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Dear Patron

In view of the COVID lockdown we are offering Tele and Video consultation in line with the karnataka government issued circular HFW54 CGM 2020 dated 26/03/2020.
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Team DSHS
 Dermaroller

Dermaroller

Dermaroller is a skincare equipment that has gained immense popularity in recent times as it is a simple, cost effective technique to achieve skin rejuvenation with minimal training. It facilitates skin rejuvenation, stimulation of hair growth and collagen, treatment of Acne Scars and reduction in signs of aging. It can also fill in fine lines and wrinkles, reduce under-eye bags and dark circles, improve skin texture, reduce the size of pores, and fade blemishes and marks.

The device has a handle on one end and on the other end there are extremely fine needles on its surface. When these tiny sharp needles are rolled on the skin surface then they cause microscopic skin injuries which may or may not bleed. This procedure prompts the body’s natural healing mechanism to boost collagen and elastin production to heal the injuries. The end result is a tighter, plumper and rejuvenated skin. Similarly, dermarolling of the scalp also stimulates collagen production which in turn improves blood circulation and hair growth.

There are different types of dermarollers depending on the size of the needles. The size of the needles usually ranges from 0.2mm to 3.0mm. Depending on the skin concern, the size of the needle is chosen. 

Let us understand the use of different types of dermarollers based on the size of the needles:

  • 0.2mm to 0.3 mm
    These are the smallest needles available that assist in absorbing skincare products. These needles can be used gently everyday including in the neck and the eye areas.

  • 0.5mm
    Apart from assisting in absorption of skincare creams and lotions, this needle aids in treating pigmentation, shallow wrinkles and skin damage caused due to UV rays. Since it is a slightly longer needle, it is advised to use it weekly or fortnightly. One may experience skin redness and blood spots that heal soon.

  • 1.0mm
    1.0mm is a slightly longer needle which helps in absorbing skincare products, treats pigmentation along with scars, wrinkles and stretch marks. A numbing cream should be used as the procedure may be painful. It is advisable to not opt for this needle more than twice a month. One should ideally keep a gap of 4-6 weeks between two uses.

  • 1.5mm-2.0mm
    These needles are used to treat skin conditions in body parts other than the face. One can treat wrinkles, stretch marks and scars in hands, abdomen, arms and thighs. Since it penetrates deeper into the skin than the smaller needles, it is important to take help of anaesthesia. One can keep a gap of 6 to 8 weeks between two uses.

  • 3.0mm
    The longest needle available, this is used to treat hard regions like lower and upper back, thighs, arms, feet and abdomen for severe burns, stretch marks and scars. A gap of two months between two uses and anaesthesia is compulsory.

It is important to note that needle length 1.5mm and above should be administered under the guidance of an expert.

PRINCIPLE OF MICRONEEDLING
Microneedling leads to reorganization of old collagen fibres and laying down of new collagen, elastin, and capillaries leading to the effect of skin tightening. A significant increase in level of collagen type I, III, and VII, newly synthesized collagen and tropoelastin leads to an overall youthful appearance of the skin by reducing fine lines and wrinkles, reducing pore size, more suppleness, and elasticity.

The effects are enhanced when the procedure is combined with topical anti aging vitamin C serum and tretinoin application. Microneedling has also been combined with human embryonic stem cells derived endothelial precursor cell conditioned medium and has shown significant reduction in wrinkles and pigmentation.

Different Types of Dermaroller Machines
Beauty Mouse
When it comes to approved devices intended for home use, Beauty Mouse is one of the options. It contains a total of 480 needles of approximately 0.2 mm size on 3 separate drums strategically placed inside a computer mouse shaped device. It has been developed to ensure coverage of larger skin surface areas, such as the arms, legs, and buttocks for the treatment of stomach or thigh stretch marks and cellulite.

Dermapen
Dermapen is an automated microneedling device which looks like a pen. This ergonomic device makes use of disposable needles and guides to adjust needle length for fractional mechanical resurfacing. The tip has 9–12 needles arranged in rows. It makes use of a rechargeable battery to operate in two modes, namely, the high speed mode (700 cycles/min) and the low speed mode (412 cycles/min) in a vibrating stamp-like manner. 

It has the advantage of being reusable in different patients as the needles are disposable, safe as the needle tips are hidden inside the guide, and more convenient to treat narrow areas such as the nose, around the eyes and lips without damaging the adjoining skin.

 It makes the procedure less painful and more economical as there is no need to buy a new instrument every time. But it is costlier and does not prove more advantageous than Microneedling radiofrequency.

Microneedling radiofrequency
The amalgamation of microneedling with radiofrequency has further expanded the prospects of application of this technology.  

