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
- The device should not be used inside of the orbital rim, such as eyelids or inside the vermillion border of the lips
- 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 such as this 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 treating 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 the 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.
TEMPORARY SIDE EFFECTS OF MICRONEEDLING
General side effects of micro-needling include pinpoint bleeding, slight bruising, redness and inflammation, scabbing, 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, not always but sometimes. Additionally, the 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 the skin, changes in skin conditions, and extended pores.
For those clients who tan or who have darker skin tones. It can result or worsen hyperpigmentation – darkening of the skin and hypopigmentation – lightening of the skin can occur, this usually goes within 6 months, but in rare cases, it could be permanent.
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 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
- Active acne
- Skin cancer
- Open wounds
- Blood thinners
- Cigarette smoker
- Abnormal skin growth
- Autoimmune conditions
- Signs of active infection
- Blood clotting conditions
- Sensitive or impaired skin
- Patients who get anti-coagulant therapy
- 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- These must be diagnosed by a practitioner prior to 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 prior to undergoing the treatment