called fibroblasts, migrate to the wound and change into collagen, resulting in increased strength and elasticity. This treatment assists in the natural repair, strength and firmness of the skin as it boosts the production of collagen. The depressed scars and wrinkles are packed with newly formed collagen, which has the effect of raising the depression so that it rises to the level of the surrounding skin. Material results are apparent in two to three months, and this treatment also supports the thickening of fine skin types.

 

Microneedling leads to three major phases of natural wound healing which results in enhanced stimulation of new healthy skin:

 

Phase 1 (days 1-3) Inflammation

Platelets are activated by the micro-wounds created in the dermal tissue. The immune system is called into action as the activated platelets release cytokines and growth factors. The body sterilises the micro-wounds and clears the debris through the help of white blood cells (neutrophils and macrophages). The supply of blood increases which kick starts the formation of new skin.

 

Phase 2 (days 3-5) Proliferation

In this phase, the fibroblasts, keratinocytes and epidermal cells continue to divide to populate the areas of damage and secrete growth factors and extracellular matrices, such as elastin and collagen, will be laid down and deposited with new tissue formation.

 

Phase 3 (days 6-30) Remodelling

Phase 3 is the reconstruction phase, where fibroblasts producing elastin and collagen multiply in the microneedling created puncture wounds. New and stronger collagen replaces the old collagen in the recently formed tissue. Also, the contraction of the dermis helps in the formation of a youthful, firm and supple skin. 

 

What are the most effective uses of microneedling?

Microneedling can be used to treat and improve the following skin conditions:

 

Wrinkles and large pores

Microneedling is valuable as a skin tightening treatment. Ageing skin droops and develops wrinkles, lines and furrows. The severity of these changes in an individual depends on the genetic tendency, skin type and exposure to environmental factors. Wrinkles occur when the skin loses suppleness and tightness as it ages. It is seen more commonly in areas of skin which are regularly stretched such as around the eyes (crow’s feet), forehead and mouth. By renewing the production of collagen, the skin becomes plumped out, thicker and retains its elasticity.

 

Acne scars

A significant proportion of acne sufferers will have some form of scarring. Medical studies suggest that between 30% and 95% of patients with acne develop some kind of scarring. Importantly, seeking early treatment for acne helps to reduce the risk and severity of acne scarring. Microneedling mechanically breakdowns existing scarring and stimulates the production of collagen and elastin, vital components of healthy skin. The collagen production has the effect of smoothing out the skin due to the reduction of the size and depth of acne scars. Clients usually have an immediate glow to the skin, but the visible changes develop over the course of several days and weeks. Collagen production continues after the treatment which implies that visible results can continue to improve for up to 4-6 months. Not all acne scars are well suited to treated by microneedling. In particular, microneedling is not well suited to treat keloid scars as there is mixed evidence of its effectiveness. Surplus collagen production leads to excess scar tissue formation which is called keloid scars.Individuals with keloids scars should consider alternative treatments such as the use of steroids.

 

Stretch marks

Prolonged skin distension due to pregnancy and weight gain causes stretch marks. It can also be caused by prolonged use of oral and topical corticosteroids which hinder the formation of collagen and elastin fibres. There is no effective treatment to correct stretch marks as the epidermis in stretch marks is weakened, and the support structure beneath it is compromised. Microneedling will improve the density of the epidermis by stimulating the epidermal growth factor, but it is important not to overpromise results.

 

Rosacea

Rosacea is most commonly seen after age 30, and may initially resemble a simple sunburn or a mysterious redness. Early treatment is essential. Rosacea cannot be cured, but it can be controlled. Microneedling can help control rosacea by stimulating the epidermal growth factor which increases the density of the epidermis. This increase in density lessens the appearance of vessels beneath the skin and the overall redness. It strengths collagen in both vessel walls and connective tissue that supports the vessels. It also increases the availability of cell nutrients and antioxidants. 

 

Hair loss

Hair loss is due to a variety of factors such as genetics, iron deficiency, infections (bacterial, fungal and parasitic) and hypothyroidism. Microneedling can help correct hair loss by increasing the availability of cell nutrients and stimulating blood flow to the scalp. It releases vascular endothelial growth factor which promotes hair growth and increases hair follicle size. Use microneedling in combination with topical products such as Minoxidil. 

 

Hyperpigmentation

It is a misconception that microneedling can cause hyperpigmentation. Microneedling in isolation regulates and normalises pigment formation. It does not cause hyperpigmentation without other influencing factors. Pigmentation occurs in two different forms - passive and inflammatory. The stimulation of our skin’s natural defence system causes inflammatory pigmentation. Trauma caused by factors such as sun exposure, inferior products or injury results in the migration of melanin to the point of damage. Passive pigmentation arises from an internal imbalance caused by pregnancy, hormonal imbalances, birth control pills and certain drugs. This imbalance stimulates the production of melanin. Microneedling can correct pigmentation by increasing the availability of skin lightening actives. It also normalises the cell signalling function which when overstimulated, causes overproduction of pigment. 

 

What should I do to prepare for my first microneedling treatment?

The microneedling treatment is more efficient with a lower risk of side effects by the following procedures.

  • Clients with a history of cold sores should take medication before the treatment. Microneedling could activate the immune system, leading to a cold sore breakout.
  • For at least a month before the treatment, you should use Vitamin A and C serums twice a day to maximise dermal collagen formation. 
  • Excessive sun exposure should be avoided two weeks before treatment.

 

What is the process involved in carrying out microneedling?

