Some ingredients introduce immunogenic particles during needling
that can cause hypersensitivity and irreversible damage
Micro-needling is a cosmetic procedure involving a fine needle device that creates micro-injuries in your skin.
These controlled injuries stimulate collagen production and promote skin rejuvenation.
However, the ingredients you use during and after the procedure can significantly impact the outcome.
Moreover, if not used carefully, these ingredients have the potential to cause hypersensitivity or irreversible damage.
Therefore, the “less is best” approach is crucial when considering skincare treatments like dermarolling or microneedling.
Your skin’s immune response becomes highly sensitive during barrier impairment, and using the right ingredients is essential to avoid negative outcomes.
To understand this, let’s delve into the physiology of the skin layers:
What Clients have to Say
We receive hundreds of emails about the side effects of poor facial needling treatments, a topic we discuss in greater detail in the article Microneedling, Beware.
Susan from Australia wrote: I had micro-needling and was given a topical Vitamin C product to use 24 hours after treatment. Initially, my skin looked calm, but after applying the Vitamin C product for three days, my skin developed a rash, five days in and my face started to swell and break out and became extremely painful; I was hospitalised and, after a biopsy, found that I had a granulomatous reaction. Three months later, the swelling has gone down, but the scarring has left me permanently disfigured.
Sarah from the USA wrote: As soon as I started using the product my skin had a protracted inflammatory reaction. My dermatologist explained that my skin had healed as fibrotic tissue, also known as “micro-scarring” instead of normal, nice basketweave collagen”. Its really devastating,
Michelle from New Zealand wrote: Initially, my treatment was ok, the worst part seems to be the aftercare from my aesthetician, Vitamin A. Lactic acid and Vitamin C on me. My skin immediately flared up, but I was told to continue using the products as this was part of my healing treatment. My skin looked like it had been dragged through gravel; I lost all my confidence and beauty. Fortunately, I came across the Naked Chemist, and it was explained to me that I was suffering from a histamine reaction. It has been a long road to get my skin under control, two years, infact! Quite why my aesthetician recommended applying these products with such active ingredients when my skin was impaired is beyond me; all this could have been avoided.
Taking the approach less is best
After reading these case studies, and this one from a client, you can see how important it is to use the right ingredients on your skin to avoid a negative outcome because your skin’s immune response is highly sensitive during barrier impairment.
Your skin’s protective layer consists of multiple layers of keratinised cells, creating an impenetrable barrier that shields the deeper, living cells. The outermost layer of the epidermis resembles a brick-and-mortar structure, with corneocytes as bricks and intercellular lipids as the mortar.
These lipid structures safeguard your skin against foreign substances and harmful agents while preventing water loss.
Invasive procedures like skin needling, laser treatments, or harsh peels disrupt the delicate microflora, which creates your skin’s acid mantle, compromising the protective barrier function and disturbing the pH balance. Engaging in needling treatments without considering these vital physiological factors exposes your skin to potential risks.
In the skincare industry, there’s a belief that because the channels created by skin needling are open immediately after the procedure, active ingredients applied during and after treatment will penetrate deeper layers. However, this approach has led to an increase in people experiencing skin problems and systemic illnesses.
Many recommended products contain overly active ingredients for use during maximum barrier disruption. Consequently, some clients suffer from adverse side effects like an “orange peel” texture, rashes, inflammation, erythematous papules evolving into plaques, and conditions like erythema nodosum and granulomatous infections.
In severe cases, clients may require intravenous antibiotics, steroids, or immunosuppressive drugs to heal their skin.
Case studies, such as the one that looks at granulomatous facial reactions after microneedling, highlight the potential dangers of applying products “during” and “immediately” after treatment.
This issue is extensively discussed in the article “micro needling beware,” and the comments on the page emphasise the real problem it poses.
Needling Mimics the Patch Test Procedure
Micro-needling and the patch test procedure share similarities in the way they assess skin sensitivity and reactions to substances.
In the industry, the patch test involves applying a diluted drop of a substance on the skin and pricking it with a small needle. After 15 minutes, any skin reaction, such as redness or raised areas, is observed to determine sensitivity. The larger the reaction, the greater the sensitivity.
