Collagen induction therapy unpacked

Collagen unpacked induction therapy

Also called micro

needling or dermal needling, collagen induction therapy involves the use

of tiny needles to make small channels/ holes in the skin, causing injury which leads to the stimulation of fibroblast making collagen, elastin and hyaluronic acid. This process leads to the rejuvenation of the skin. History 1950s: Micro-needling is first described by the founder of mesotherapy, Dr Michel Pistor, who didn’t employ the method himself but came up with the concept that pricking skin would promote collagen formation. (Pistor, M. Presse Med. 1958 Jun 4;66(44):999-1000). 1995: Subcision, a new method of subcuticular mining for the treatment of depressed cutaneous scars and wrinkles, is introduced. Mechanism of action is two-fold: releasing action of the procedure; and new connective tissue via the wound-healing response. (Orentreich DS, Orentreich N. Dermatol Surg. 1995;21:6543–9). 1997: Needle dermabrasion using a ‘tattoo pistol’ to treat scars. Intended to remove the tension and tightness in the skin caused by scarring. Patients receiving skin-coloured tattoos over facial scars saw evidence of pigmentation after one to two years even though the tattoo pigment was long gone. Scars were immensely improved in texture, appearance and colour. Not feasible due to time and labour intensive nature of using just one needle to treat scars. (Camirand A, Doucet J. Needle dermabrasion. Aesthet Plast Surg. 1997;21:48–51). 1998: Dr Des Fernandes of South Africa presented his findings on needling at a conference in San Francisco. He introduced a needling device, a small needle stamp, to induce collagen and used as a regular treatment in his surgical practice. (Fernandes D., Minimally invasive percutaneous collagen induction. Oral Maxillofac Surg Clin North Am. 2006;17:51–63) 2000: Horst Liebl, inventor of the original German Dermaroller, designed the very first In this article, SONETTE DONKER of Skin iD, outlines the history, applications and benefits of micro-needling.

microneedling medical device. It consisted of many fine needles on a drum-shaped roller device, with the ability to treat larger areas of the skin easily and quickly. 2004: Clinical Resolution Laboratory, a California company, redesigned the device, called MTS Roller.

Effect on skin So, what actually happens in the skin during and after a microneedling session? Phase 1 Injury done to the skin leading to inflammation.

When there is inflammation in the skin, neurotrophils and macrophages are released. These secrete antibacterial chemicals. It is vital for the removal of foreign particles and necrotic debris in the skin, which initiates angiogenesis and the granulation process. Phase 2 Tissue proliferation: Fibroblasts proliferate in the wound and release glycoproteins, growth factors and collagen. Epidermal cells migrate from edge of wound. Granulation tissue is formed. Continued capillary formation. Continued fibroblast proliferation. Phase 3 Tissue remodelling. Fibroblasts replace collagen 3 with collagen 1. Contraction of the wound for increased tissue integrity.

Due to the these three phases that take place, it is suggested to only needle every four weeks if you work 1mm and deeper on the skin. If you work 0,25mm or 0,5mm in the skin, then you can needle every two weeks. If you just see erythema on the skin, then you are only working in the epidermis and this is the best depth for treating pigmentation. If, however, you see pin prick bleeding, then you know you are in the dermis. Dermal penetration is needed for treatment of acne scars and wrinkles.

Tools Micro-needling can be performed with either a pen device or a roller device. The pen has a vertical insertion method, while the roller has a sloped/ curved insertion method.

Who can perform micro-needling? Doctors or aesthetic therapists working with doctors can go deeper than 1mm in the skin. Skin therapists not working with a doctor can only go as deep as 1mm.

Indications • Skin rejuvenation (tightens and firms) • Reduce wrinkles and fine lines • Acne scarring • Stretch marks • Scars • Epidermal pigment • Burn wounds

Contra Indications • Active acne (USA dermatologists needle active acne) • Rosacea (often get good results if needling 0,5 mm) • Raised surface areas (swelling or inflammation) • Actinic Keratosis • Eczema • Skin Cancer

Number of treatments • Sebaceous Hyperplasia • Keloid scarring

Client benefits • More affordable than laser or IPL treatments • Less discomfort • Minimal downtime if any (The client looks and feels sunburnt for a day or two.) Quick treatment • Excellent results The client may not go out in the sun for at least 10 days and should wear sun protection at all times. It is advisable to give the client post needling products that will also soothe and start the healing process.

Benefits to offering micro-needling in your clinic Minimal investment Multi-application procedures Little disposable cost Quick treatment (30 to 60 minutes only) Good profit

Before doing a treatment on a client it is vital to do a thorough skin analysis and health history, i.e. to determine if the client is prone to fever blisters, or has diabetes or any autoimmune disorders etc. PB

Sonette Donker is a qualified professional skincare therapist with 20 years of experience, having worked for Dermalogica, Nimue Skin International, Skin Rejuvenation Technologies and pHformula. She has travelled the world presenting at congresses, press events and medical conferences. At her clinic, Skin iD, Donker specialises in the treatment of acne, hyperpigmentation and the visible signs of ageing.

sonette@skinid.co.za

Application Treatments Intervals Needle Depth Speed Fine skin: wrinkles 4-6 7-14 days 0.4 - 1.0 2-3 Normal/ oily: wrinkles 6-8 10-14 days 0.2 - 1.25 2-3 Acne scars 6-8 14-30 days 0.6 - 1.50 2-3 Stomach 6-8 14-30 days 0.8 - 2.00 3 Arms 6-8 14-30 days 0.8 - 1.50 3 Thighs 6-8 14-30 days 0.8 - 1.50 3 Décolleté 4-8 10-21 days 0.50 - 1.00 3