The use of microneedling was first recorded in 1905 by the German dermatologist Ernst Kromayer. He used dental burs mounted on a flexible, motor-driven cord to treat scars, birthmarks, and hyperpigmentation.
90 years later, Dr. Desmond Fernandes developed a new technique that allowed him to treat scars and wrinkles with the use of hypodermic needles. He evolved his technique and later developed a small needle stamp.1
Today, these methods of application have changed thanks to new technology and FDA regulations. Devices are now electrically powered with tiny needles that make precise, microscopic punctures in the skin.
What is microneedling?
Microneedling is also known as collagen induction therapy. This treatment inserts tiny needles into the skin at various depths to stimulate the body’s natural wound healing response. The depth of needle penetration is dependent on several factors, including skin condition and scope of practice. The micro channels that are created fill with new collagen, elastin, and hyaluronic acid, leaving the skin looking plump, pink, and glowing immediately following the treatment. In some instances, the skin may look irritated and red after the treatment and may peel for a few days. It takes about a week to complete the healing process, though it is dependent on the depth of needle penetration.
The open channels within the skin serve as pathways to deliver products—like platelet rich plasma (PRP), exosomes, and/or hyaluronic acid, depending on the esthetic protocol—at deeper levels. Estheticians should always follow the protocol outlined by the manufacturer and the rules and regulations of their state.
Indications and contraindications
Microneedling is used to improve skin texture, address conditions like crepey appearance, scarring, fine lines, and wrinkles, and diminish pigmentation. According to a 2008 study, skin treated with four microneedling sessions one month apart showed up to a 400% increase in collagen and elastin after six months post treatment.2
It’s important to prep the skin with high quality skin care products leading up to the treatment and to ensure your client is following post care instructions, including a daily SPF. Although this treatment is indicated for all skin types, higher Fitzpatrick skin types should proceed with caution and be prepped with a skin lightener to reduce melanocyte activity for several weeks leading up to the treatment. Clients with active acne should avoid receiving any microneedling treatments until their condition is under control.
Clients suffering from severe rosacea may experience flare-ups or infection and should be treated on a case-by-case basis. Other contraindications include bleeding disorders, active herpes simplex, skin infections in the area to be treated, eczema, and psoriasis. When in doubt, don’t treat.
The different types of microneedling
There are three main types of microneedling devices: electric handheld devices, manual devices like a stamp or dermaroller, and radio-frequency (RF) microneedling.
Electric microneedling pens move across the skin with needles going in and out like a tattoo machine. Manual tools require you to use some pressure to push the needles in and are not as common. Radio-frequency (RF) microneedling releases RF energy through the tips of microneedle electrodes. RF adds the element of heat to also tighten the skin and may also assist with fat reduction.3
Unlike microneedling, which uses actual needles, nano-needling utilizes a tip with silicone pyramid-like pins that do not puncture the skin. This treatment is ideal for the esthetician who is not able to perform true microneedling or is looking for a less invasive procedure.
Effective 2018, the FDA is classifying all microneedling devices for esthetic use as class II devices.4 This alone impacts many estheticians in states who say estheticians cannot use devices higher than class I. It’s possible that estheticians may be able to use higher class devices under the direction of a medical director and should consult with their state board to do so.
Some states have rules outlining the use of microneedling devices with or without a medical director and the depth at which you can penetrate the epidermis. For states that do not directly address microneedling, the law must be interpreted to determine whether estheticians can use class II devices or penetrate beyond the stratum corneum.
By Maggie Staszcuk
ASCP's Esty Talk episode 206, A Deep Dive into Microneedling, discusses everything you’ve ever wanted to know about this multipurpose treatment..