Harnessing the Skin’s Natural Healing Response


When I first heard about microneedling early in my medical career, I was a bit skeptical. It seemed counterintuitive—to purposefully puncture or injure your skin to improve it. Wouldn’t you want to protect your skin from such a thing?

Many years and multiple experiences later, I am a convert. I have witnessed the tremendous effects of microneedling in myself and others. This is backed by scientific literature, supporting its use in treating wrinkles, scars, hair loss (alopecia), stretch marks (striae), photodamage, and other concerns, as well as improving overall skin texture and quality.

The procedure dates back more than 20 years ago to 1995, when Dr. Norman Orentreich (the father of modern hair transplantation) and Dr. David Orentreich used hypodermic needles to treat scars, which they coined “subcision.” Around that time, Dr. Camirand was beginning to use tattoo guns without ink to treat scars. Flash forward to 2006 and the first prototype of the Dermaroller was invented by Dr. Fernandes.

Microneedling starts a cascade of positive effects with puncturing of the skin. It “tricks” the skin into repairing these very minute punctures. It essentially harnesses the healing power of the skin and is in that way a very natural process. Specifically, it increases epidermal thickness and density, collagen production, glycosaminoglycan enrichment, and fibronectin expression. The micro-punctures also allow medications or serums to be delivered more efficiently.

Devices come in various shapes and sizes, such as a handheld pens or rollers, to more precise systems like the Vivace. Needles have varying diameters and lengths. Some are even designed for aestheticians to deliver, although in California, aesthetician delivery is prohibited.

While microneedling is traditionally considered uncomfortable, requiring pre-application of numbing cream to the skin, it has come a long way. Now there are devices that can deliver the needling with very little discomfort. I have even done it on my face without any numbing cream!

In terms of recovery, there is very little down time when done properly or with the right device. Clients may notice mild skin irritation such as redness, dryness, or mild swelling for one to three days following the procedure. Clients may appear like they have a mild sunburn.

The future is combining microneedling with other techniques. For example, we know that platelet-rich plasma (PRP), which is derived from a client’s own blood, is full of powerful growth factors. When punctures from microneedling are created, and then PRP is applied, the skin effect is significantly augmented. This is also true for radiofrequency microneedling, where a small dose of radiofrequency energy warms up the skin, triggering collagen formation.

When I hear about microneedling now, instead of skepticism, I am full of excitement– about how it can help clients look and feel their best, and its growing role in one of many nonsurgical techniques used in aesthetic medicine.


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