Microneedling at The Aesthetic Studio at Claytor/Noone Plastic Surgery


Photodamage and the aging process damage the layers of the skin. Wrinkles develop for reasons such as loss of structural extracellular matrix components, such as collagen and elastin, as well as dehydration from loss of hyaluronic acid (HA) and overall thinning of epidermal and dermal layers.
Rejuvenation of the skin by replenishing glycosaminoglycan (GAGs) and the remodeling of collagen and elastin are the rationale behind microneedling therapy. The microneedling procedure, also known as collagen induction therapy (CIT) and percutaneous collagen induction (PCI), is a micro-invasive technique which utilizes small needles made of stainless steel. These needles are in the range of 0.1 mm in diameter and can vary from 0.1 mm to 3 mm in length. Different needles depths can reach different anatomic layers of the skin depending on which area of the body is being treated. Depending on the body location, the epidermis can range anywhere from 0.05 mm to 1.5 mm. The dermis can range from 0.5 mm to 3 mm. Different areas of the face in the same individual, can have varied thickness. Additionally, skin thickness can vary depending on age, race, gender, lifestyle (i.e., smoker, sunbather). In the facial skin the needle depths of 0.25 mm can penetrate anywhere from the granular or mid spinosum layers of the epidermis to the papillary dermis. Longer needle lengths of up to 3 mm can reach down as far as the subcutaneous layers. Therefore, the varying needle depths can reach desired layers of the skin to deliver targeted micro-trauma to the cells which need rejuvenation.

 This allows the practitioner to customize the treatment. During the procedure, each puncture creates a micro-channel in the respective layer and the tissue initiates an inflammatory response at the site of injury. The healing process activates the cells at each respective level of the skin treated. The increased production of keratinocytes and cell turnover can improve smoothness of the skin and overall epidermal thickness. The melanocytes of the deep epidermal layer may be stimulated to improve skin color. The activation of fibroblasts at the level of the dermis results in increased glycosaminoglycans, collagen and elastin which promotes improved tissue hydration, thickness and tightness of the treated areas.
Immediately following the microneedling treatment, inflammation attracts immune cells, such as neutrophils and macrophages, to the site of injury. The next stage is tissue proliferation during which new capillaries are formed and fibroblasts in the wound begin to produce new extracellular matrix substances such as collagen, proelastin and HA.
Additionally, there is epidermal cell migration from the wound edges. In the tissue remodeling stage contraction of the wound leads to skin tightening and increased tissue integrity. Contraindications for microneedling would be a history of keloid scars, scleroderma, collagen vascular disease, active bacterial or fungal infection. 
Treatment regiments will differ depending on the indication being addressed. A 4 week interval between treatments with a cycle of 3 treatments is optimal when treating fine wrinkles. However, acne scarring, may require upwards of 6 treatments. Intervals of microdermabrasion may be spaced in between treatments to achieve a more robust result, but caution should be exercised about causing scarring or hyperpigmentation. Repeat treatments are optimally repeated at 6 months to 1 year intervals for maintenance.
By promoting the normal process of wound healing and stimulating the proliferation and migration of fibroblasts, collagen production is increased.  

Whether the provider uses an automated microneedling pen with oscillating needles or a roller is dependent on the provider’s experience and training. The main objective is to create thousands of micro-channel sites per square centimeter. End point for treatment is a clinical determination but hyperemia or punctate bleeding are some of the many indicators used to determine efficacy of the treatment. Check with your trainer for clinical signs to look for. 

More treatment may be needed at areas which have deeper wrinkles or more severe scarring. Microneedling can be used to rebuild epidermal health and provide a natural and organic approach to skin rejuvenation. 

Article by
Bryn Mawr Plastic Surgeon