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What is Microneedling, and is it right for me?

By Dr. Brent Taylor Premier Dermatology and Mohs Surgery
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It’s tough not to cringe when you first think about microneedling: the idea of introducing tiny needles into your skin does not sound desirable at first blush. However, microneedling is an established and respected method for improving scars and rejuvenating skin. Treatment is usually easy to tolerate and is one of the few effective methods for treating facial scars, lax skin, and fine lines and wrinkles.
Microneedling is a minimally invasive cosmetic treatment that involves creating controlled micro-injuries to the epidermis and dermis. The needles are usually regularly spaced and mounted on either a roller or on a stamping device that resembles an electronic toothbrush. Microneedling is most often used on the face, neck, chest, and hands or for stretch marks elsewhere on the body. These injuries trigger skin’s repair process and collagen production.  By creating superficial injuries on the skin, the skin reacts by speeding up collagen production to repair the skin. Most medical-grade microneedling devices have the ability to change the depth of the needles, thus allowing for customized treatments according to one’s individual needs.

The scientific basis for microneedling is a principle that is quite remarkable. Researchers discovered that large injuries to the skin result in scarring, just as expected. Interestingly, small enough injuries can heal seamlessly, without a scar. But, most surprisingly, very small injuries to skin that already has scars or laxity can gradually replace scars or laxity with normal skin. A rule of thumb is that no more than 5% of a scar or a zone’s treatment area can be injured with each treatment – otherwise, the injuries will merge and act more like a single large injury than numerous small injuries. Repetitively piercing less than 5% of the skin with spaced tiny injuries once every four to eight weeks gradually replaces a treatment area with more aesthetically and functionally healthy skin.

At their most dramatic, the principles of microinjury are used to treat burn victims and injured military heroes and gradually replace large, contracted and restrictive scars with softer, pliable and more comfortable scars that allowed increasingly free range of motion. This application requires large, expensive lasers and is often performed at a referral hospital. For patients with acne scars or seeking firmer skin, the same principles apply, but large expensive lasers are rarely necessary. This is microneedling’s niche.

First, a microneedling assessment beings with evaluation of a client’s skin during which patient goals are discussed. If microneedling is chosen, a treatment plan is crafted. The depth of the treatment will vary over different facial structures such as the forehead vs cheeks. Deep, pitted acne scars require a greater treatment depth than skin being treated to achieve a youthful appearance. Microneedling can be safely performed on all facial structures including around the eyes or lips as long as the practitioner adjusts needle depths ad treatment technique appropriately.

Many patients that look into microneedling are concerned about the possible pain during a session. For the most part, microneedling may be uncomfortable but it should always be tolerable. Patients need not worry: generally a prescription strength topical numbing cream is applied and allowed to sit on the area to be treated for at least 15 minutes. During treatments a patient may feel a light prickly sensation, but it is rare that a patient rates this sensation as “pain.” Furthermore, recovery time for microneedling is usually minimal. Patients may feel a sensation similar to a light sunburn post treatment for 24 hrs.

In general, microneedling is a procedure that needs to be performed multiple times in order to achieve desired results. After treatment, it can take up to six weeks before visible signs of regeneration and repair are seen, and the healing process can continue over several months. Treatments are best repeated 4-8 weeks apart. Deeper scaring will require more procedures than the number required to plump and rejuvenate skin.

As with all procedures, microneedling carries some risks and side-effects, so be sure to discuss these with your board certified dermatologist. Seek out someone qualified and who you trust will guide you to the procedure that is right for you and your goals. Premier Dermatology and Mohs Surgery of Atlanta offers medical-grade microneedling in addition to a broad array of surgical, medical and cosmetic services, all performed by board certified dermatologist and fellowship trained Mohs surgeon Dr. Brent Taylor. ■

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