Skin microneedling was the first method of fractional skin resurfacing. This technique of skin trauma has been practiced for the past two decades. My last skin-rolling microneedling patient was in 2007 as this treatment can be now classed as outdated. Skin needling has been replaced by insulated energy based radio frequency microneedling . This device is called Infini RF and can be classed as a fourth generation skin needling device, compared to first generation skin rollers. Infini RF provides a much better improvement in skin rejuvenation and acne scarring due to controlled remodelling of collagen. I do however acknowledge that skin needling provides an entry-level treatment for acne scars and improving skin tone. This page will out line the progress in technology from 2007 to 2017.
- Skin needling is a form of fractional non-laser resurfacing using needles
- Needling can either be with a manual skin roller, a digital Dermapen, or an energy device that delivers RF or RadioFrequency
- The depth of needles can be controlled by the device- ranging from 0.5 mm needles thru to medical grade 3.5 mm needles
- The number of passes, depth and pressure all determine the outcome of skin needling
- Skin needling can help with rolling acne scars, as well as box car scars
- Multiple sessions can also help improve skin texture and tone
- Newer treatments such as RF Insulated Skin Needling, are much more effective than non energy based skin needling. Insulation play a vital role in the efficacy of the device.
- The addition of PRP or Platelet Rich Plasma to energy based Infini skin needling takes this treatment to another level
Skin needling, including Dermapen and DermaRollers can treat conditions that occur under the skin’s surface. This includes-
- Acne scars
- Poor skin tone
- Stretch marks- especially old ones (white in colour)
- Open pores/ enlarged pores
- Sun damage and loss of collagen
Multiple treatments can also help with skin texture by decreasing fine lines, and skin pigmentation. The addition of PRP or platelet rich plasma can improve healing times, as well as increase the efficacy of skin needling. PRP is a process by which we take your own blood, and seperate the contents of platelets and growth factors from red blood cells. This procedure is not to be confused with the Hollywood Vampire Facelift (outdated 7 years ago). Vampire Facelift only uses NON-Energy based micro needling or skin needling with first or second generation devices. The current standard is to use 4th Generation Insulated Micro Needling energy devices (RadioFrequecncy) in conjunction with high concentration PRP.
No, just as long as local anaesthetic is used. My nurses use a specialist grade anaesthetic called 23/7- this is over 5 times stronger than EMLA and local anaesthetic creams from beauty clinics and cosmetic doctors. Numbing cream applied at least 45 minutes before skin needling.
Skin needling works on the basis of physical trauma, namely needles breaking the skin’s surface to hit collagen. Once the skin’s surface is broken (epidermis), this also releases growth factors to remodel scars, and stimulate collagen. This is called CIT or Collagen Induced Therapy- a scientific name for poking holes in the skin!
The biggest downside about skin needling is that this treatment does not provide controlled heat, unlike RF (eMatrix), ePrime- profound, INFINI RF or Fraxel laser. Controlled heating of the skin provides the greatest benefit for scar remodelling and wrinkle reduction.
The Dermapen is a controlled digital and electronic form of skin needling that delivers holes vertically. Skin rollers puncture the surface at an angle and are manually controlled. Dermapen provides a much better, safer, and cleaner fractional wound compared to skin needling rollers. Cleaner wounding decreases infection, scarring as well as increases healing times.
Following a proper skin needling session your skin will take up to one week to heal. Home kits that contain 0.5 mm needles provide virtually no downtime, whilst clinical skin needling kits provide needle depths up to 3.5 mm, hence the prolonged healing.
In fact skin needling provides the longest downtime with the least benefit of all the procedures we perform- hence we label this as ‘entry-level treatment. ‘
The latest skin fractional treatments utilise controlled laser heat (Fraxel) or RadioFrequency such as with INFINI RF or eMatrix with minimal skin trauma. Both of these treatments are associated with far less downtime compared to skin needling, with added benefit of better results. Such is the progress of technology over two decades.
Comparing skin needling to computers- needling is like using a 20 year-old computer compared to today’s technology.
Skin microneedling and stretch marks
Skin microneedling has been shown to improve old stretch marks- ie. Stretch marks that are white, silvery or papery in texture and colour. New stretch marks respond much better to Vascular laser treatments.
Dermapen can improve the appearance of old stretch marks by up to 30-40% after 5-6 treatments. I tend to combine Vitamin A therapy, PRP with Dermapen for the best results. The use of INFINI RF with PRP can give a marginal increase in efficacy of stretch marks removal.
