Originally training in micro needling with a Korean company at Cosmoprof Hong Kong in November 2008 I was both excited and nervous to be performing these procedures because the science behind the protocol made significant sense. However, I had never seen this treatment in Australia and was unsure if this modality was considered a medical procedure. Fast forward to around 2010 skin needling began popping up in salons across Australia and of course today it is widely recognised across the globe as an effective skin rejuvenation modality.
Discovery of the benefits of skin abrasion go back as far as 1905 by German dermatologist Ernst Kromayer however this was using surgical abrasion methods. In 1950 Kurtin McEvitt published many articles on his clinical observations utilising different skin abrasion methods. In 1980 an alternate skin abrasion method was developed by dermatologist Dr Philipe Simonin using acupuncture needles and then followed by Dr Orentreich in 1995 he developed a surgical method of inserting hypodermic needles under the skin through a needle puncture.
Dr André Camirand a surgeon from Montréal (Québec) in Canada made his observations in the late 80s and published them in 1996. Followed by Dr. Des Fernandes from South Africa, founder of Environ Skin Care who published his findings in ’96, Fernandez introduced the first derma roller into the aesthetics industry. Most recognisable in the aesthetics industry is Dr. Lance Setterfield who has published a book “The concise guide to Dermal Needling third medical edition.”
There are two types of ageing;
1. Intrinsic aging is genetically determined
2. Extrinsic aging is determined by external and environmental factors including sun exposure and lifestyle. It appears 85% of all aging is extrinsic.
Factors affecting extrinsic ageing range from poor nutrition, drinking, smoking, medications and a poor skin care regimen.
Skin needling is useful to treat extrinsic skin ageing by providing skin rejuvenation.
Skin needling provides a controlled skin injury without actually damaging the epidermis.
These micro injuries may lead to minimal superficial bleeding and set up a wound healing cascade with release of various growth factors and the needles allow proliferation of fibroblasts and laying down of intercellular matrix. A fibronectin matrix forms after 5 days of injury that determines the deposition of collagen resulting in skin tightening persisting for 5–7 years in collagen III.
It has been documented that skin treated with 4 micro needling sessions 1 month a part shows up to 400% increase in collagen and elastin deposition with a thickened stratum spinosum.
Our skins fibroblasts are responsible for the production of collagen, elastin and glycosaminoglycans. GAGs are a natural moisture factor, most commonly known as hyaluronic acid which creates a fluid filled space between the collagen and elastin fibres in the dermis. Fibroblasts main function is to maintain skin integrity.
This skin rejuvenation technique stimulates the release of growth factors, optimising cell function, improving cell to cell communication, and turnover which improves skin tone.
Our skin is exposed to oxidative stress daily through diet, toxic inhalants, pollution and UV radiation.
Oxidative stress occurs when the production of oxidants and free radicals exceeds the body’s ability to handle them and prevent damage.
Free radical damages collagen and affects the firmness and suppleness of our skin, leading to dryness, fine lines, wrinkles, as well as reduced elasticity. It also causes depletion of antioxidants like Vitamin C and E and chronic exposure to free radicals accelerate skin ageing.
If glucose is consumed in excess, it can bind to skin’s collagen and cause damage, called glycation. The end product of glycation are called AGEs (Advanced Glycation End products.)
Glycation accelerates skin ageing by damaging cross-linking leading to thinning, discolouration and loss of elasticity. Glycation may lead to stiffer and more brittle collagen, skin inflammation, disrupt sebum production and limit skin tissue renewal. Elevated blood sugar is associated with skin ageing, acne, rosacea, psoriasis and eczema.
Diets higher in Vitamin C, linoleic acid and lower carbohydrate intake help minimise effects of glycation and skin ageing appearance. Antioxidants stabilise free radical damage. Vitamin E defends body lipids, Beta carotene defends lipid membranes, and Vitamin C protects skin and blood fluid.
You can do a lot for yourself at home by focusing on improved nutritional requirements for optimised skin health. Cut out the sugar, too much sugar causes glycation of the skin presenting as fine criss-cross lines similar in appearance to elephant skin and glycation cannot be improved with skin needling.
Our body uses enzymes as a defence against antioxidants; copper, selenium, manganese and zinc.
Copper is useful for iron metabolism, defence against oxidative damage, acts as antioxidant, synthesis of collagen, production of elastin, production of melanin and it’s anti-inflammatory.
We can get copper in our diets from legumes, whole grains, nuts, shellfish, dark chocolate, seeds, liver organs and water delivered through copper plumbing. Selenium can be found in seafood, pork, turkey, lamb, chicken, organ meats and Brazil nuts. Grain products provide Manganese. Zinc from meat, seafood, poultry, milk, legumes, nuts and seeds.
Your healthy skin diet should be low glycemic, alkaline, Mediterranean style, rich in phytonutrients which are colourful fruits and vegetables, antioxidants to fight oxidative stress, balanced fats with omega 3’s carbohydrates and proteins, whole unprocessed foods and remember to stay hydrated aiming for 2 litres of water per day.
Don’t forget a good skin care regimen is also vitally important.
Not everyone is a perfect candidate for this type of skin rejuvenation procedure and managing client expectations are vitally important. Micro needling results don’t occur overnight and can take months, however the following persons probably should choose a different skin rejuvenation method:
- Smokers due to lipid peroxidation.
- People with allergies and asthma due to the histamine response caused by needling.
- Blood pressure medications.
- Those taking aspirin as the procedure may cause bruising.
- Diabetes due to impaired wound healing, risk of infection and glycation.
- Auto immune disease like lupus or rheumatoid arthritis.
- Those prone to Keloid scars.
- Menopause is a blocking factor to impressive results.
- Cold sore sufferers may require antiviral prior to treatment.
- Pregnancy and breast feeding is a no to this procedure.
- Those with raised moles, warts and open wounds, skin cancer, severe solar keratosis, fungal skin infections, irritated skin, skin infections of any type, psoriasis, active rosacea.
What else should you know?
Scarring is an adverse outcome from overworking the skin or using the incorrect needle depth.
Excessive treatments may trigger PIH (Post Inflammatory Hyperpigmentation) on darker skin types and PIH and Melasma may appear darker immediately after and for several months before you see improvement.
Topical products should not be infused due to the risk of an adverse immune response and the possible risk of causing granulomas although Hyaluronic acid has been shown to be ideal for used to create a barrier on the skin.
Scope of Practice
Length of needles will determine use of topical anaesthetics. Any needle that penetrates the dermis will require use of topical anaesthetics, applying a full face of topical anaesthetic is a dangerous practice and if performed incorrectly can cause serious complications and adverse reactions ranging from light headed to chest pain, palpitations to shortness of breath, convulsions and unconsciousness only to name a few. Also, a long list of skin reactions has been reported.
Choose your practitioner wisely
The scope of practice of Dermal Clinicians is defined by their education and training. The title “Dermal Therapist”, “Skin Therapist” or “Dermal Clinician” are used by many in the non-surgical cosmetic industry which can be misleading or confusing for consumers and colleagues in the industry. Make sure you look for members of the Australian Society of Dermal Clinicians ASDC as they have attained a Bachelor of Health Science (Dermal Therapy) or equivalent.
The ASDC also provides the opportunity for practitioners within the industry without a Bachelor of Health Science (Dermal Therapy) Degree to join as Associate members as well as student memberships like me or those still studying programs related to Dermal Science and Therapies.
To find our more or to find a Dermal Clinician visit the ASDC website https://www.dermalclinicians.com.au/