Micro Needling

Micro Needling is a safe and effective way to treat scars including acne scars and scars to the body, stretch marks, pigmentation, fine lines and wrinkles.

Is Micro Needling The Next Big Thing?

ACNE SCARRING
Micro-Needling treatment can provide dramatic results improving the appearances of acne scars. The micro needles create new collagen and elastin to be generated and deposited called collagenesis, however the added benefit of new capillary growth is also a result which can improve blood supply to the area which helps create healthier existing skin as well as provide a healthy foundation for the new skin. The physical nature of “skin-needling” breaks up this fibrous and uneven scar tissue and stimulates the growth of new tissue. Currently there are ablative and non-ablative treatments offered which can damage the epidermis and evaporate the skin leading to thinner epidermis problems. The Micro-Needling keeps the epidermis integrity full intact while treating the area which quickens healing time and causes less pain.

HOW MANY TREATMENTS DO I NEED?
For the treatment of acne scarring, it is recommended that the treatment be performed once every four weeks for a minimum of five treatments in total. Treatments performed more frequently are not recommended, as the skin is healing and undergoing the natural process of collagen induction. Consult with our physicians to discuss ongoing treatment after the initial five.

• There are differences between facial microneedling at home and in office treatments.  Dr. Kerner advises Is Facial Microneedling at Home Safe and Effective? 

FINE LINES AND WRINKLES
Wrinkles are lines, folds, or ridges in the skin caused by aging, sun damage, poor hydration and nutrition, and smoking. Wrinkles form where elastin is decreased and subdermal fat is reduced. Matrix metalloproteinases (MPPs) have been implicated as they increase in concentration with age. The MMPs include collagenases (cleaves fibrillar collagen), gelatinases (cleaves IV collagen and gelatin), and stromelysins (cleaves extracellular matrix proteins). With age, the balance between creation and destruction of dermal proteins shifts to destruction.

The treatment of wrinkles has historically taken three paths:

Take off the peaks – through surgical or laser dermabrasion, now a largely abandoned practice.
Elevate the troughs – by adding dermal volume either endogenously by Micro Needling treatment or exogenously by injecting dermal fillers.
Change the tension – through surgical lifts or botox.
Both Micro Needling and dermal fillers can been used for fine lines and wrinkles. Both treatments elevate the troughs of wrinkles. Micro Needling is used for both dynamic and static wrinkles; fillers are generally reserved for static wrinkles. (Botox is used for dynamic wrinkles.)

Micro Needling produces controlled micro-injuries that reengage the healing cascade and produce collagen and elastin in the dermis. The body’s own collagen adds volume to the dermis (Aust et al., 2008). Histological examination reveals a thickening of the dermis by 50% and an increase collagen and elastin deposition. The collagen has the normal basket weave structure. Dermal fillers generally thicken the dermis by the physical volume of the introduced substance. There are exceptions, however. Calcium Hydroxyapatite (Radiesse) provides a scaffold for the body’s collagen. Polylactic Acid (Sculptura) stimulates collagen production as the particles degrade. Because exogenous substances are injected into the skin, irritant and allergic reactions are possible with dermal fillers.

The onset of the dermal thickening effect depends on the mechanism of action.  Micro Needling uses the body’s healing to produce collagen and dermal thickening, like the fractional laser, it takes time for the patient to see the effects of treatment.  Collagen production continues for 60-90 days (Aust et al., 2008; Aust et al., 2010).  The dermal thickening effect for most dermal fillers is immediate (except for PPLA and Calcium Hydroxylapatite).

Patients will be impressed with the Micro Needling treatment in 30 days, so the clinician must tailor the expectations, perhaps by marketing a multiple treatment package.  The delayed results are similar to fractional laser or RF treatments.

The side effects Micro Needling are predictable and mild.  The down time after therapy is a matter of just a few hours and consists of mild erythema with a subjective feeling of tightness – like that of a sunburn.   With careful selection of topical solutions, the incidence of allergic reactions is minimal.  The actual filler effect is provided by the body’s own collagen, so reactions due to chronic exposure don’t exist.

There are anecdotal reports of Micro Needling being used to correct the lumps and bumpsleft by dermal fillers.

STRETCH MARKS

Known collectively as striae (such as in striae distensae, striae gravidarum, striae atrophicae, and more), stretch marks are those unsightly, off-color stretch that arise from tearing of the skin from sustained stretching. Stretch marks are most commonly associated with physical changes due to rapid growth, muscle building, weight gain, pregnancy, or even puberty. While not usually a cause of physical problems requiring medical intervention, many people feel embarrassed at the appearance of stretch marks on their bodies and would like to see them faded or even completely gone.

