Microneedling: A Review and Practical Guide
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Microneedling is a relatively new treatment option in dermatology and has been touted for a broad range of applications including skin rejuvenation, acne scarring, rhytides, surgical scars, dyschromia, melasma, enlarged pores, and transdermal drug delivery. The significant increase in minimally invasive procedures that has been reported over the past several years suggest that microneedling may occupy a specific niche for patients who desire measurable clinical results from treatments with little to no recovery.
OBJECTIVE
To review the published medical literature relating to microneedling in dermatology and provide a practical guide for its use in clinical practice.
MATERIALS AND METHODS
A thorough literature search of microneedling in dermatology using PubMed was conducted, and all references pertaining to skin scarring and rejuvenation were reviewed. Based on the information presented in these publications and the authors' clinical experience, a microneedling technique is outlined for clinical practice. Pretreatment recommendations, intraoperative technique and treatment end points, and postoperative considerations are outlined.
RESULTS
Microneedling produces substantial clinical improvement of scars, striae, and rhytides with expedient recovery and limited side effects. Controlled dermal wounding and stimulation of the wound healing cascade enhances collagen production and is likely responsible for the clinical results obtained.
CONCLUSION
Microneedling is a safe, minimally invasive, and effective esthetic treatment for several different dermatologic conditions including acne and other scars, rhytides, 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.
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Additional Info
Microneedling: A Review and Practical Guide
Dermatol Surg 2017 Aug 07;[EPub Ahead of Print], TS Alster, PM GrahamFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Recently, microneedling has gained increasing popularity as a relatively new modality in the treatment of certain difficult dermatologic conditions such as atrophic acne scarring, recalcitrant melasma, skin rejuvenation, rhytides, skin tightening, and transdermal drug delivery. The mechanism of microneedling is thought to promote wound healing through dermal injury. Upregulation of various growth factors, neovascularization, neocollagenesis, and increased deposition of elastin have been shown after microneedling. Most interestingly, upregulation of TGF-β3, which promotes scarless wound healing, after microneedling may partially explain its efficacy.
One of the most attractive features of microneedling is that it can be used in all skin types. Although both lasers and microneedling can achieve similar depths of treatment based on histologic assessments (though these are highly variable), microneedling may be comfortably performed with minimal risks of post-inflammatory pigmentary alteration when compared with ablative lasers. Evidence-based treatment protocols do not exist; however, in general, treatment depths should be tailored to the body location and the indication treated, and the clinical endpoint is confluent pinpoint bleeding.
This article provides a current review and general treatment recommendations for microneedling. Information provided in this article suggests a series of microneedling treatments can be highly effective, safe, and well tolerated with limited adverse events for the management of a broad range of conditions. A comparison of its efficacy, safety, downtime, and cost of treatment with other treatments having similar indications, such as nonablative and ablative lasers and chemical peels, would be helpful for physicians and patients to choose the best treatment options.