Skin needling: Everything you need to know

Well respected and extremely talented Dermal Therapist Danielle Viljoen, the owner of  popular Wildlife Skin & Beauty in Sydney, details the ever popular and proven treatment of micro-needling (also known as skin needling, a treatment that we absolutely love at 50sowhat).

Danielle Viljoen, Owner Wildlife Skin & Beauty
50SW: What is micro-needling/skin needling/collagen induction therapy?

Danielle: There are many names used for this treatment; Percutaneous collagen induction (PCI),
collagen induction therapy (CIT), dermarolling, dermal needling, skin needling, micro-needling and the list goes on. They are all the same thing. The only difference is if it
is a ‘medical’ or ‘cosmetic’ type treatment which is determined by the depth of needle penetration. I like to call it skin needling. The name speaks for itself.
Skin needling is a minimally invasive, non-surgical, non-ablative procedure which involves pricking the skin multiple times using a specially designed device (either a roller or electronic pen) with sterile needles to induce skin regeneration via the skin’s natural wound healing cascade.

Visible scar reduction before and after (four treatments in total)
What is it for? What does it treat?

Skin needling is far more than collagen production. Initially needling was predominantly promoted for increasing and remodelling collagen however, collagen production is just
one aspect of this treatment. Micro-injury of the skin also resets and improves normal cellular function. For example; If the cells that produce melanin (melanocytes) either overproduce or under-produce pigment, skin needling will normalise the melanin production(melanogenesis). The same goes with keratinocytes (cells that produce keratin in the skin) and oil producing cells (sebocytes). If all the cells in your skin are functioning and doing their job properly then you should have incredibly healthy, radiant skin. So in saying all of this, skin needling treats the following:
– Ageing skin, lax skin, fine lines and wrinkles
– Tightens skin (but not like a face lift does)
– Acne scars, surgical scars, any scars
– Stretch marks
– Sun damaged skin (sun damage looks like: pigmentation, uneven skin tone & texture,
lacklustre, fine lines & wrinkles, loss of elasticity etc)
– Thin fragile skin
– ‘Tired’ skin – skin that needs a boost and to have its glow back
– Uneven skin tone & texture (not necessarily related to sun damage)

What doesn’t it treat?

– Melasma
– Hypopigmentation (complete loss of pigment – nothing can treat this)
– Severe loss in elasticity & sagging skin where a face/neck lift is needed however,
needling can be used to prepare the skin before having any surgical procedure.
Healthy skin prior to surgery = way better results and better wound healing post
surgery.can have it?

Who can have it?

Skin needling is safe for all skin types of all ages.

What is the process?

Skin Prep
Before having cosmetic surgery or any skin treatment that requires healing it is always
best to prepare the skin prior to the treatment in order to get the best results and to
support the wound healing involved. Prepping the skin means using good skin care (at
least 3 weeks prior to treatment) that contains certain ingredients that support the health
of the skin and promote optimal cell function. Vitamin A & C in the skin are essential for
fibroblasts to produce collagen and elastin. Prepping your skin by applying topical
cosmeceutical serums and creams containing high doses of vitamins A & C and
antioxidants at least 3 weeks to 3 months before needling will give you 150% better
results than the effect of needling on its own (Dr Des Fernandes). If your skin’s surface is
thickened and rough then a course of peels (as well as topical skin care) is needed to get
the surface prepared for skin needling. Protecting your skin from the sun and applying a
physical sunscreen (zinc based) in the mornings (3 months before, during and after
treatment) is mandatory and is a non-negotiable.

The Treatment
1. Your skin is cleansed and sterilised.
2. Numbing cream is applied and left on for about 30 minutes (you may bring in your
own prescription strength numbing cream to be applied. This cream can be obtained
by prescription from your doctor.)
3. Numbing cream is removed and an antiseptic spray is sprayed onto the skin.
4. A hyaluronic gel is applied to the face to allow for the needling device to glide over the
face effortlessly.
5. The needling treatment starts at the forehead then the rest of the face, neck and
décolleté if requested. The actual needling part treatment only takes 20 minutes.
6. Once completed, a cooling sheet mask is applied directly onto the skin for about
10mins.
7. Then residual gel and any dried blood from pin point bleeding is removed.
8. You may then sit under an LED light for 20mins to reduce any inflammation and
promote wound healing.
9. The appropriate moisturiser and zinc based sunscreen is applied.
10. The treatment is completed.

What to expect afterwards immediately after treatment

Your skin will be red and feel warm like sunburn. It is not an uncomfortable feeling and
does not affect ones sleep at night.
Minor bruising may be present in the form of tiny red dots. These take a day or 2 to
disappear.

