Micro Needling For Scars Part - I

The Dermapen microneedling device provides an unparalleled response via the fractional delivery of micro-needles, creating micro-injuries to the epidermis and dermis. These micro-injuries to the skin encourage and harness the power of the body’s innate ability to repair the skin through the normal physiology of skin. The first phase begins with the release of the bodies growth factors and the further cascade of new epidermal growth, fibroblast chemotaxis, fibroblast proliferation and matrix production.

This proliferation of the body’s tissue continues to release growth factors from fibroblasts, keratinocytes and monocytes. The second phase of wound healing involves deposition of collagen III, IV and I, elastin, proteoglycans, and GAGs. The last phase results in tissue remodeling where the skins vascular matrix matures and skin tightening. The body’s ability to heal itself is at the heart of this amazing process.

What makes Dermapen Different:

The closest technology to the Dermapen is a fractional laser. A fractional laser “drills holes” in the skin to create a wound healing response and leaves normal tissue around the holes to be a reservoir for fibroblasts and stem cells to migrate into the holes. Fractional radiofrequency devices work on a similar principle and have many of the same side effects as fractional lasers (Yeung et al., 2012). Dermapen also makes holes in the skin to create a wound healing response and leaves normal tissue around the holes. These technologies have similar results, but achieve them in very different ways, and result in very different side effects profiles. The laser uses light to char and obliterate epidermis to produce small pits which vary in diameter and depth, depending on the laser type (Erbium, YAG, CO2; nonablative vs ablative) and manufacturer. Dermapen produces reproducible and consistent holes in the skin.

Side effects differ between technologies. Most fractional lasers leave erythema and edema up to 96 hours after treatment. Resultant downtime is approximately 3-4 days for fractional laser treatments (Gold, 2010). Dermapen treatments result in erythema with slight chance of edema for about 24 hours. Common side effects of fractional lasers are:

Pain (higher in dark skined patients (Mahmoud et al., 2010)

Persistent erythema (Gold 2010)

Infections (viral and bacterial). Facial herpes reported in 10.6% of patients in spite of antiviral prophylaxis (Naouri et al., 2011)

Post inflammatory hyperpigmentation in up to 18% (Vaiyavatjamai and Wattanakrai, 2011; Chan et al., 2010; Mahmoud et al., 2010; Yeung et al., 2012)

Postinflammatory hypopigmentation – seen in patients up to two years after a laser treatment. Occurs in up to 20% of patients with photo-aged skin (Gold 2001).

Light based therapy is not for all skin types. For example, the indications for use cleared by the FDA may put limits on the skin types that may be treated with a fractional laser. For example, the indications for use may prohibit the use of the laser on Fitzpatrick 4, 5 , and 6 (darker skin colors), for example: “The EXELO2 with the fractional scanning unit is indicated for ablative skin resurfacing in people with skin types 1, 2 or 3 based on Fitzpatrick skin type scale.” K090639. The fractional holes “drilled” by the laser are a function of skin type, skin thickness, and vascularity. Dermapen does not rely on skin color to turn light into heat.

A major complication from light based therapy includes Postinflamatory Hyperpigmentation (PIH) in Oriental, Mediterranean, and African skin types (Yeung et al., 2012; Metelitsa and Alster 2010; Chan et al., 2007). PIH presents as symmetric hyperpigmented macules and patches on the face. PIH is one of the most common and distressing pigmentary disorders seen in dermatology clinics. It is notably difficult to treat and may relapse.

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