Microneedling (MN) is a novel therapeutic modality in dermatology. Through physical trauma from needle penetration, MN induces a wound healing cascade with minimal damage to the epidermis. This allows for enhancement in the absorption of mainstay topical therapies across the thick stratum corneum. MN has become increasingly utilized over the last several years as it is a relatively simple procedure that is cost-effective, well tolerated, and offers both cosmetic and therapeutic benefits. The ability to treat localized areas of the disease has led to numerous studies gauging its potential in focal diseases of inflammation, dyschromia, and photodamage. This review discusses the principles and evidence behind the expanding applications of MN. It has shown promising results as adjuvant therapy for enhanced drug delivery in the treatment of atrophic scars, alopecia, actinic keratoses, and disorders of pigmentation such as melasma. The efficacy in the treatment of vitiligo remains limited. Overall, the procedure has few adverse sequelae compared to other therapies, is highly efficacious, and is a viable resurfacing option for the skin of color. Future research is needed to determine the frequency, interval, and specific device settings that foster optimal results. Additionally, large controlled trials are needed to shed light on the utility of MN as an evidence-based regimen for the treatment of various dermatologic conditions
Many different terms have been used to describe minimally invasive skin rejuvenation procedures including subsurface resurfacing and laser toning. Combination treatment is considered an approach that includes at least 2 different and unrelated modalities, such as microneedling combined with platelet-rich plasma (PRP, vampire facial) (vampire facial) or with trichloroacetic acid (TCA), or a laser or light device combined with nonlaser technology such as radio frequency.
Appropriate patient selection and a combination of different procedures allow individualized treatment with optimal outcomes. Multiple sessions of combined minimally invasive modalities, along with the use of future home devices, would fill the gap between ablative and nonablative approaches in maintaining the clinical and the histological improvement.
Combined minimally invasive procedures are used in the management of many cosmetic skin problems such as the treatment of post-acne scars, skin laxity, hyperkinetic facial wrinkles, and hyperpigmentation disorders.
Acne is prevalent in over 90% of adolescents, and it may persist into adulthood in approximately 12%-14% of cases with psychological and social impacts. In some patients with acne, the inflammatory response results in permanent, disfiguring scars from either increased tissue formation or due to loss or damage to tissue.
There are many types of treatment for post-acne scars including medical, surgical, procedural management, tissue augmentation, and various ablative and nonablative lasers and light energies. Of these multiple options, treatment has to be tailored to patient’s needs, tolerance, and goals along with the physician’s assessment, skills, and expectation. The patient should be informed that the ultimate goal of any intervention is to improve the scars, and no currently available treatment will attain total cure or perfection.
As the demand for less invasive, highly effective cosmetic procedures is growing, a combination of treatment for acne scars has shown good results with no high failure rates or loss of days at work. There is a high level of patient satisfaction, minimal downtime, and the treatment is cost-effective to the
Microneedling is considered as a newer collagen inducing procedure. The use of microneedling is gaining the momentum as laser alternative for skin tightening, skin rejuvenation, wrinkle removal, and scar treatment. Originally it started as a hand-held device that ends with a roller equipped with microneedles. The newer devices are automated ones with either continuous or actuated perpendicular movement. The new microneedling devices are easy to operate and have less trauma than the older roller. The depth of the needle can we controlled to be between 0.25 to 3 mm. The needle will create micro-puncture that help tissue remodeling and collagen induction resulting in skin tightening and wrinkle removal. This micro-wound healing process will stimulate the fibroblast to produce new college bundle and straighten the skin. It is recommended mainly in areas with thicker skin such as the perioral skin. It can be used to treat photoaged skin, wrinkles and acne scars. Some cases might take up to six microneedling sessions over the period of 3 months to see significant improvement. Some other research should significant results on atrophic acne scars with as little as three sessions. The main side effects are the pain, erythema, and edema. Since most of the skin is intact, several side effects reported with other modality (lasers) is avoided. The newer more expensive microneedling systems utilize radio frequency as an energy source. This energy will be converted to heat and work as a substitute laser photon energy. The new systems are referred to as Microneedling fractional radio-frequency (MFR).
In recent years, the use of autologous platelet-rich plasma (vampire facial) has become increasingly popular mainly for skin tightening, acne scars, and wrinkle removal. The PRP is prepared from the own patient blood and contains a high number of platelets which is a generous source of growth factors. One study showed the using PRP with Microneedling has a better effect of skin tightening, acne scar removal and wrinkle removal than microneedling alone. One study compared the use of a 1450-nm diode laser and micro needling radiofrequency on mild-to-moderate acne vulgaris and seborrhoea in Korean patients through a 20-week prospective, randomized, split-face study. Both the diode laser and FMR demonstrated efficacies for acne and seborrhoea, with reasonable safety profile. FMR was more effective than DL for the long-term maintenance, and subjective assessments for texture and scar improvements. Therefore, a few sessions of these devices would be a viable option for acne treatments.
In conclusion several research study positions microneedling as a safe and effective therapeutic option for the treatment of scars and wrinkles. The current literature does show some methodological shortcomings, and further research is required to truly establish microneedling as an evidence-based therapeutic option for treating scars, wrinkles, and other skin conditions.
Do not hesitate to contact us for a free consultation. Albany cosmetic and laser center is Edmonton most advanced aesthetic clinic. Our quality laser and microneedling machines, along with experienced medical aestheticians is the best choice for all skin tightening, wrinkle removal, laser hair removal, pigmentation removal, melisma treatment, body shaping, fat reduction, fat removal, body slimming, body contouring, skin care, skin resurfacing, skin rejuvenation.
Important notice, since it is not a research article, this post did not use references index
Dr. Kamal Alhallak
Ph.D., MSc, CDE, CRE, APA, MBA candidate
Director of Albany Cosmetic and Laser Centre INC