Prescription retinoids, dermabrasion, and laser resurfacing are commonly used therapies to improve the appearance of stretch marks, but so far there is no “gold standard” treatment. These methods may not be effective in some cases or, as with lasers, bring with them potential side effects and risks many patients simply don’t want. Lasers are also limited in their ability to treat darker skin because the energy needed for effective treatment may cause burning and, in the case of stretch marks, the skin to be treated is often very sensitive and/or thin. Numerous creams are also available but their effectiveness is questionable at best.

One truly safe, effective solution for stretch marks on almost anyone is Micro Needling dermabrasion. The motorized, piston-driven Micro Needlinga features an array of tiny, ultra-thin surgical steel needles at its tip that rapidly puncture the skin to make thousands of tiny wounds as the device is passed over the skin. With topical anesthetic there is virtually no discomfort, and the tiny wounds heal rapidly so downtime is minimal—one day or even less. This micro wounding causes stimulation of the body’s natural healing processes without causing much real damage to the skin. Newer, healthier skin is produced during the healing process. This type of treatment is called collagen induction therapy (CIT). Additionally, Micro Needling treatment may include the application of topical serum that, because of the many minute holes in the skin created by Micro Needling, will penetrate and perform more effectively. Treatment with Micro Needling is also relatively inexpensive.

One potential side effect of other treatments is post-inflammatory hyperpigmentation, which is more common in patients with skin of color and quite difficult to treat if it arises. With Micro Needling, the nature of the micro-wounding creates conditions favorable to orderly healing response and clearance of cellular debris, with little excess inflammation, so the significantly reduced incidence of PIH is a major benefit of Micro Needling therapy for any condition.

With perhaps 5 or 6 sessions at intervals of about four weeks between treatments, patients will be pleased at the way stretch marks fade and skin texture improves. Some patients report seeing a difference after a single treatment, but the full result will not reveal itself until several weeks after the final treatment session.

With perhaps 5 or 6 sessions at intervals of about four weeks between treatments, patients will be pleased at the way stretch marks fade and skin texture improves. Some patients report seeing a difference after a single treatment, but the full result will not reveal itself until several weeks after the final treatment session.

PHOTOAGING AND HYPERPIGMENTATION

Microdermabrasion, or abrasive removal of epidermal tissue for therapeutic ends, has numerous applications and has long been a less aggressive alternative to indications treatable by laser- or other energy-based therapies.[Karimipour 2010] In terms of the microneedle realm, microneedle dermabrasion (also known as percutaneous collagen induction, or PCI) could be simply defined as causing thousands of microscopic columns of epidermal damage via microneedle with the goal of stimulating neocollagenesis (among other benefits) for therapeutic effect, leaving the majority of the skin intact with only temporary compromise of barrier function.  Treatments will vary depending on skin damage.

WHAT CAN BE EXPECTED WHEN GETTING MICRO-NEEDLING

Day 1 and 2 A red or pink hue persists, similar to a moderate sunburn. Swelling may be more noticeable on the second day.

Day 3: Skin can be pink or simply remain normal in color. Swelling subsides. Our office will prescribe an Oxygen facial to help with soothing and calming of the skin Active skincare can be resumed again after day 3.

HOME CARE:
A. Wash the face thoroughly a few hours after treatment. Gently massage the face with tepid water (a shower can provide an easier ability to massage the face while washing at the same time), and remove all serum and other debris such as dried blood. This will improve the appearance of the skin and also allow for better subsequent absorption of PHYTO-BOOST serum. Mineral makeup may be applied the following day.
B . For the first 1-3 days the skin will may feel dry and tight. Frequent use of our soothing serum will help alleviate this as, well as the use of moisturizers.
C. After 2-3 days patients can return to regular skin care products or as soon as it is comfortable to do so. Vitamin A products are optimal and suggested.
D. Avoid alcohol based toners for 10-14 days.
E. Avoid direct sun exposure for at least 10 days if possible.
F. Do not apply chemical sunscreen the same day as treatment. Undesirable chemicals can penetrate if used in large amounts. Only Use approved  sunscreen.

REMEMBER:

CLEAN – Use a soothing cleanser or face wash with tepid water to cleanse the face for the following 48 hours and dry gently. Always make sure your hands are clean when touching the treated area.
HEAL – Copper based skincare is recommended post treatment as the mineral properties are perfect to help heal the skin but will also create a sterile skin too.

MAKE-UP – It is recommended that make up is not applied for 12 hours after the procedure although your practitioner may be able to supply you with specialized mineral make-up that they feel would be suitable for use during this period. Do not apply any make-up with a make-up brush, especially if it is not clean.