Exit CO2 Laser, Enter Micro-Needling?

Before and After micro-needling
Before and After micro-needling (courtesty of Dr. Sikorski and Natural Image)

For over a decade, a major form of treatment for facial fine lines, wrinkles, acne scars and skin irregularities has been CO2 laser resurfacing. Skin products containing retinol and hydroquinone also improve skin, but not as aggressively as laser. The downside of laser treatment includes increased downtime, discomfort, and cost. A new development may be changing all that.  This new treatment requires less downtime, causes less discomfort, and is less expensive, yet can significantly improve skin surface irregularities and restore a more youthful, fresh-looking appearance. The new treatment is micro-needling.

Micro-needling has been gaining a lot of attention and works by stimulating the body’s natural ability to rebuild and heal itself.

How it works

layers of human skinHealthy skin is built on a scaffold made of collagenElastin makes skin firm and elastic, able to resist sagging.  Collagen and elastin production drops substantially in your 40s, 50s and 60s.  Sun-damage and other problems can further degrade the quality of our skin.  Without collagen, the skin sags, and fine lines and wrinkles appear.

Minimally invasive therapies designed to improve facial skin work by stimulating collagen and elastin production.  Skin specialists accomplish this by inducing a controlled injury to the skin in order to stimulate collagen production. The challenge has always been to accomplish this “injury” in a cosmetically acceptable way. Ablative lasers do a great job – but with significant discomfort, downtime and expense.

Micro-needling – a highly promising new treatment

Micro-needling works by piercing the skin with short, fine short needles, creating microscopic channels in the outer layer of skin.  This skin injury kicks collagen and elastin production into high gear as the skin repairs itself.

Microneedling crow's feet B &AThe procedure is typically performed by a qualified licensed esthetician or permanent make-up artist under the supervision of a physician. The skin is cleansed and a topical anesthetic is applied. Once adequate anesthesia is achieved, special serums are massaged into the skin just prior to the micro-needling. This sequence enables the nutrients and healing factors to be introduced into the micro-channels during treatment. Upon completion of the micro-needling, additional serum is massaged into the skin, further augmenting the growth factors that help the skin heal. The ultimate result is a smoothened, shiny, healthy layer of new skin.

Platelet Rich Plasma and The Vampire Facial

Platelet-Rich PlasmaA number of commercial serums are available for use after micro-needling. In my practice, I achieve the best results by using the serum from the patient’s own blood.  This initial blood-draw is what gave rise to the increasingly popular term, the “vampire facial”.  Prior to micro-needling, about 7-8 mL of blood is drawn from the patient’s hand or arm, then centrifuged for a five-minute period. This divides the blood into its major components. A serum, separated from other blood components, is rich in platelets and growth factors. This serum is applied immediately before and after micro-needling.

Once that has absorbed, the skin is sealed with a -Vaseline®-type product and home instructions are provided for further care. Generally, two to four sessions, scheduled about four weeks apart, are recommended to see results, even though many patients report improvement after a single treatment.

Don’t try this at home

Some companies sell micro-needling rollers for home use. These are not medical grade and their efficacy is not fully known. Additionally, there are significant risks associated with any facial skin procedures that may require medical attention. If you feel micro-needling is for you, I strongly recommend a complete evaluation by your plastic surgeon or dermatologist and that your treatment be performed by qualified personnel.

Is micro-needling the future?

Microneedling acne scars B & AMicro-needling is a new therapy that is safe, more comfortable, and less expensive than laser resurfacing. The use of the patient’s own serum, rich with platelets and growth factors (“vampire facial”), adds to the overall effectiveness of the procedure and is gaining popularity amongst doctors and patients alike. Only time will tell if this new treatment will edge out lasers in cosmetic medicine. Newer and better therapies are being discovered all the time.  For now, I believe this modality is here to stay.

All photos – courtesy of Natural Image



About Dr. Arnold Almonte, D.O.

Dr. Arnold Almonte is a gifted board-certified plastic surgeon. He is one of the only plastic surgeons in Sacramento that has ( read more )

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