As with other conditions, newer treatments such as eMatrix and Fraxel laser can deliver similar results as Dermapen, with quicker recovery times, and half the number of treatments.
Skin microneedling can be partially effective for acne scars, however lasers, fillers, and newer devices such as eMatrix RF, CO2 CORE and FRAXEL can be more effective for certain scar types.
Skin microneedling is best for acne scars that are rolling, tethered, anchored, or atrophic. The best methods to treat acne scars are directed at the scar type, and not just a procedure, or brand- this includes even the most advanced laser systems like Fraxel. Sometimes a simple procedure such as TCA CROSS or punch elevation will produce superior results than a machine. Lately I find that the use of 4th Generation Insulated RF energy microneedling, namely INFINI RF provides a better result than even my most powerful laser devices. In fact for acne scars, INFINI RF with PRP beats Fraxel lasers in every aspect of scar revision.
More on treating acne scars
Skin needling works best for these types of acne scars- called atrophic and rolling scars. Lasers such as Fraxel are much more effective, making needling an obsolete treatment for acne scarring.
3-5. Skin needling is not a one off treatment session.Deeper treatments are usually better than shallow ones, however the deeper the skin needling, the longer the recovery time.
Skin needling breaks down collagen and scars. Remodelling occurs much slower with skin needling and not as efficiently compared to controlled heating of the deeper layers of skin- such as erbium laser, CO2 Fractional CORE Laser, eMatrix RF or Fraxel laser.
- Healing time and wounding is much longer with proper 3.5 mm skin needling than with CO2 CORE laser, INFINI RF or Fraxel laser
- Results are much better with newer devices, including eMatrix, CO2 CORE, INFINI and Fraxel laser
- Newer treatments need fewer sessions compared to skin needling
For the best in collagen remodelling and scar revision, controlled heating of the lower dermis MUST be achieved. This heating is between 65-70 degrees, can only be delivered via lasers or radiofrequency.
Heat is not generated with ordinary skin needling- Dermapen, but the INFINI RF Skin Needling provides heat at depths between 0.5 mm to 3.5 mm.
Lasers such as Fraxel also provide heating, with controlled depths and coverage.
My preferred treatment for all skin types is the INFINI RF system- this is by far the best solution for treating acne scars . So, how does INFINI RF differ from other systems like Secret and Intesif RF by Endymed? Insulation and sequential delivery of the needles together with unparalleled power and adjustably set INFINI RF apart. Insulated needles means that the delivery is deep in the dermal layer of the skin, with no loss of energy in the upper epidermal layers. This means more effective treatments with faster healing times. Combine this with PRP and the results are even better. I call this treatment INFINI + or PRP+.
I only offer Dermapen+PRP needling- also known as the “Vampire Face Lift’, however we also have on display a skin roller (about to be donated to the museum). Needling is an entry-level treatment for patients who may elect to undertake this procedure under their own supervision- see Dr Davin Lim YouTube Channel on “How to skin needle at home.”
In my professional view, skin needling does work, however there are treatments that are far more effective, with less risks and quicker healing times compared to first generation skin needling devices. My Lead Nurse performs PRP Dermapen- this procedure cost $990 per session- 2-4 sessions recommend for best results.
By Dr Davin Lim
Skin needling was the very first method of fractional skin resurfacing. This technique was first invented decades ago by tattooist to remove unwanted ink. Dermatologist then re-invented the tattoo gun with skin needling rollers. Over the years, rollers evolved into digital or electronically controlled hand held devices that provided vertical skin wounding via needles, rather than angled wounding (skin rollers). This device is called the Dermapen.
The question is – does skin needling actually work? Yes, it does, however newer medical grade equipment, coupled with clinical experience can deliver far superior results with eMatrix RadioFrequency, insulated RF Needling, or Fraxel laser- fractional laser resurfacing.
We see skin needling as an outdated treatment however still offer this service to patients who want to start an ‘entry level’ treatment, or are unsure about technology. Skin needling resurfacing gives rise to a much longer recovery period compared to RF INFINI, or Fraxel Dual laser. As a average comparison, a patient needs to undertake 3-4 treatments of skin needling resurfacing, compared to one treatment of a 4th generation device for the same results. This is the progress of technology. Do I still use skin needling- yes I do- it is called ‘homework’ for patients to get even better results between treatments with me. Most often I combine home skin needling with Vitamin A, and copper peptides for additional results. Every single helping procedure counts- even with ‘home skin needing’.