The first step is to cleanse the client’s face to ensure the skin is entirely makeup and dirt free. Microneedling is usually performed under the influence of a topical anaesthetic cream which is applied for a minimum of 45 minutes before the start of the procedure. After 45 minutes, the area to be treated is washed with saline and then an ethanol solution. The depth of penetration, the number of passes, and degree of overlap is highly dependent on the underlying condition, the treated area, the brand of device used, and the length and frequency of the needle insertion. For treating acne and other scars, the needle length selection is based on the depth of the scars present. A needle length of 1.5-2 mm is usually used for acne and other scars. The recommendation for treating ageing and wrinkles is 0.5-1.0 mm needles. Once the microneedling is complete, the treated skin is cleaned with a saline solution. The cleansing is usually followed by the application of a serum containing Vitamin A, C or E.

 

What does recovery entail?

The recovery process requires avoiding direct sun exposure, using serums (Hyaluronic acid, Vitamin A, C & E) and no hot showers. A day after the treatment, pure mineral makeup may be worn to cover the redness and also to assist healing. It is recommended to use physical sunscreen (ideally zinc based) products. For a few days, individuals should avoid chlorinated swimming pools and activities that cause excessive perspiration.

 

What are microneedling results after one treatment? How often should microneedling be done?

Microneedling should not be performed any sooner than every 30 days. The number of treatments depends on the severity of the skin condition which is being treated. Six treatments are recommended for acne scars and anti-ageing treatments. Scar treatment should be no more frequent than at least six weeks apart, ideally at 8 to 10-week intervals. The response to microneedling treatments is highly individual, and it is challenging to predict what the results will be after just one treatment. There is no limit to the number of procedures. 

 

What are the benefits of microneedling?

Microneedling is becoming very popular treatment as it has many advantages:

  • The micro channels created by microneedling increase the absorption rate of serums, increasing their overall efficacy. Medical studies have shown that microneedling can amplify the absorption of serums by a factor of 1,000 times.
  • It is suitable for all skin types and most areas on the body.
  • Microneedling complements other acne scar treatments like subcision, chemical peeling, microdermabrasion and fractional resurfacing giving maximum benefits.
  • It leads to regenerative healing, as opposed to cicatricial healing (with a risk of scar tissue formation) with most other alternative treatments.
  • It is more affordable than laser resurfacing and does not have the associated risks. Six to ten sessions at a gap of four weeks are sufficient.
  • Can be easily personalised by going deeper in some areas where the skin condition requires a more intensive approach.

 

Is microneedling under eyes safe? Are microneedling lips recommended?

Yes, microneedling under eyes is safe, and we recommend always treating below the eyes as this is the first area to show signs of loss of structural integrity. However, this is not useful for treating dark circles or puffiness under the eyes. On the other hand, microneedling lips are very painful and will not plump your lips. Lips produce much less collagen and will not show the similar collagen build-up to facial skin.

 

Microneedling vs lasers vs chemical peels vs microdermabrasion. Which is better?

Treatments such as laser resurfacing or dermabrasion, offer a significant improvement in facial scars but are invariably associated with considerable downtime and longer recovery time. This downtime interferes with the individuals’ daily activities. Treatments with microdermabrasion and non-ablative lasers are associated with minimal downtime but do not show the same level of efficacy as microneedling. Microneedling is suitable for areas that chemical peels or laser resurfacing cannot be used, such as around the eyes. With a lower risk of hyperpigmentation and scarring, it is safer for darker skin tones than lasers. Deep chemical peeling used for the treatment for scars may render the skin more sensitive to photo damage and dyschromia. In contrast, microneedling preserves and thickens the epidermis over time.

 

Are there any side effects from microneedling?

The common side effects from microneedling are stinging, dryness and flaking. Flaking may only appear about five days after the treatment.The biggest challenge is the pain resulting from aggressive treatments with longer needles 2-3 mm. It is important to have adequate anaesthesia to alleviate the pain. Another disadvantage is that microneedling takes time and money to see the results. It is recommended for most clients to receive between two and four treatments spaced approximately six weeks apart. 

 

Which serums to use with microneedling?

As stated earlier, the micro channels created by microneedling increase the absorption rate of serums, increasing their overall efficacy. It is recommended to use serums containing Vitamin A and C to help in collagen formation. Without Vitamin C, collagen fails to produce triple helixes, resulting in weak connective tissues. The weak tissue may interfere with wound healing and accelerate the ageing process. Vitamin C also protects Vitamin from oxidation. Studies show that sun-protected skin, more so than sun-exposed skin, treated with Vitamin A, results in increased collagen. Hyaluronic acid can also be used as it helps in keeping the skin hydrated.

 

How much does microneedling cost?

The price of your microneedling treatment will be dependent on your location, unique needs, area treated and the microneedling device used. Many clinics offer a free consultation to discuss your treatment plan and pricing. The recommendation for acne scars and anti-ageing treatments is six treatments. Skin Aspirations offers a free consultation along with highly competitive prices for our treatment courses. Email us at hello@skinaspirations.co.uk to book your free consultation. 

 

Microneedling price list

 
Area Single Treatment   

3 Treatments   

6 Treatments   

    (20% discount)    (30% discount)   
Half face £210

£504

save £130

£880

save £380

Full face £250

£600

save £150

£1,050

save £450

Full Face & Neck £300

£720

save £180

£1,260

save £540

 

Email us at hello@skinaspirations.co.uk to book your free skin consultation. 

 

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