The technique of needling dates back to 1995 when clinicians used a tattoo gun to treat acne scars. In 2005, Fernandes proposed the concept of minimal invasive percutaneous collagen induction or PCI, which later was coined Microneedling.
As the term implies, microneedling involves the use of a number of tiny needles to perform minimally invasive, nonsurgical, and nonablative therapy to the surface of the skin. The initial device contains multiple fine needles - typically 0.5 to 1.5 mm net, located on a barrel and roll - onto the skin to create numerous punctures on the skin. The length of the needles varies depending on the depth of penetration desired, which in turn is decided by factors such as skin thickness, location of the skin and the indication of usage. Microneedling can be uncomfortable, and topical numbing cream can be applied before the procedure.
Depending on the length of the needles on the device, micrioneedling can enter the entire depth of the stratum corneum and even to the upper part of the dermis. The micro-punctured wounds created by any of the microneedling devices initiate the release of growth factors, triggering collagen and elastin formation in the dermis. Microneedling can also be used to enhance transdermal drug delivery through the creation of pores in the stratum corneum.
In the beginning, microneedling devices were used to treat atrophic acne scars and fine wrinkles. However, recently the applications have expanded considerably. It has been used in the treatment of androgenetic alopecia or age-related hair loss, post-inflammatory hyperpigmentation, melasma, stretch marks and even burn scars. Many papers have been published in medical journals to support the use of this technology in a wide array of medical indications.
Microneedling can be used alongside the more expensive light-energy-based devices in the treatment of certain skin conditions. It can also be used at home by the patient, although the depth of the needle will limit the efficacy because of pain, and there is a risk of complications if used inappropriately. Qualities of the microneedling devices do vary and one has to be careful in choosing a well-made reliable device. Side effects of microneedling include persistent erythema or redness, pigmentation, scarring, and infections. However, with the proper technique and training, microneedling is safe and can be a good adjunct to other office-based procedures.
Microneedling has really evolved over the past few years. High-tech variations of these devices have been used clinically. This includes the use of motorized microneedling pens which can create multiple holes over the treatment area in a short period of time. Microneedling can also deliver radio frequency energy to various skin depths to enhance the treatment results. Such devices are gaining more and more popularity. Microneedling, with the proper setting, can be used on all skin types, and is less likely to cause dyspigmentation and infection.
In a future post, I will provide a more comprehensive review on microneedling with radiofrequency, also known as MRF.
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