Microneedling
Must Know Facts About Microneedling
Microneedling is a very simple, safe, cheap, effective, and minimally invasive therapeutic technique… that has gained mass popularity and acceptance over a short period of time. In particular, it is a very safe technique for dark skin types, where the risk of post inflammatory hyperpigmentation is very high with other techniques that damage the superficial layers of skin, i.e., the epidermis.
Uses of Microneedling
Traditionally, it was used as a collagen induction therapy for facial scars and skin rejuvenation. A very wide range of other indications include acne scars, acne erythema, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, Traditionally, it was used as a collagen induction therapy for facial scars and skin rejuvenation. A very wide range of other indications includes acne scars, acne erythema, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, stretch marks, and many more. It is also widely used now as a transdermal delivery system for therapeutic drugs and vaccines.Get Closer with Us
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The Instrument
The standard medical dermaroller has a 12 cm long handle with a 2 × 2 cm wide drum-shaped cylinder at one end studded with 8 rows and 24 circular arrays of 192 fine microneedles, usually 0.5–3 mm in length and 0.1–0.25 mm in diameter. Rolling with a standard dermaroller over an area of skin for 15 times results in approximately 250 holes per square cm up to the upper dermis depending on the pressure applied.
Advanced and automated versions of microneedling devices – Nanopore is available at our clinic for faster and a better-controlled procedure.
Mechanism of Action
Micropunctures are created using microneedles which produce a controlled and spaced out skin injury without actually damaging the epidermis. These micro-injuries lead to minimal superficial bleeding and set up a wound healing cascade with the release of various growth factors such as platelet-derived growth factor (PGF), transforming growth factor(TGF-α and TGF-β), and fibroblast growth factor (FGF). The needles also breakdown the old hardened scar strands and allow it to generate new blood vessels.
Neovascularization and neocollagenesis is initiated by migration and proliferation of fibroblasts and laying down of intercellular matrix. A fibronectin matrix forms after 5 days of injury that determines the deposition of collagen resulting in skin tightening persisting for 5–7 years.
Procedure and Post Procedure
Microneedling is a simple office-based procedure lasting 10 to 20 minutes depending on the area to be treated. The patients are counseled prior to the procedure explaining the expected outcomes, delayed response, and need for multiple sittings. The skin is preferably prepared preoperatively with vitamin A and C formulations twice a day to maximize dermal collagen formation. The procedure is performed under topical cream-based anesthesia for 45 minutes to 1 hour. After preparation of the area with antiseptic and saline, the skin is stretched with one hand, and perpendicularly, rolling is done 5 times each in the horizontal, vertical, and oblique directions with the other hand. The treatment endpoint is identified as uniform pin-point bleeding which is easily controllable.
Post-procedure, the area is made wet with saline, or ice packs can be used for comforting the patient. Thereafter, the patient is advised to use sunscreen regularly and follow sun-protective measures. The procedure is well-tolerated by the patients and there are usually no post-treatment sequelae except slight erythema and edema lasting for 2–3 days. There is no downtime and the patient can resume daily work the very next day.
Treatments are performed at 3–8 week intervals and multiple sittings are needed to achieve the desired effect on the skin. The final results cannot be viewed immediately because new collagen continues to be laid down for approximately 3–6 months after treatment has ceased.
This technique can be combined with other surgical techniques to provide better results. Use of topical anti-aging and anti-pigmentation serums aids in better delivery of drugs at a deeper layer of skin. It is also combined with PRP for facial rejuvenation (vampire facelift) and hand rejuvenation or for hair growth on the scalp. Microneedling can be used for inducing a microinjury related response in alopecia and vitiligo and also for deeper drug delivery.