Microneedling: Fountain of youth with a sting

Sheryl Schreiber takes pride in looking younger than her 54 years, but she admittedly works hard at it. Unhappy with large pores in her face, she discovered microneedling, a non-invasive procedure that promotes collagen and elastin remodeling in the skin.

During the 15-minute procedure, an aesthetician glides a handheld device with a series of tiny needles across the surface of her skin, forming microscopic holes, to promote collagen growth.

"It really helps," said the Voorhees resident, who has had seven microneedling procedures since first trying it two years ago. She goes to a doctor's office, where the aesthetician applies numbing cream, then rolls the tool across sections of her face.

"There are needles that stick out and they go back and forth, piercing your skin. You bleed a little bit, but the pain is tolerable," she said. Sometimes the aesthetician uses the tool to rub hyaluronic acid or stem cells over her skin.

There is very little downtime – some redness for a couple of days, like a sunburn, Schreiber said.

"It's putting off the inevitable that one day I would have to have a face-lift," she admitted. "Even in lieu of a laser, which is much more intrusive and much more expensive."

Though microneedling originated in the 1990s, the procedure has become increasingly popular in the last decade, said Meghan Feely, a dermatologist practicing in New York City and New Jersey and a media expert for the American Academy of Dermatology. That's due in part to the anti-aging craze – think chemical peels, collagen injections, laser treatments, and microdermabrasion.

But microneedling equipment has also become more effective. Needles are longer – up to three millimeters — and it is now possible to deliver platelet-rich plasma (PRP) or stem cells through the device. Devices also have been developed for spas and at-home use.

"Patients who undergo microneedling can experience improvement in fine lines, large pores, acne scars, stretch marks, burns, and scars," said Feely. With a few exceptions, microneedling is safe for all skin types and can be used on the face or other areas of the body, such as the abdomen and thighs for stretch marks.

The needles actually damage the skin, explained Howard Krein, associate professor of facial plastic and reconstructive surgery at Jefferson University Hospital. "When it heals, it causes collagen to be laid down."

Although the machine, on its own, is effective for discoloration and scarring, for patients hoping to improve fine lines and wrinkles or stimulate collagen for plumper skin and a more youthful glow, stem cells or PRP are inserted into the microchannels created in the skin by the device – "to stimulate a further rejuvenation," Krein said. PRP comes from the patient's own blood, drawn by a physician and filtrated to break down red blood cells from the platelets that help in the body's healing process. A substance highly concentrated with these platelets is injected into the damaged skin to help promote new soft tissue growth.

Results are best with repeated treatments, Krein said. For fine lines and wrinkles, two treatments three months apart should show results, "though people are often so pleased with the results that they come in every three to six months, almost like a facial," he said. For scarring and discoloration, three or four treatments six to eight weeks apart are recommended.

Insurance generally doesn't cover the procedure, which costs about $300 for the microneedling alone. Adding stem cells or PRP adds $800 to $1,500 per treatment. Improvement should last three to six months.

"They would last longer but environmental effects of the sun, wind, and dehydration, limit the length," Krein said.

One of the newer introductions to microneedling involves radio frequencies (RF). In addition to creating channels in the skin, RF microneedling delivers radio-frequency energy into the tissue, Feely said. This heat aids in the production of elastin and collagen in the dermis.

Microneedling – often called dermarolling — at spas and through in-home kits is a similar process but uses much shorter needles, between 0.5 and 1.5 millimeters.

"The micro canals are not as deep," said Kim Zimmerman, director of e-commerce & marketing at Rescue Spa in Center City. "But, with continual use, you're going to notice pigmentation reduction, acne scars fading, plumping of the skin, and fine lines being reduced."

The key is aftercare, she said, as it will allow products to penetrate deeper into the epidermis.

Spa treatments, $250 for 60 minutes, are recommended anywhere from once a year to a once a month, depending on the client's personal needs.

Taryn Weiss, 34, bought an in-home microneedling device in June 2018, deciding it was less invasive than Botox. "In my first trimester of pregnancy I broke out a lot and it left discoloration on my face, so I was looking to lighten that," said the South Philadelphia  resident, who appreciates the convenience of an in-home device. "Anti-aging and preventing fine lines was an added benefit."

She uses her Environ device ($100) a couple times each week. After washing her face, she spends about five minutes with the tool – rolling it in quadrants of her face in up and down, side by side, and diagonal motions. Then she uses skin products that are absorbed more easily into her skin.

"It doesn't hurt at all," she insisted. "It feels like little prickles to your skin."

Her results? "My skin is glowing."

Though at-home and spa treatments likely won't cause harm, they won't offer the same benefits as professional microneedling machines, Krein said. And be sure that anyone doing the procedure is board certified. Schreiber, who now will only have the procedure done in a doctor's office, learned that the hard way.

"At one place, I was so red for days because of the way they rubbed back and forth on my skin," she recalled.

Feely noted that patients with a history of keloidal scarring may not be good candidates for the procedure. There might be some redness or crusting post-procedure, but generally there's little downtime after microneedling. Sun protection should be a focus for those who care about their skin, but it's especially important after a procedure such as  microneedling.

And if you use an at-home device, make sure to sterilize it, Feely said, because otherwise you're risking infection.