Dermarolling: Don’t Go Under the Needle Without Reading This

Dermarolling: Don't Go Under the Needle Without Reading This

It seems there’s nothing we won’t do in the pursuit of beauty. But are we really willing to plunge thousands of tiny needles into our face repeatedly? It seems the answer is “yes, absolutely!”. Dermarolling – it’s the skincare craze that’s sweeping the nation.

If the rise in clinics offering needle-based treatments, and the emergence of dermapen at-home devices is anything to go by, we’ve gotten over our squeamishness around these tiny aerators, and are only thinking about the end result: glorious, glowing skin. However, all may not be what it seems.

Navigating the vast world of dermaroller treatment can be confusing. The device is used to prick the skin in multiple alternating passes and a lot comes into play:

  • The number of passes
  • The area being treated
  • Hygiene and sterilisation
  • The depth of penetration
  • The products used on the skin
  • The type of derma needling being used
  • The experience of the person performing the treatment.
  • Degree of overlap are highly dependent on the underlying condition
  • The length and frequency of the needle insertion, hygiene, sterilisation

Now you can be forgiven for thinking that all you need is a dermaroller and a tube of cream; however, you are in for a big surprise, as this treatment is far more complex, which you can see in the comments in the article  microneedling beware. You need to first establish the underlying cause of your skin condition and link the appropriate product ingredient if you are to succeed.

After writing this article, many of my readers reached out to me, to write an article on treatment protocol and what to expect, because, with so much involved, it’s really important that you go fully prepared – so here’s what you need to know before going under the needle.

Know before you go

  • Avoid the use of Accutane in the 6 months prior to beginning your treatment sessions, as it thins the skin
  • Use skin-strengthening actives such as DNA Complex prior to your treatment to help make the skin more resilient
  • Introduce internal supplements such as Zinc, Magnesium, and Vitamin C into your daily regime, to strengthen your skin
  • Stay out of the sun for at least 4 weeks prior to beginning your treatment sessions – avoid treatment if you have any sunburn
  • Discontinue the use of Retin A, Retinols, Vitamin A creams, and other topical medications at least 4 weeks before embarking on the treatment
  • Ensure there is no waxing, depilatory creams, or electrolysis to the area being treated for 2 weeks prior. Any dense hair present in the treatment area should be removed before treatment
  • Avoid invasive treatments such as IPL, laser, chemical peels, or microdermabrasion. These all have intensive ingredients and should be avoided for at least 6 weeks prior to beginning the treatment sessions
  • Avoid blood-thinning medications such as Advil or Ibuprofen during the week leading up to the procedure. They interfere with the natural inflammatory process that is critical for skin rejuvenation and may increase the risk of bruising

What to expect on the day of the procedure

The practitioner will start off by applying an antiseptic and cleaning your skin with a saline solution.

  • Prior to the procedure, your skin will be numbed with a topical anesthetic. This should be removed – usually, with an alcohol wipe and time allowed for the alcohol to evaporate.
  • Your practitioner will undertake a thorough facial analysis and consultation with you. Inform your skincare specialist about any relevant changes in your medical history and any medications you are taking.
  • Good hygienic practices and equipment are paramount to reduce the risk of infection. Your practitioner will thoroughly clean your skin with sterile gauze and a saline solution prior to treatment. Only sterile saline, or Hyaluronic Acid such as H20 hydrating complex, without active ingredients, should be used during the procedure; these are used to facilitate the “glide” of the skin needling device if required.
  • Your practitioner should wait 15 minutes after treatment before applying topicals. Some studies show that the channels close within this time frame, so any dermal absorption of ingredients that may be responsible for triggering an immune response will be minimised.

In the article skin needling, could it be ruining your skin, I discuss the dangers of creating a wound in the skin, which has the potential to cause a range of skin conditions including irreversible granulomatous scar tissue and possibly tumor formation.

This is why it is so important to do your research well and ensure you get an experienced practitioner, as much depends on the operator’s technique. A careful needling professional will be thorough and know how to hold, position, and stretch the skin on the face to vary the depth of penetration. The possibility of cross-contamination is very real during this treatment and if a derma roller is being used, there is a potential for backflow into the handpiece. Not only is it vital that the dermapen, dermaroller or micro-needling device is changed for each patient, but the holes should also be thoroughly sprayed to minimise the risk of contamination.