Day 1

Your skin will still be slightly red, may appear flushed or mildly sunburnt and may be feel
mildly puffy. Your skin will feel slightly tight and dry.

Day 2

A red hue may still persist. Make-up may be applied at this stage (at least 24hours after
treatment). Skin may feel even drier which is totally normal.

Day 3

Skin is slightly pink at this stage and redness and any bruising is visibly starting to fade.
Skin may still feel very dry and may be slightly flakey.

Day 4

Redness is almost completely gone and natural skin hydration is starting to come back.

Day 5-6

Redness and dryness should be completely gone. A gentle enzyme exfoliator may be
used to get rid of any residual dryness and flakiness. Your skin is glowing and looks
pretty much normal again.

Day 7

Your skin should look and feel completely normal by now. It should be glowing and
feeling extremely soft.

Downtime

– 5 days
– Mineral make-up can be worn 24 hours post treatment which will hide any signs of
treatment.

Post Care

– Cleanse skin morning and night with a milky or creamy type cleanser. As the skin will
feel tight and dry for the first 3-5 days, moisturisers that contain ceramides work best
to alleviate this. As mentioned before, vitamin A & C are essential in collagen and
elastin production so the use of a moisturiser or serum that contains these vitamins is
paramount. Zinc oxide and titanium dioxide based sunscreens are just as important.
These are called physical sunscreens where UV radiation bounces off the mineral and
doesn’t penetrate the skin. This is the best sunscreen to use when protecting your skin
from sun damage, it’s like wearing a piece of clothing. After about a week you may
continue with your normal skin care routine.
– Avoid direct sun exposure for at least 10-28 days if possible, always wear a physical
sunscreen and a hat.
– Do not swim or do vigorous exercise for 24 hours after needling.
– NO saunas or steam rooms for one week post treatment.
– LED light therapy 3x a week works wonders for speeding up wound healing and
relieving the redness.

How many treatments do I need and how often?

When having needling for the first time, a minimum of at least 3 treatment is required to
reap benefit. 6 or more treatments is recommended for anti-aging and scars. There is no
limit to the number of treatments you can have. How many treatments you need is
dependant on the severity of the condition being treated. Deep lines and wrinkles as with
deep acne scars require more treatments than fine lines and surface scarring. After
having completed a course of skin needling treatments, one should wait 3 months before
having another treatment. This is because it take about 3 months for collagen and elastin
production to complete.
Ideally treatments should be done 2-4 weeks apart but no further than 6 weeks apart.

Contraindications

Needling must not be performed on:

– irritated skin
– infected skin
– open wounds
– Active cold sores (if you suffer from cold sores, you must take a herpes prophylactic 2
weeks prior to treatment)
– skins with fungal infections
– active pustular or nodular rosacea
– psoriasis
– severe solar keratosis
– active skin cancers (yet once removed, needling can be used to treat the residual
scarring)
– directly over raised moles or warts
– Severe cystic acne
– Roaccutane – postpone needling for 6-12 months after discontinuation

Not Contraindications but Precautions:

Atopy – Asthma, Hay Fever & Allergies
Anybody, but especially those with a history of allergies, may be prone to urticaria after
needling due to the release of histamines. This may result in itching or a burning
sensation that may last for a couple hours to a day or two. It is not an indication that
anything has gone wrong but would probably alarm someone if not mentioned prior to the
treatment. This reaction is rare and often becomes less with subsequent treatments.
Taking a long-acting antihistamine prior to needling should help.
Being on Anticoagulants (blood thinning) Supplements and Medications:
Example: fish oils, omega-3 oils, vitamin E, St Johns-wort, ginko biloba, ginseng,
ibuprofen, NSAIDS warfarin, heparin etc.

If you’re on a prescription anticoagulant medication for potentially life-threatening
conditions then it’s obvious not to discontinue the use of these medications purely for the
benefit of having a cosmetic treatment. You will need to get the tick of approval from your
doctor allowing you to have a needling treatment whilst being on such medications.
If you have taking anticoagulant supplements (fish oils, St Johns-wort etc) these need not
necessarily be discontinued but obviously the risk of bruising is increased. If you would
like to decrease the risk of bruising, discontinue the use of these supplements 2 weeks
prior to treatment.

Anti-wrinkle Injections and Fillers

If you’ve had anti-wrinkle injections (eg: Botox) then wait 48 hours before having skin
needling.
If you’ve had filler injected then wait 2 weeks before having skin needling

Note We highly recommend Danielle for skin-needling treatments. Her professional, warm and caring nature make her the perfect choice. You can contact Danielle via wildlifeskinandbeauty.