Conversely, micro-needling involves repetitive micro-injury to the outer layer of skin, the epidermis (outer layer of skin). This process opens channels in the skin, increasing the absorption of topical substances beyond its natural protective surface.
These channels remain open for extended periods to achieve the desired result. Ingredients in topical products interact with the skin’s chemical composition, and if the skin doesn’t recognise a substance as its own, it can trigger an immune response. Cytokines, signalling molecules, prompt the immune system to send cells to the injured site to repair the skin’s integrity.
This immune response can result in inflammation and, in some cases, lead to pathological responses like granulomas (scar tissue), allergic reactions, contact dermatitis, pain, and even functional impairments, including speech or visual distortions and breathing difficulties.
A simple example of this immune response is seen in allergies to substances like nuts or bee stings, where a small amount of the allergen entering the body can trigger anaphylaxis, a potentially life-threatening reaction.
What Should I Use on My Skin?
When it comes to caring for your skin before and after a micro-needling or dermarolling procedure, it’s crucial to be gentle and cautious about promoting healing and avoiding potential complications.
Here’s a breakdown of what to use on your skin during and after the treatment:
- Saline or Pure High Molecular Weight Hyaluronic Acid (HMW-HA): During the procedure, it’s recommended to use saline or pure HMW-HA to prevent friction and assist in the gliding of the device. This will also minimise irritation and discomfort.
- Cool-Off Period: After the micro-needling procedure, allow your skin to rest and recover for several hours. Even with shallower cosmetic needles, your skin’s vulnerability period persists as long as the micro-perforations are open. It’s advisable to wait at least 24 hours before applying any products to see how your skin responds.
- High Molecular Weight Hyaluronic Acid (HMW-HA): After the cool-off period, focus on “sealing” your skin to prevent trans-epidermal water loss and replenish moisture. HMW-HA is recommended for this purpose because it aligns with your skin’s natural physiology. It is film-forming and safe, provided it does not contain active ingredients or microbes. HMW-HA doesn’t easily penetrate the skin but sits on the surface, binding to water to maintain hydration. It also forms a temporary barrier to protect your skin and help it to heal.
- Gentle Healing Products: Once your skin has had time to recover, use only very gentle healing products on your skin; use ones that mimic the physiology of your skin. Look for products containing skin-identical ingredients to support the healing process without causing further irritation.
It’s important to stress that you need to be patient and cautious with your skincare routine after micro-needling to ensure your skin heals correctly and to minimise any risk of adverse reactions.
Always follow the guidance of a skincare professional or dermatologist for personalised recommendations based on your specific needs and skin type.
To conclude. The naked truth
So, we have demonstrated the importance of understanding the potential risks associated with this treatment, and we have also looked at the best practices when it comes to needling procedures such as micro-needling or dermarolling.
These invasive treatments can disrupt your skin’s protective barrier, opening channels for increased absorption of topical substances. Repeatedly using harsh actives during needling can trigger an immune response that can lead to long-term complications.
Contrary to the assumption that skincare companies only provide safe products specifically formulated for use with needling and other modalities, it’s crucial to recognise the lack of regulation in the industry concerning product safety in combination with such treatments.
Here are some key recommendations:
- High Molecular Weight Hyaluronic Acid (HMW-HA): Use HMW-HA before, during, and after treatment. This large molecule sits on the skin’s surface, maintaining hydration and forming a temporary barrier during healing.
- Skin-Identical Ingredients: After at least 36 hours without a skin reaction, introduce skin-identical ingredients such as ceramides, cholesterol, lipid and copper peptides. These ingredients mimic those naturally found in your skin and support replenishment and barrier repair.
- Avoid Vitamin C: It can cause unusual conditions like an “orange peel” texture, allergies, and granulomatous infections, so it’s best to avoid it during the recovery phase. This includes any acid or chemical peel!
- Product Selection: Be mindful and cautious in your product selection. If you’re unsure about what your esthetician recommends, take a step back and consider the “less is best” approach. Do your research well and become a label detective to ensure you make informed choices.
Micro-needling and similar treatments are not to be taken lightly; understanding the potential risks and the appropriate products to use can help you achieve the best results while minimising the chances of complications.