After-care is key

As with any cosmetic skin treatment, it’s important to look after your skin following a face needling procedure, for best results follow these aftercare instructions:

  • Avoid any type of heat treatments, such as sauna or swimming, until the skin has fully settled down
  • Avoid taking anti-inflammatory medications for several days, as they could interfere with your body’s healing process
  • Let your skin breathe; do not put on makeup for the first 48 hours and then only use mineral makeup using clean makeup brushes
  • Give your skin time to heal; dryness, scaling, redness, and swelling may last for several days, depending on the depth of penetration of the needles
  • Your barrier function has been disrupted, so post-procedure, you may experience mild erythema, bruising, and some mild edema; all of which should subside within 48 hours
  • Do not wash or touch your face – leave it for 48 hours and do not use any harsh products, actives, and other such chemicals, as your skin will be highly sensitive following the procedure
  • Because the outer layer of skin has been disrupted, the skin will be sensitive to the sun. Avoid direct sun exposure for a month, as the stratum corneum takes 28 days to repair itself from the mechanical injury of micro-needling. If that is not feasible, try to avoid the sun for the first week of healing

The bottom line –Keep it SIMPLE, keep it SAFE; forget about “absorption of product ingredients” being the key function of your treatment. Anything applied after is done purely for the purpose of “sealing” the skin, thus preventing Transepidermal Water Loss, and replenishing any moisture loss as a result of the needling. Pure Hyaluronic Acid is a perfect option such as in H₂O Hydrating Complex as mentioned above, it is safe to use, film-forming, and contains no hidden trouble makers, which are often lurking in hyaluronic formulas.

Immediately after the dermarolling skin needling treatment, the skin is porous and momentarily allows some percutaneous drug penetration. There is a tendency in the industry for practitioners to apply ascorbic acid/vitamin C immediately afterward. However, studies show this can trigger an immune response which may cause granulomatous scar tissue.

The healing process

Day 1-2: After treatment, you may typically look like you have a severe sunburn and you may feel flushed and hot in the area treated. The skin may feel dry or sensitive to touch; this is the visible inflammation phase which typically lasts around 48 hours. Applying cooling masks soaked in pure Hyaluronic Acid can be extremely helpful in reducing inflammation.

Day 3-5: There may be general slight swelling and bruising that fades within 2-5 days, and the skin may also feel tight.

Day 6-14: You’ll notice skin dryness and flaking which is due to an increased turnover of skin cells for about 7 days, this will, of course, depend on needle depth.  DO NOT pick, scratch, or scrub at treated skin. Skin rejuvenation may be seen as early as 2 weeks after, or as long as 6 to 8 weeks.

Complications

General side effects of micro-needling include bleeding, slight bruising, redness and inflammation, dryness, and skin flakiness. It is not uncommon to see some very small marks on the skin after the procedure has been performed, but these micro-holes should close quickly.

More serious issues include hyper- and hypo-pigmentary changes, tracts on the skin, a change in texture and extended pores. Post-operative wound infection may occur and antibiotic creams may be prescribed if considered necessary. If you experience acute inflammation, avoid the use of steroids as they can have a negative effect on the skin; altering its regenerative repair mechanisms, thereby change the texture, tone, and appearance.

If you experience these or any other problem, you should contact your specialist immediately.

When you should avoid the treatment

Contraindications prevent the dermarolling treatment from going ahead, as this will affect the skin’s natural healing ability and could cause unseen problems:

    • Eczema
    • Psoriasis
    • Sunburn
    • Diabetes
    • Dermatitis
    • Melanoma
    • Cold sores
    • Skin cancer
    • Blood thinners
    • Cigarette smoker
    • Abnormal skin growth
    • Signs of active infection
    • Sensitive or impaired skin
    • Roaccutane/Accutane within the last 6 months
    • Blood clotting problems or poor wound healing
    • Areas of the skin that are numb or lack sensation
    • Autoimmune problems of the skin, such as Lupus
    • Chemical peels, laser, or IPL within the last 6 weeks
    • If you have had radiation treatment within the last year
    • If you have active bacterial, viral, or fungal infections
    • Very dark or unstable skin types – being a 1, 2, or 3 on the Fitzpatrick scale
    • History of keloid or hypertrophic scars, poor wound healing, or scars that are less than 6 months old

References

1. Dunkin C.S., Pleat J.M., Gillespie P.H., Tyler M.P., Roberts A.H., McGrouther D.A. Scarring occurs at a critical depth of skin injury: precise measurement in a graduated dermal scratch in human volunteers. Plast Reconstr Surg. 2007;119(6):1722–1732.
2. Zhao M., Song B., Rajnicek A.M. Electrical signals control wound healing through phosphatidylinositol-3-OH kinase-g and PTEN. Nature. 2006;442:457–460. 
3. Kloth L.C. Electrical stimulation for wound healing: a review of evidence from in vitro studies, animal experiments, and clinical trials. Int J Low Extrem Wounds. 2005;4(1):23–44.
4. https://www.ncbi.nlm.nih.gov/pubmed/24846587
5. https://www.spabeauty.co.nz/Beauty+Articles/x_post/when–what-to-use-after-medical-microneedling-00273.html
6. http://dermarollerinfo.com/derma-rolling-mistakes/
7. https://miabelleskin.com/blogs/wandering-aesthetic/14373443-interview-with-dr-lance-setterfield
8. https://www.dailymail.co.uk/femail/article-6066929/Dermatologist-issues-warning-dangers-DIY-derma-rolling.html

 

4 thoughts on “Dermarolling: Don’t Go Under the Needle Without Reading This

  1. Georgina Dickson says:

    Hi Samantha, thanks for continuing to write about microneedling. It’s important that people are educated so they can make informed choices about treatment options. I wanted to add a comment that I am hoping will help your readers.

