Dermal microneedling in the journals again

The Dermatologic Surgery journal has just published a literature review of microneedling including all references to skin scarring and rejuvenation. The article conclusion was "Microneedling is a safe, minimally invasive, and effective aesthetic treatment for several different dermatologic conditions including acne and other scars, rhytids, and striae. Given its expedient post-treatment recovery, limited side-effect profile, and significant clinical results, microneedling is a valuable alternative to more invasive procedures such as laser skin resurfacing and deep chemical peeling."

They refer to the studies that hypothesise the mode of action is that the creation of numerous microchannels physically breaks up compact scar tissue in the superficial dermis, while spontaneously inducing the production of new collagen and elastin underneath. The same production of new but native components of the dermis works to elevate existing furrows and wrinkles, and tighten and rejuvenate the skin. The microchannels represent tiny wounds which also stimulate the release of various growth factors such as platelet-derived growth factor, fibroblast growth factor, and transforming growth factor (TGF) alpha and beta. Perhaps most exciting is that the data shows up-regulation of TGF-B3 over TGF-B2. TGF-B2 is associated with fibrotic scarring in most wounds, but TGF-B3 promotes regeneration without scarring (scarless healing). A direct demonstration of this phenomenon is seen in foetal wounds that heal without scarring because of the predominance of TGF-B3 over TGF-B2 in the foetus.

While there is nothing particularly new in this article, it summarises well the advantages of this minimally invasive but effective treatment. We have been consistently very pleased with the results in our own patients. It is worth noting that the collagen induction and skin improvement is not immediate and the beneficial effects of each treatment can continue to work for up to 12 months. Treatment intervals are usually between two to four week to allow time for the cumulative effect to take place. There are a myriad of products and procedures advertised to treat scarring and skin rejuvenation. The benefits of skin microneedling are that it is promoting your own skin to rejuvenate itself with your body's own growth factors and dermal components rather than applying these or injecting them. The effects are therefore likely to last much longer and are much safer.

The authors indicated they had no significant interest with commercial supporters.

Reference: Microneedling: A review and practical guide. Alster TS, Graham PM. Dermatol Surg 2017;0:1-8.