Micro-needling is a collagen stimulating procedure for the skin which is performed with an instrument containing tiny ‘micro-needles.’ Each treatment induces new collagen formation beneath the skin as the device is moved over the skin.
Micro-needling is often performed in combination with either a chemical peel, a jet-peel or with PRP(platelet-rich plasma) to further enhance the rejuvenation effect.
Downtime is minimal for the micro-needling treatment alone, erythema, typically lasts for 2–3 days, mild-to-moderate edema and bruising for approximately 4–7 days, and crusting for 1–2 days.
Ideally 3-4 sessions are performed every 4–6 weeks.
FOR SCAR MANAGEMENT
The various treatment options used to manage post-acne scars include surgical techniques (punch graft, punch excision, subcision), resurfacing techniques (dermabrasion, ablative laser treatment, chemical peel), non-ablative laser treatment, autologous fat transfer, and injection of dermal fillers. Each of these techniques has variable clinical outcomes and complications, and to date no treatment has been universally effective for the treatment of acne scars.
Post-acne scars have been classified into many morphological types, such as pitted, rolling, boxcar, linear, and hypertrophic scars. Post-acne scars have also been graded into four different grades depending upon the overall severity of the scarring present, regardless of the individual morphology of the scars. The choice of treatment depends to a large extent on the morphological type as well as the severity of each scar present.
As with any other procedure, the dermaroller has its own limitations in the treatment of atrophic acne scars. Some morphological types of scars, i.e. pitted scars, linear scars, and deep boxcar scars, are less responsive to this type of treatment.
A few adverse effects have been reported with microneedling treatment. These include pain during the procedure, transient erythema and oedema, and post-inflammatory hyperpigmentation (PIH). Regular-patterned scarring, consisting of multiple discrete papules in a linear pattern in the horizontal and vertical direction similar to a tram track, has been reported following microneedling for acne scars. These papular scars were predominantly seen over bony prominences like the temporal area, the zygomatic arch and the forehead. Use of a larger needling device or strong pressure while using the microneedling device predisposes to this side-effect.
Hypertrophic and burn scars
Microneedling has found its place in the treatment of hypertrophic scars and burn scars as well.
There are certain advantages with dermaroller or microneedling therapy over laser resurfacing as the former does not lead to any epidermal injury as is seen with lasers; there is minimal downtime associated with the procedure unlike ablative laser resurfacing, and the treatment is far cheaper. The treatment can be performed in an office setting and does not need any long-term special training or any expensive instruments. The use of microneedle rollers for enhancing cosmesis of the face through collagen induction and enhanced penetration of topical cosmeceuticals has been well-described.
FOR TRANSDERMAL DRUG DELIVERY
This mode of drug delivery bypasses the effects of digestive tract and first-pass liver metabolism and, therefore, it provides more consistent and reliable means of drug delivery than the oral route. When compared with intravenous injections, transdermal drug delivery is safer and less painful. Its greatest disadvantage is that only drugs with low molecular weight (MW) can penetrate the intact epidermis. To overcome this limitation, several enhancement methods, such as intra‑epidermal administration, iontophoresis, ultrasound, electroporation, and chemical enhancers are used. Micropores facilitate an increase in skin permeability for many compounds, ranging from small chemicals to nano molecules, such as gene therapy vectors. These microchannels are reversible in nature and close within a few hours of microporation; the time frame being dependent on the length of the microneedles. This reversible nature of microchannels is very advantageous for the controlled delivery of cosmetic agents/therapeutic compounds.
FOR HAIR RESTORATION
One of the recent applications of microneedling has been in the field of hair disorders. Beneficial effects of microneedling have been reported both in androgenic alopecia as well as in alopecia areata. Dhurat et al, in a study on 100 patients with androgenic alopecia found better therapeutic results with a combination of microneedling and minoxidil in comparison with minoxidil alone. The hair counts at 12-weeks as well as the response on a visual analogue scale were claimed to be statistically better in the patients receiving the combination when compared with the minoxidil-only group.