In an industry where new devices and treatments continuously hit the market, dermal micro-coring—a procedure that’s just starting to gain popularity in derm offices across the country—stands out because it truly is unlike anything else out there. “We have things such as laser energy, microneedling, radio frequency, and ultrasound, but micro-coring is an entirely new class of treatment devices. It’s a mechanical way of achieving skin tightening without using any type of energy—and without having to go straight to surgery,” says Dr. Amelia Hausauer, a board-certified dermatologist in Campbell, California. The premise is fairly simple, and while it’s still the new kid on the block (none of the doctors we spoke with even had a pricing model for it yet), the results are pretty promising. Here’s what you need to know.
What is micro-coring?
“Micro-coring involves removing tiny pieces of skin, essentially taking multiple punch biopsies. You’re reducing the overall surface area so that when the skin heals it’s tighter,” explains Dr. Hausauer. “It’s not unlike what happens during a facelift, when the skin is cut and redraped. In this case, it’s just happening on a microscopic level.” It’s also similar to microneedling, in that microscopic holes are being created in the skin. The key difference? In the case of micro-coring, the skin that was in those holes is actually taken out, because the needles used are hollow.
If the idea of having ‘cores’ of your skin removed freaks you out, keep in mind that these are miniscule, microscopic amounts we’re talking about. “You’re taking sections of skin that are only about half a millimeter, so small that it doesn’t even leave a visible scar,” notes Dr. Mathew Avram, a board-certified dermatologist in Boston. (The needles used go through the epidermis and dermis only and don’t penetrate into the deeper structural layers of the skin.) But those tiny amounts still add up. Both doctors we spoke with say that you can end up removing around 5% of the skin in any given area during one micro-coring treatment.
The secondary mechanism of skin-tightening action, at least theoretically, is that removing the skin in this type of controlled manner stimulates a wound healing response, in turn triggering the production of collagen, notes Dr. Hausauer. (This is the same premise behind many other cosmetic treatments, including lasers and microneedling.) However, while histology studies did show an increase in collagen production, there was no increase in the production of elastin, points out New York City board-certified dermatologist Dr. Sheryl D. Clark. How that translates to real-world results remains to be seen, she adds.
What kind of results can it deliver?
There’s currently only one FDA-cleared device on the market; the Ellacor system with micro-coring technology from Cytrellis was cleared for the treatment of moderate to severe wrinkles in the mid- to lower face this past summer. (However, Dr. Hausauer notes that another device, which takes slightly larger-sized pieces of skin, is currently in clinical trials, to address wrinkles and laxity on the neck and chin.) Both doctors we spoke with say Ellacor’s results—when it comes to improving both wrinkles and sagging—are impressive. They also note that, while multiple treatments often do equate with better results, patients may notice a significant improvement even after just one session. Also noteworthy? Those results show up fast. Most people start to see some tightening as soon as the skin has healed and the holes have closed up, usually within 60 to 90 days, says Dr. Hausauer.
Who is a candidate for micro-coring?
There’s been some talk of micro-coring as a facelift alternative, but Dr. Avram cautions that the two definitely aren’t equal. “Micro-coring isn’t going to yield the same results as a facelift. That being said, it can be a good option for patients who either don’t want or don’t need surgery but do want to see a recognizable, clear result—which micro-coring can deliver, in the right patient,” he says.
Dr. Hausauer adds that, like many other treatments, it can also be a good preventive option. “It definitely can play a role for younger patients, those who are noticing slight changes and want to stave off or prevent future surgical intervention.” Similarly, “Micro-coring also yields a much more natural-looking result than surgery. Couple that with the reduced risk and recovery time, and this is a procedure that can be accessible to a very broad age group,” adds Dr. Dendy Engelman, a board-certified dermatologist in New York City.
It bears mentioning that the clinical trials for Ellacor were conducted on Fitzpatrick skin types I–IV, says Dr. Avram. However, he adds, the fact that there’s no energy involved does somewhat mitigate the risk of hyperpigmentation, which can be a concern for those with darker skin. Dr. Clark agrees with this point, saying that she thinks micro-coring will be a strong option for dark-skinned patients.
What are the procedure and recovery like?
A micro-coring machine is small and features a handpiece that’s not unlike those used in microneedling. As mentioned, the needles are hollow and small—22 gauge, says Dr. Engelman, who says those used for Botox are usually 30–32 gauge. (The higher the gauge, the smaller the needle.) It works extremely quickly to punch out and remove the micro-cores of skin. According to Dr. Avram, a micro-coring treatment takes only 30 minutes on average and is performed under local, injectable anesthesia. Expect three to four days of downtime—swelling, redness, and potential bruising. You’ll also want to keep your skin-care routine mild and minimal. Dr. Clark recommends using only a gentle cleanser, Aquaphor, and a mineral-based sunscreen as well as steering clear of makeup until the holes have closed up, which typically takes about a week.
What’s the future of micro-coring?
The doctors we spoke with were enthusiastic about this new treatment. “A cautious approach is still merited, and we need more studies,” says Dr. Avram. “But this is a new device and new technology that I think has the potential to make a significant difference in facial wrinkles and laxity, and it’s an exciting time to explore how it can help that happen.” Dr. Hausauer predicts that the number of areas where micro-coring can be performed will continue to grow. That includes not only the chin and neck (notoriously tough areas to treat) but also other spots with a propensity for laxity, such as the eyelids. “There’s also the potential for applications beyond the face and on the body, on areas such as the upper arms and inner thighs,” she adds.
