It’s no secret that the majority of people look in the mirror at some point and think, “How did so much time pass?” or “When did these fine lines sprout up?” or “I wish I could erase those acne scars.” Later, we’re thumbing through our Facebook posts and Instagram feeds and see advertisements for microneedling coupled with pictures of before and after photos. It’s tempting, but the first question that crosses our minds is whether or not it actually works. Do these strange needled instruments actually help your skin and possibly reverse time?
Microneedling is an increasingly popular, minimally invasive procedure involving lightly puncturing the skin with a handheld rolling device or pen containing fine needles. The device administers tiny pinpricks to the skin in order to encourage the body's natural healing responses. In response to perceived risks, the FDA has stepped in to issue draft guidance regarding when at-home microneedling devices are considered to be medical devices and thus subject to regulation.
The theory is that the needles create a controlled injury that causes the skin to heal itself, resulting in the creation of collagen which tightens the skin. It was initially introduced for skin rejuvenation; however, it is now being used for a wide variety of indications including scars, alopecia, skin rejuvenation, excessive sweating, stretch marks, and more.
Microneedling at home
One of the main questions that you might have is whether or not at-home microneedling is different from a clinical procedure. If you plan to do microneedling at home, you should be sure to speak with your doctor or dermatologist on the specific instrument and needle size that would be safe and healthy for your skin as well as the pre- and post-treatment skin routine to ensure the best and safest results. Typically, at-home needling may be less invasive than clinical procedures as the needle size is smaller and doesn’t puncture so deeply into the skin. However, this doesn’t necessarily mean that it will ultimately be less effective, it simply means that the repetition may need to be more frequent. Using an at-home device could pose a risk if it is not kept properly sterile, if it is not uniformly applied or if it is used on open wounds or infected skin.
Clinical microneedling
If you are looking into having a clinical procedure done, make sure to have a consultation with your doctor and confirm that they plan to use a substance like pure hyaluronic acid or saline while needling to help hydrate your skin. To obtain optimal results, many doctors will recommend multiple procedures over an extended period of time. The procedure itself lasts between 20 and 30 minutes. To keep patients comfortable during the procedure, a topical anesthesia is applied to the treatment area about 45 minutes to an hour before the procedure begins. The procedure is minimally painful but may leave minor bruising or inflammation for a few days after completion. Also, you will experience some bleeding during the procedure, but it is typically minimal and manageable. It is important to follow all pre- and post-procedure instructions because your skin will be slightly more vulnerable.
What are the risks?
Certain adverse events are known to have occurred with the procedure, the common ones being potential erythema (redness) and irritation which usually subside within a few hours. Other various complications are possible like, post-inflammatory hyperpigmentation (dark patches), aggravation of acne, systemic hypersensitivity, allergic or inflammatory reactions and local infections following the use of a nonsterile instrument.
As with all medical treatments, it is important to educate yourself about potential risks and benefits. Although microneedling may be right for many people and skin types, there are contraindications including active acne, herpes infection, psoriasis, blood thinners and recent chemotherapy, The key is to make sure you speak with your doctor to see if it makes sense for you.
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AK: Dermatologists
CA: Saint John’s Health Center; Providence Medical Institute Dermatology and Laser Center