Editor’s Note: As always, Skin Inc. recommends that skin care professionals know the regulations within your state and obtain the proper training before offering any new treatments or services.
Though the name initially may be off-putting to clients unfamiliar with the treatment, microneedling is quickly becoming one of the most popular procedures for skin resurfacing. Also commonly referred to as collagen induction therapy, it is proving highly valuable in its ability to improve the appearance of fine lines, acne scars and the overall appearance of the skin.
A study1 of 480 patients treated throughout 10 years with microneedling showed a 60–80% improvement, a significant increase in collagen and elastin, as well as a 40% thickening of the stratum spinosum—the epidermis’ spinous layer or prickle cell layer. With these results, microneedling could prove a game changer for clients. This modality may not be for every skin care practice, but for those offering it knowing specific care protocols before, during and after may be the difference between a satisfied client and an unhappy one.
The roots of microneedling
Skin resurfacing is said to have been in existence2 since ancient Egyptian times. While the Egyptians used products much less advanced than what’s available today, historians claim acids, sandpaper and other materials made from minerals and plants were used to slough off layers of the skin. Some of the first forms of controlled resurfacing abrasion of the skin appeared in the early 1900s when a German dermatologist used rotating wheels and rasps to treat acne scars, keratosis and hyperpigmentation.
Skin abrasion procedures didn’t start to pick up steam, however, until the middle of the century when numerous research articles on efficacy and technique began to appear. This validation helped to make skin resurfacing a more mainstream practice in the medical world.
In 1995, an early form of microneedling, called subcision, was introduced. It used a tri-beveled hypodermic needle to reach the tissue under depressed scars, wrinkles or contours, in effect creating controlled trauma to the skin, which then initiated healing of the area.2 From this innovative procedure came more techniques, which eventually developed into the sophisticated process of microneedling.
What exactly is microneedling?
The process of microneedling involves using tiny needles to create micro-perforation into the dermo-epidermal junction.
This precise stimulation creates very controlled wounding, which stimulates collagen and elastin production as the skin repairs itself. New, healthy tissue surrounds the wounded area, rejuvenating skin. Another tremendous benefit of microneedling is its ability to allow other skin-building ingredients to more efficiently penetrate the skin, where they can affect cells at deeper levels. These properties may make microneedling an excellent treatment for aging and hyperpigmented skin.
Sometimes, professionals will take microneedling as far as the upper layers of the dermis, but that depth is considered outside the scope of practice for an esthetician. While deeper procedures can help remodel scar tissue from stretch marks or acne, subcutaneous scarring can be caused if pushed too deep. This would be similar in nature to a third degree burn and not the level for estheticians to be entering unless working with a physician.
Another application for microneedling that nets great results is the treatment of melasma. Since heat aggravates this condition and there is no heat component to microneedling, it’s a suitable treatment for the repairing skin.
Microneedling in the treatment room
Microneedling is becoming more popular as clients look to more cost-effective skin-resurfacing alternatives that don’t require much downtime. But, as with any resurfacing procedure, proper training and precautions must be taken before introducing the treatment to clients.
With microneedling, the goal is controlled wounding. It is important to be careful not to bring the skin to the point of bleeding, and to rather keep the stimulation at the superficial level. The barrier function should be kept intact in order to promote optimal healing levels. Also, since this is a fairly aggressive treatment, it is best to be performed it on its own, as opposed to coupled with any other therapies. Microneedling treatments may be contained to specific regions of the skin or performed on the entire face. See Microneedling Tips sidebar.
Client consultation. Talk to clients prior to their microneedling treatment to manage expectations, educate them on proper pre- and post-care, and to outline a treatment plan. As a rule of thumb, clients need to avoid waxing or resurfacing treatments a couple of weeks leading up to the procedure. These also should be avoided folling the treatment until the skin has fully healed from the microneedling.
Clients have shown positive results after their first procedure, and they may return every four to six weeks until the desired goal is achieved.
A couple of other points worthy to note:
- Numerous websites tout at-home microneedling. Be sure to talk to clients about the dangers of this, as it may do more damage than good; and
- Caution must be used with microneedling and other resurfacing treatments for clients who may be pregnant or lactating, have active acne lesions, skin cancers or any serious health issues.
Boosting the effects of microneedling
Since microneedling supports optimal penetration of ingredients, hyaluronic acid, vitamin E, epidermal growth factors, antioxidants and peptides applied just prior to the procedure will deliver hydration, and work to fortify, rebuild and heal the skin.
Following the treatment, a milk-based mask paired with a mask containing herbs such as rosemary and basil may be used to nourish, soothe and support the skin. Hyaluronic acid, a heavy water (D2O) and a mineral-based SPF also may be applied to finish.
The effects of microneedling also may be boosted with the proper home care before and after the client’s appointment. Depending on the client’s skin type and desired outcomes, gentle enzymes, alpha hydroxy acids, beta hydroxy acids and retinols may be used prior to the treatment to prepare the skin and deepen the rejuvenation.
Following the treatment, clients may experience some redness and minimal swelling, which typically dissipates within a few hours. Skin may be slightly pink for up to 48 hours post-procedure, but these inflammatory results are a normal response as the skin works to repair itself. This, however, also means proper post-care support is imperative:
- Send clients home with hyaluronic acid, peptides, epidermal growth factors and essential fatty acids to speed the repair and recovery time, and to keep the inflammation at bay; and
- Always instruct clients to use a mineral SPF daily to protect and heal the skin.
As microneedling continues to grow in popularity, it will behoove skin care professionals to educate themselves on it. Whether you plan to add microneedling to your treatment menu—check out 5 Microneedling Musts on Page 50)—or not, clients may ask about it and it is always prudent to be in the know of new procedures and how you can support your clients if they pursue this method.
- MC Aust, D Fernandes, P Kolokythas, et. al. Percutaneous collagen induction therapy: an alternative treatment for scars, wrinkles, and skin laxity, Plast Reconstr Surg 121 4 1421–9 (2008)
(Website accessed Feb 13 2015)