Dermal Needling, Micro-needling, Collagen Induction Therapy

Microneedling, or Dermal Skin Needling, is an aesthetic technique used for decades prior to resurfacing lasers, but it has recently experienced a surge in popularity, particularly for ethnic skin. In 1995, dermal needling was identified as an effective treatment for scars. Since then, the technique initially referred to as Collagen Induction Therapy has become a staple in the treatment of acne scars, surgical scars, photo ageing, and stretch marks.
The skin needling technique involves using fine sterile needles 0.1mm-2.5 mm in length that repeatedly pierce the stratum corneum, producing microscopic “holes” in the dermis. These microscopic wounds lead to the release of growth factors stimulating the formation of new collagen, elastin, and neo-vascularization in the dermis. There are many brands and manufacturers of micro-needling tools on the market, including at-home devices. At-home devices usually have shorter needles and provide significantly less penetration and injury, and therefore may be less effective.

Prior to the procedure, patients are often anesthetised with topical numbing cream for up to 1 hour. The area is cleansed with professional Medik8 and a micro-needling device is used to either roll or prick the skin in multiple alternating passes. The depth of penetration, number of passes, and degree of overlap is highly dependent on the underlying condition, the area being treated, the brand of device used, and the length and frequency of the needle insertion. Petechiae and pinpoint bleeding occur during the treatment. Treatments are usually done 4 weeks apart but can be done more often. Post procedure, the patient often experiences mild erythema (redness of the skin) for a day or two.
This technique has been particularly beneficial to patients with olive or darker skin who are not candidates for factional lasers because of the risks of hyper-pigmentation and scarring. There is low risk of hyper- or hypo-pigmentation with micro-needling, and multiple treatments can be performed in patients with types III-VI fitzpatrick skin and those with a history of melasma.

Contraindications and precautions when considering micro-needling include: history of keloid or hypertrophic scarring, recent skin rashes, history of herpes simplex infections if the perioral area is being treated, and the presence of raised moles, warts, or any raised lesions on the targeted area. Absolute contraindications include: scleroderma, collagen vascular diseases clotting problems, active bacterial or fungal infection, and immunosuppression.
Written by Lily Talakoub MD