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Is Microneedling an Alternative to Lasers?

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While lasers can work wonders for some skin types, it’s not the ideal treatment for everyone. Specifically, individuals with Fitzpatrick Types III to VI are prone to post-inflammatory hyperpigmentation (PIH). This is where microneedling can provide patients a much-needed alternative.

“Microneedling doesn’t pose risk of hyperpigmentation for darker skin types making it a very valuable tool of improving skin texture for women of color,” said Masha Banar, inventor of MesoLyft and founder of Visage Sculpture, a Boston-based clinic specializing in nonsurgical facial shaping. “Exposure to the sun after microneedling can pose some risk of hyperpigmentation for any skin type, so you have to apply sunscreen and avoid direct sunlight for several days after the treatment.”

“Microneedling doesn’t pose risk of hyperpigmentation for darker skin types making it a very valuable tool of improving skin texture for women of color.” -- Masha Banar, inventor of MesoLyft and founder of Visage Sculpture.

Banar noted that many nonablative laser treatments are based on specific wavelengths of light penetrating the upper layer of the epidermis, stimulating new collagen production. Microneedling follows the same concept without the light or heat, which causes a reaction in some patients.

“One can argue that some laser treatments and microneedling would achieve similar results, but both would depend on the length of the needle and the wavelength of light and how deep they penetrate the dermis,” she explained. “That would dictate how fast the results will be achieved, but also how extensive inflammation and downtime would be. Conditions helped by both treatments include loss of collagen and tightness of skin, fine lines, large pores, scars and even stretch marks.”

Microneedling in Practice

Because fractional lasers use thermal injury to instigate tissue remodeling, both darker skin types as well as lighter skin types in the summer months can be susceptible to pigmentation issues associated with their use.

“One can argue that some laser treatments and microneedling would achieve similar results, but both would depend on the length of the needle and the wavelength of light and how deep they penetrate the dermis.” --Masha Banar

“This has to do with presence of more chromophore/pigment in dark/tanned skin as well as the type of reaction the body has after a thermal injury verses a mechanical one, such as microneedling,” said Jelena Boldt, senior director of marketing for Bellus Medical, manufacturers of SkinPen. “This raises the risk-benefit ratio for these patient types, and, therefore, has traditionally limited use of fractional laser therapy on those populations.”

But that’s not to say that fractional lasers will be replaced by microneedling. Boldt noted that there is a place for both modalities in a medical spa setting.

“Since the capital loss of acquiring a laser can be quite large and the cost of [microneedling equipment] is quite low comparatively, it makes good sense to have both so that you can broaden the demographic that you are able to successfully and safely treat for scarring, wrinkles [and] general cosmesis.”

Ideal patients for microneedling include anyone looking for a reduction in the appearance of scars, especially acne scarring, or fine lines and wrinkles. Boldt pointed out that while there is still limited clinical evidence as to what other indications microneedling can be efficacious for, there are very little restrictions for who can receive microneedling.

Pre- and Post-Treatment Care

As with most medical esthetic devices, proper training is essential when considering adding microneedling to your medical spa’s repertoire. Patients should also be educated in pre- and post-treatment care, which can also have a big impact on results, according to Crystal Kwon, senior sales and marketing manager for Clinical Resolution Laboratory Inc., manufacturers of InnoPen.

Kwon advises patients take the following precautions before and after treatment.  

Before treatment:

  • Physician may need to prescribe appropriate antiviral medication prior to treatment for individuals with a history of herpes simplex infections or cold sores as microneedling could trigger a breakout.
  • No Retin-A products or applications for 12 hours prior to treatment.
  • No autoimmune therapies or products for 12 hours prior to treatment.
  • No aspirin or non-steroidal anti-inflammatory products for at least 10 days prior.
  • No prolonged sun exposure or sun burns to the treatment area 24 hours prior to treatment.
  • Skin should be clean and makeup free on the day of treatment.

After treatment:

  • Avoid sun for at least seven to 10 days after treatment, and take precautions against direct sun exposure. No tanning beds.
  • Apply a broad-spectrum UVA/UVB, chemical-free sunscreen with SPF 30+ designed for use after cosmetic procedures.
  • No vigorous exercising or activity for at least 48 hours post-treatment.
  • Avoid steam baths, saunas or swimming at least 48 hours following the treatment.
  • Do not apply makeup on the same day of treatment.
  • Use tepid water to cleanse the treatment area thoroughly while gently massaging to remove debris. Carefully pat dry without rubbing.
  • Avoid use of sensitizing drugs, skin cosmetics or cosmetics that contain mineral oils, acids or alcohol-based toners.
  • Use post-procedure skin care products prescribed by the practitioner to soothe, calm and protect the skin until fully recovered and ready for normal skin care.

Note: treatments that a licensed esthetician may perform in a medical spa space vary by state. Please consult with your state board before adopting or performing any unfamiliar treatment.