    I had medical microneedling done last year on a weekly treatment regimen for 4 weeks. I went to a “reputable” skincare clinic which claimed to follow the Dr. Fernandes protocol (who invented microneedling). It was a huge mistake. It disrupted my skin barrier, caused chronic and persistent dryness, orange peel texture, created fine lines in my cheeks when smilling (which weren’t there before), made my cheeks appear to lose “volume”, made existing scars more noticeable and even caused scrape marks in places (which have turned into scars under the skin) where the device was dragged across the skin. 10 months later and my skin is still damaged although fortunately, it has substantially recovered. The depth of needles used was between 1mm and 1.5mm and I followed after-care instructions diligently. But still, my skin had a protracted inflammatory reaction, which resulted in the skin healing as fibrotic tissue, also known “microscarring” instead of normal nice basketweave collagen. The treatment, in other words, significantly worsened the skin instead of improving it.
    Some people get good results from microneedling. So what went wrong with my treatments?
    -I have sensitive type 2 skin.
    -I got the flu after I had the treatment done which lowered my immunity and made it more difficult for my skin to recover
    -I was needled at depths of 1-1.5mm when nowadays experts such as Dr. Lance Setterfield are suggesting that going any deeper than 0.5mm carries a greater risk of scarring and pigmentation
    -I was needled WEEKLY – the skin should have been left at least a month in between treatments to recover
    -In my final treatment, the device was dragged across the skin in straight lines. It should be done in very small, controlled circles with even pressure.

    It was recommended that I use anti-inflammatory skincare products to help the skin recover. Fortunately, I have been using anti-inflammatory skincare for the last few weeks. If I had not, then the skin may have been even more compromised and damaged than it was.

    Ironically, it was also recommended to me by Dr. Setterfield that I embark upon MORE microneedling to fix the damage. This to me seemed completely counterintuitive and downright scary. However, when my skin’s recovery seemed to plateau, I decided to give it a go. I did not trust clinics or providers with my skin so I bought a home microneedling skin kit. AnteAge brand which has a home roller of 0.25mm plus an anti-inflammatory aftercare serum containing growth factors and hyaluronic acid. I tested it on my body and then on a small part of my face. Then finally I tried it on my face. I did not notice any difference at all. Negative or positive.
    However, I have now been doing this twice weekly for two months. The difference between my chest (where I did not needle but was damaged from the treatment) and my face/neck was apparent. The skin is markedly more improved on my face and neck than on my chest. It is now almost (almost) back to where it was before the treatments. So I have started on my chest as well.

    With microneedling, the adage is: less is more. Except when it comes to hygiene then more is more (you must ALWAYS ALWAYS sanitise your skin and device, no exceptions) I notice that even at depths of only 0.25mm, my skin’s sensitivity is increased and I need to avoid using actives for a couple of days after doing it.

    I am not planning to use the kit long term as I believe that there are other ways of maintaining the skin. But for anyone who has been struggling with skin recovery from damage, it might be something considering.

    Other oral supplements that I have used (although I am not sure if they have helped or not): high-quality fish oil, blackcurrant and evening primrose oil, MSM supplement, bone broth with vitamin C and hyaluronic acid, hibiscus and white tea, matcha green tea, a multivitamin, probiotics, anti-inflammatory diet, lots of fresh water and try to get good amounts of sleep.

    After all of this, although I acknowledge that microneedling has helped some people’s skin (or at least, for now) I do believe that it is a seriously risky treatment protocol, and its not something that I would ever recommend to anyone. It has been so expensive and stressful trying to find ways to help the skin recover and all this could have been avoided by simply not having the treatment in the first place.

    Keep it simple, keep it natural, and avoid unnecessary inflammation in the skin!

    • Emma says:

      Hi Georgina — Unfortunately a similar thing happened to me. I too reached out to Dr. Setterfield, who suggested doing more microneedling as well. Out of curiosity, which AnteAge kit did you buy? And what anti-inflammatory products have you been using? How did you get over the fear of microneedling yourself? What protocol do you use? Was your barrier compromised (burning whenever you put anything on your skin)? Thanks for your help.
      Emma

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