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. We are only thinking about the result: glorious, glowing skin. However, all may not be what it seems.
Navigating the vast world of dermarolling treatment can be confusing. The device is used to prick the skin in multiple alternating passes, and a lot comes into play:
- number of passes
- area being treated
- hygiene and sterilisation
- depth of penetration
- products used on the skin
- type of derma needling being used
- experience of the person performing the treatment.
- the degree of overlap is 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 derma roller 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“. First, you need to establish the underlying cause of your skin condition and link the appropriate product ingredient if you are to succeed.
Since writing the article, many of my readers reached out to me, asking me to write an article on treatment protocol and what to expect, because, with so much involved, you must go fully prepared. So here is everything you need to know before you consider going under the needle:
Know before you go
- please avoid the use of Accutane in the 6 months before beginning your treatment sessions, as it can thin your skin
- the device should not be used inside of the orbital rim, such as eyelids, or inside the vermillion border of your lips
- begin to use gentle hydrating and skin-strengthening formulas such as DNA Complex before your treatment, to help make your 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 before 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 your treatment
- ensure you have not waxed, used any depilatory creams, or electrolysis on any area that you are having treated 2 weeks before treatment. Any dense hair present in the treatment area should also be removed before you have the treatment
- avoid any invasive treatments such as IPL, laser, chemical peels, or microdermabrasion. They are intensive treatments and should be avoided at least 6 weeks before beginning your dermarolling sessions
- avoid blood-thinning medications such as Advil or Ibuprofen during the week leading up to your procedure. They interfere with the natural inflammatory process that is critical for the rejuvenation of your skin and may increase the risk of bruising
We can’t stress enough, that what you use on your skin pre, during, and post-treatment will mean all the difference between a good outcome and a negative one. Your skincare needs to be kept to a minimum, a topic we discuss in great detail in the article, “Derma-needling Ingredients Into Your Skin”.
What you can expect on the day of the procedure
- before the procedure, your skin will be numbed with a topical anaesthetic. This should be removed – usually, with an alcohol wipe and time allowed for the alcohol to evaporate.
Your practitioner must undertake a thorough facial analysis. Inform your skincare specialist about any relevant changes in your medical history and any medications you are taking. If they don’t perform a thorough consultation on you such as this, it’s not a good sign, and you may want to look for a more experienced practitioner
- 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 before treatment. Only sterile saline, or Hyaluronic Acid
Anything applied to your skin after dermarolling is purely for “sealing” your skin to prevent TEWL (Transepidermal Water Loss), and to replenish moisture that was lost as a result of the treatment. This is why we recommend pure high molecular weight hyaluronic acid, which serves this purpose well because it is film-forming and is extremely safe to apply immediately afterwards. Even then, we recommend waiting at least 30 minutes, as it is thought 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 kept to a minimum.
In this article, we discuss the dangers of treating a wound in the skin, which can cause a range of skin conditions, including irreversible granulomatous scar tissue and possibly tumour 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 your face to vary the penetration depth.
The possibility of cross-contamination is genuine 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.
Aftercare is paramount, ensuring the correct healing process
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 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 oedema; 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 susceptible following the procedure
- because the outer layer of your skin has been disrupted, it will be sensitive to the sun. Avoid direct sun exposure for a month, as the stratum corneum (outer layer) takes 28 days to repair itself from dermarolling’s mechanical injury. If that is not feasible, try to avoid the sun for the first week of healing
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. Your 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 your skin may 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 your treated skin.
Be patient – skin rejuvenation may be seen as early as 2 weeks after, or as long as 6 to 8 weeks.
Temporary side effects of dermarolling
Micro-needling’s general side effects include pinpoint bleeding, slight bruising, redness and inflammation, scabbing, dryness, and skin flakiness. It is not uncommon to see some minimal marks on your skin after the procedure, but these micro-holes should close quickly, not always but sometimes. Additionally, your skin may look and feel rough, almost like sandpaper; these effects generally last 3-7 days as the treated skin flakes off and is replaced by new tissue.
More serious issues include tracts on the skin, a change in texture, raised milia-like bumps across your skin, changes in skin conditions, and extended pores.
For those of you who tan or who have darker skin tones, it can result in worsening the hyperpigmentation, darkening your skin tone. In some cases, it may cause hypopigmentation – a lightening of your skin. This does usually go within 6 months, but it can be permanent in rare cases.
If you experience post-operative wound infection, antibiotic creams are usually prescribed. If you begin to suffer from acute inflammation, we recommend avoiding the use of steroids, which can harm your skin; altering its regenerative repair mechanisms changing the texture, tone, and appearance.
If you experience these or any other problem, you should contact your specialist immediately and ask for a biopsy; chances are you may have an infection.
When you should avoid the treatment
Contraindications prevent the derma rolling treatment from going ahead, as this will affect the skin’s natural healing ability and could cause unseen problems:
- cold sores
- skin cancer
- open wounds
- blood thinners
- cigarette smoker
- abnormal skin growth
- signs of active infection
- sensitive or impaired skin
- if you are getting anti-coagulant therapy
- on 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 active bacterial, viral, or fungal infections
- active inflammatory skin conditions like hives, rashes, infections
- scleroderma, collagen or vascular diseases, and cardiac abnormalities
- if you have had radiation treatment within the last year or chemotherapy
- very dark or unstable skin types – being a 1, 2, or 3 on the Fitzpatrick scale
- suspicious Lesions- A practitioner must diagnose these before beginning treatment.
- history of keloid or hypertrophic scars, poor wound healing, or scars that are less than 6 months old
- accutane or any related acne medication – they should be discontinued for a minimum of 6 months before undergoing the treatment
Conclusion- Keep it simple, keep it safe
As you can see, it’s not a simple procedure; in fact, it is very technical. Still, from our own experience working within the industry, many practitioners are not stringent enough around treatment protocol and the products used.
The bottom line. Forget about “absorption of product ingredients” being the key function of your treatment. Anything applied after is done purely for “sealing” your skin, thus preventing Transepidermal Water Loss, and replenishing moisture loss. 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 many hyaluronic formulas such as aloe vera or extracts.
Immediately after your skin needling treatment, your 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 afterwards. However, studies show this can trigger an immune response which may cause granulomatous scar tissue.