What is Skin-needling? Skin-needling is the penetration of the skin by very small needles. This can be in the form of a stamp type tool with a long handle, a roller, or a mechanical device, known as a dermapen, micro-needling pen or needling device.
The penetration of the needles at a certain depth creates micro-trauma, which initiates the wound healing response. New collagen is produced during the wound healing process, and old misaligned collagen is broken down and removed by the body. This is particularly important when dealing with scar tissue and stretch marks. Over the next few weeks, a new collagen and elastin matrix is created, which continues for up to several months. This new matrix will start to thicken the skin and improve skin texture giving the skin a fresher, more youthful glow.
These “micro-injuries” do not leave scars; they work by helping to stimulate the skin to repair itself naturally through a process called dermal remodelling.
What conditions does micro-needling treat?
Micro-needling is used to treat a variety of skin conditions that cause depressions in the skin such as acne scarring, surgical scars, other scars, burns, enlarged pores, wrinkles, and stretch marks.
History of needling
It is believed that skin needling originated from an old Traditional Chinese treatment. Acupuncture needles would be inserted beneath scar tissue with a view that this would stimulate the healing process and reduce the scar tissue. The very first recorded use of needles was originally designed for product absorption back in 1998.
It was discovered that inserting microneedles 0.15mm in length and left in the skin for ten seconds increased the absorption of the products into the skin by a 10,000 fold increase.
How does Micro-Needling work?
The micro-needle roller works in two ways. The first is that it assists transdermal absorption, and the second by increasing collagen production.
Epidermis – This is composed of four layers except on the palms and soles of the feet, where you will have the Stratum Lucidum.
Stratum Corneum – This is the surface layer of the epidermis. It is a layer of flattened keratinocytes. This layer is what provides the skins waterproof barrier. This layer is 0.01- 0.02mm thick, so very short needles can be used to puncture it and increase transdermal absorption.
Stratum Granulosum – This section consists of 3-5 layers of flattened keratinocytes undergoing cell death.
Stratum Spinosa – This is the second deepest layer of the epidermis. It is made up of 8-10 layers of many-sided keratinocytes. There has been a dramatic increase in the thickening of this layer from micro-needling.
Stratum Basale – The deepest layer of the epidermis, this section contains some cells, which are stem cells that continually produce keratinocytes.
Dermis – Lying beneath the epidermis, the dermis comprises the majority of the skin’s thickness. Minor trauma to this area caused by needles causes the fibroblasts to induce collagen as part of the wound healing process.
Benefits of Micro-Needling: Facial Rejuvenation
The increase in collagen and elastin will help tighten skin and thicken skin, reducing and preventing the thinning of skin due to the ageing process.
Fine lines and wrinkles are smoothed and relaxed, enlarged pores reduced in size and skin luminosity restored.
Benefits of Micro-Needling: Scars
Skin-needling has great success at reducing the appearance of scars. It is great for acne scarring, It will work equally as well of hypertrophic (raised scars) and atrophic (sunken scars) however, those with a previous history of Keloid scarring scar tissue; are strictly contraindicated. Scars are created when an increase of collagen forms over or around an area where trauma has occurred. This misalignment of collagen causes a disturbance in the basketweave matrix of normal healthy skin, leaving the client with scar-like indentations or raised bumps on the area.
Benefits of Micro-Needling: Stretch Marks or Striae
Stretch marks differ from scars resulting from trauma. When there is a rapid expansion of skin, the collagen and elastin matrix is stretched out of alignment, and the result is silver, pink or red lines absent or containing little of the collagen matrix.
Stretch marks can take considerable time to see results. However, when results are seen, they are often quite impressive.
From case studies that we have seen personally, stretch marks respond better to an aggressive needling technique. The trauma stimulates collagen and elastin to rebuild in the area.
Benefits of Micro-Needling: Cellulite
Cellulite is caused by fat cells becoming swollen and pushing through the collagen and elastin matrix at the basic level.
When the fat cells begin to push through the healthy basket weave matrix of collagen and elastin, they distort the matrix producing a dimple like appearance associated with cellulite. Many clinicians use micro-needling to effectively assist this condition.
The exact mechanism by which this works is not yet understood. It is possible that micro-needling benefits this condition by producing a new stronger collagen and elastin matrix, which can then better control the swollen fat cells.
Benefits of Micro-Needling: Hyper-pigmentation
Hyper-pigmentation The causes of hyperpigmentation are complicated, as are the ways in which micro-needling benefits it.
Many cases are found in individuals with darker skin, such as those of African and Asian origins.
Excessive sun exposure is a key-cause, but there can be various other causes, including acne vulgaris.
This treatment is a godsend to many Asian clients, where other conventional salon treatments are more high risk for them.
For example, IPL Skin Rejuvenation and Microdermabrasion can cause heat and friction to the skin’s surface, causing further hyperpigmentation or pigment loss.
Scientifically the main cause of hyperpigmentation is disorders of the melanocytes which produce melanin.
The mechanism by which micro-needling benefits hyperpigmentation has not yet been studied.
However, it is believed that the micro-needling breaks down pockets of melanin and normalises the signalling between the keratinocytes and melanocytes and normalise melanogenesis and melanocyte differentiation.
Benefits of Micro-Needling: Rosacea
This is a chronic skin condition characterised by redness of the face.
The use of micro-needling to benefit this is relatively recent but has shown positive results.
Medically, rosacea is associated with hypersensitivity of the blood vessels in the face. The constant expansion of these blood vessels causes the redness of the face.
This constant expansion leads to the weakening of the collagen and connective tissue between the blood vessels.
