Microneedling

This treatment was first invented by dermatologist as an entry level therapy to improve skin texture & to enhance the delivery of topicals. 

Since its inception nearly 2 decades ago, this treatment has been commercialised as the treatment of choice for almost every skin condition ranging from wrinkles, enlarged pores, acne scars through to melasma, pigmentation, acne, hair loss, insomnia & haemorrhoids.

Microneedling works in 3 way-

• Stimulation of collagen or CIT, Collagen Induction Therapy. 

1. Physical breakage of scar tissue, deep microneedling beyond 0.5 mm
2. Channels to increase absorption of topicals 

The most common application is CIT or collagen stimulation. It does this via limited collateral damage to the upper layer of skin, the epidermis. This creates a cascade of growth factors & inflammatory mediators, that stimulate collagen producing cells in the deeper layers of skin. 

Microneedling treatment should be used according to your skin concerns & goals, not as a marketing tool to address a myriad of conditions. From a marketing POV, microneedling can-

• Increase collagen
• Reduce fine lines & wrinkles
• Treat laxity
• Treat melasma
• Treat acne scars
• Improve pore sizing
• Treat pigmentation
• Improve volume & skin texture

The real applications of microneedling are limited to treating androgenetic alopecia & optimising dermal drug delivery. 

Here’s refreshing news- rollers are just as good, if not better than pens– if technique is correct. In fact, dermatologists prefer manual microneedling over pens & motors because we can FEEL what is going on. 

Provided needles are sharp, needle length is sane, & technique is good, a $5 DermaRoller can give faster, superior results than a $900 DermaPen – SkinPen. The key is traction & counter traction of the skin.

Yes, microneedling can be used as a non-specific treatment for superficial acne scars. Scar directed therapy gives infinitely better results, as can RF microneedling. 

Acne scars should be treated based upon their morphology. Dermatologists use chemical peels, RF microneedling, lasers, & surgery to effectively treat scars. 

Learn more (link to acne scar treatments) 

Yes, only if the pore size is LARGER than the needle diameter. You will require up to 5 sessions for optimal outcomes. If the pore is smaller than the needle, you run the risk of making pores worse. 

Small spot lasers including CO2, thulium & non-ablative lasers giver far superior results with much lower risks. 

Learn More (link to treating enlarged pores) 

Yes, it can contract collagen, in turn improving skin turgor & laxity. Most patients require 3-5 sessions over 4-6 months. Lasers do a much better job- in one treatment. 

Learn more (link to Hybrid lasers under the laser section)

It is probably one of the worse treatments, only second to Plasma Pen Fibroblasting. Why? Firstly, it is because the skin around the eye is super-thin, less than 50 microns. This equates to a needle length of only 0.05 mm. Most practitioners needle over 8 time this depth.

Trauma to this area, coupled with the ubiquitous Growth factor injections upsell, creates bleeding. Bleeding creates bruising, leading to more pigment. Approach dark circles with an understanding of what causes dark circles in the first place. 

Learn more (link to dark circles treatment) 

Yes, however there are many better solutions. The eye skin is the thinnest, hence we prefer small spot short PD lasers, including thulium 1927, 1940, erbium & CO2 lasers. 

One session of laser resurfacing gives infinitely better results compared to 5 sessions of microneedling, saving patients time, effort & money. 

Learn more (link to LANDING PAGE of eye rejuvenation) 

We employ microneedling in specific settings where it is considered as the best standard of practice, namely

• Treatment of hair loss. This where microneedling & Growth factor injections can be used. 
• Trans-dermal drug delivery with heat, especially in burns scars (whereby idiosyncratic reactions occur with very low-density CO2 lasers)
• Research based papers. 

RFM or radiofrequency microneedling provides controlled insulated heating of the dermis. This in turn provides far better stimulation of collagen, in turn giving superior clinical results. These devices are used specifically for the treatment of skin laxity & deep rolling acne scars. 

RFM devices include Infini RF, Genius RFM, Morpheus 8, Instensif, Vivace, Secret RF & Intracel. Insulated RF microneedling gives superior results with far less side effects. 

Learn more (link to RF microneedling)

Don’t get us wrong, microneedling is a useful treatment. Cutis microneedles at least half a dozen patients a day, but only in the context of ‘best treatment applications.

The truth is there are far better options that are both more effective & cost effective for patients. Examples include-

• Lasers for melasma, cost $139, much better results. 
• Acne scar treatments are under Medicare.
• Dark circles can be treated with topicals.
• Skin laxity can be treated with HIFU, RF or lasers.

3-5 depending on the application, expectation, goals, skill sets, depth of delivery & patient factors. 

The most common side effects from microneedling are-

• Worsening of melasma pigmentation as needles push pigment deeper into the skin. This converts superficial pigment to deeper dermal pigment. 

• Idiosyncratic pore enlargement – especially to fine pores. Needles should ALWAYS be smaller than the pore size itself. 

• Scarring is rare, it is due to dragging of the needles & can occur if lubrication is poor, motor strength is poor, batteries are weak, or skill sets are low. 

Dark circles are made worse with pigment induced bleeding or post treatment purpura. Often in combination with Growth factor injections.