Once this is damaged, the blood vessels can expand more easily and are closer to the surface, making the appearance of rosacea worse.
Long term rosacea can also lead to scar tissue forming in the skin.
Micro-needling can assist by thickening and strengthening the collagen and elastin matrix.
Micro-needling should not be done on clients with pustular or nodular rosacea.
Benefits of Micro-Needling: Acne
The use of micro-needling on acne is highly effective but also difficult to perform effectively. Micro-needling can be used to increase the absorption of the products that benefit acne.
However, rolling across active acne will spread the bacteria. This means that the treatments must be performed in between outbreaks or around active areas.
If treating acne, ensure your clients are not taking acne medications that are contraindicated with micro-needling.
Benefits of Micro-Needling: Enlarged pores
Enlarged pores are particularly common on the nose and cheeks but can also be found elsewhere on the face.
In China, they are treated by tapping the area with a derma stamp to increase circulation. Over time this reduces the size of the pores.
The micro-needling works in the same way, and over time, it improves the texture of the skin and inducts collagen to that area, reducing the size and appearance of the enlarged pores.
Benefits of Micro-Needling: Hair loss
Micro-needling can effectively benefit several different types of hair loss.
The first of these is Androgenetic Alopecia, more commonly known as male pattern baldness.
Despite its more common name, it also occurs in women in the form of thinning hair.
Micro-needling works well in postpartum hair loss. Although this type of hair loss naturally resolves over time, micro-needling appears to reduce the amount of hair loss and speed up recovery time.
Micro-needling helps hair loss by increasing the release of endothelial growth factor, which has been shown to promote hair growth, increase follicle and hair size, and benefit platelet-derived growth factor, which helps the interactions that lead to hair canal formation.
Combined with the use of Minoxidil, the micro-needling allows the product to be absorbed better, giving far better treatment results.
We recommend a diagnosis from a specialist before hair treatments.
Contraindications/cautions
Any open skin wounds, including broken skin, scabs, wounds, bleeding skin and blisters, should be avoided.
If there is a history of cold sores, it is best to begin taking acilovir medication before beginning skin needling as any form of skin needling can activate the immune system and cause an outbreak of cold sores.
Pustular acne spots should be avoided. Skin needling should only be done in between outbreaks.
Rashes, psoriasis, eczema, pustular or nodular rosacea and fungal infections should all be avoided.
Contagious skin conditions should be avoided.
Raised moles, warts or moles that have changed shape or colour and unidentified skin growths should be avoided.
Bruised skin can be painful to treat and should be avoided.
Skin cancer must be avoided.
Keloid scars are a strict contraindication.
Anti-coagulant medications as these prevent the blood from clotting.
Any medications that cause photosensitivity as this can lead to Post Inflammatory Pigmentation (PIP)
Areas, where topical medication is being applied as the product can be forced trans-dermally and may cause unwanted side effects.
Cosmetic treatments such as microdermabrasion, IPL, chemical peels or cosmetic surgery until all signs of inflammation has gone.
Skin needling over Botox will reduce its effectiveness. It is best to wait until the client is due for her next Botox injection or simply avoid the area where the Botox has been injected.
Pregnancy is a contraindication as it may stimulate PIP. It is advisable to leave skin needling until six months from the birth or six months post breastfeeding to allow the client’s hormones to regulate.
Haemophiliacs are a strict contraindication.
Aftercare
There will normally be redness in the area. This is normal and is a result of the inflammation that causes collagen induction. This will usually clear within a few hours but can persist for up to 2 days in some cases.
You may experience some itchiness in the area due to the release of histamines. An antihistamine may assist in the reduction of this.
Some dry skin may be experienced, and a hydrating skincare cream is useful to assist this. This dry skin is caused because the moisture barrier of the skin has been breached by the needles and is a normal reaction.
The skin may feel tender to touch.
You may experience an immediate feeling of tightening in the skin. This is because skinneedling immediately shortens the elastin fibres so tightening the skin.
You may also be more sensitive to sunlight straight after treatment. This effect can last for several days. Avoidance of direct sunlight is preferable, and if this is not possible, SPF 30 or above sunscreen should be applied.
In rare cases, there may be some bruising, swelling or marks where the needles have entered the skin.
In rare cases, small pustules may form on the skin. They should disappear on their own. If they persist, please see a GP.
What to Do Following a Treatment?
Try to leave the products on overnight that were used during your treatment.
In the morning, wash your face/body area with a sensitive face or body wash and a clean flannel.
Pat the area dry with a clean towel.
Apply a soothing cream to hydrate skin.
Apply an SPF of at least 30. And try to avoid direct sun exposure for at least two weeks.
Makeup can be worn; however, Mineral make up is preferred, and clean brushes should be used to apply the makeup.
If you experience any unexpected adverse reactions, please contact your practitioner or seek medical attention.
Results/expectations
After the first treatment, the skin will often feel tighter and look fresher.
The increase in collagen induction begins within 48 hours of treatment. However, it usually takes at least four weeks for superior results to be seen.
The results will continue to improve for 3-12 months after the treatments as a whole new collagen matrix is formed within the skin.
New collagen laid down should last for a period of 5-7 years, making micro-needling a very long-lasting treatment.
The collagen induction will usually result in a decreased appearance of lines and wrinkles and an increase in the firmness of the skin.
Depending on what is being treated, there should also be a reduction in visible scar tissue, reduced signs of UV damage, tightening of the skin, reduced hyperpigmentation, less rosacea, thickening of the skin, reduced skin laxity, increase in scalp hair.