Insulated needles are used to penetrate the skin and release radiofrequency currents from the needle tips producing thermal zones in the dermal structural components and accessory glands without damaging the overlying epidermis. This triggers long-term dermal remodelling, neo elastogenesis, and neocollagenesis. The depth of the needles can be adjusted from 0.5 mm to 3.5 mm allowing us to target different layers of the dermis discreetly. 

Operating person can exercise good control over tissue damage by adjusting the power level and duration of energy pulse. The main energy delivery system has a disposable tip with 49 gold plated needles. Microneedling radiofrequency (MNRF) technology does not damage the epidermis, and is therefore safe in darker skin types. Its indications include scar treatment, hyperhidrosis, skin tightening, rejuvenation, and many more.

At Dr Divya’s Skin and Hair Solutions Clinic, the internationally acclaimed ENdymed Intensif system is used for MNRF. 

Light emitting microneedling device
LED microneedling rollers have been recently launched. These incorporate titanium microneedles and LED light to combat wrinkles and scarring.

Who can benefit from Dermarollers?
Dermarollers can benefit people who have:

  • Acne Scars:
    The most frequently used indication of microneedling is post-acne facial atrophic scars in combination with chemical peels, platelet-rich plasma, subcision, cryotherapy, and CROSS technique. Microneedling has been found to be more effective for rolling and boxcar scars and relatively less effective in ice-pick scars. Only the affected area needs to be treated and there is minimal risk of post-inflammatory dyschromia. However, a minimum of 4–6 sessions are required for a significant improvement.

  • Male and Female pattern Hair Loss:
    Use of microneedling over scalp for alopecia is one of its recent advances. It has been compared with minoxidil alone and has been found to be better in combination.Microneedling has also been combined with topical triamcinolone acetonide application in alopecia areata and better response has been observed

  • Melasma and Periorbital Hypermelanosis:
    The introduction of Dermafrac technique and smaller drums with needles sizes approximately 0.5 mm has made the microneedling to periocular skin amenable. Microneedling has been combined with various skin lightening agents and chemical peels to reduce melasma as well as periorbital hypermelanosis

  • Skin Laxity:

  1. Lax skin on arms, abdomen, neck, thighs, areas between breast and buttocks.

  2. To tighten skin after liposuction.

People with large pores, thin hair, dull skin, pigmentation and rough skin texture can also benefit from dermaroller.

CONTRAINDICATIONS

  1. Active acne

  2. Herpes labialis or any other local infection such as warts

  3. Moderate to severe chronic skin disease such as eczema and psoriasis

  4. Blood dyscrasias, patients on anticoagulant therapy

  5. Extreme keloidal tendency

  6. Patient on chemo/radiotherapy.

Dermarolling has its own set of limitations despite its assembly of effective uses and advantages over other procedures. It is less efficacious in some types of scars such as pitted scars, linear scars, and deep boxcar scars. However, combining other surgical procedures to microneedling can improve its results.

There are certain adverse events also known with the procedure; the common ones being potential erythema and irritation which usually subside within a few hours. Other events noted are post-inflammatory hyperpigmentation, aggravation of acne and reactivation of herpes, systemic hypersensitivity, allergic granulomatous reactions and local infections following the use of a nonsterile instrument Allergic contact dermatitis to materials used in the needles has also been observed.Tram-track effect after two sessions of microneedling has been reported in a patient with acne scars who developed regularly placed linear papular scars over bony prominences of the face. This can be avoided by using less pressure and smaller needles over these areas.

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FAQs

When the tiny sharp needles of dermaroller are rolled on the skin surface it creates many microscopic injuries on the skin (that can bleed). This prompts the body’s natural healing mechanism that sends collagen and elastin production into overdrive to heal the injuries. The result: skin becomes tighter and plumper. For more pronounced results lipopeptides and other anti-ageing topical medicines can be used after every session of dermaroller.

Similarly, the dermarolling of the scalp also prompts to produce more collagen which supports the growth stage inside the hair follicle and improves blood circulation. The increased blood circulation is a reaction of the epidermis to the wound, hence, it is highly advised to apply topical medicine that substantiates the hair growth such as peppermint oil or minoxidil following dermarolling sessions.

Dermaroller studded with 192 needles of 200 µm length and 70 µm diameter create approximately 250 holes/cm2 when applied 15 times over a certain area.* Skin produces new collagen (natural collagen) and elastin in the papillary dermis in response to microneedling as done by dermaroller. This neovascularisation and neocollagenesis following the treatment with dermaroller leads to the reduction of scars. A recent study of microneedling therapy showed safety and effectiveness against atrophic acne scars in Vietnamese patients.

Similarly, clinical studies in androgenic alopecia patients demonstrated clinical effect after using derma-rolling for hair loss over 12 weeks. In a small study of alopecia areata patients, dermaroller used three times at three-week intervals showed significant results.

People with acne scarring, larger pores, who want a skin-tightening boost, androgenic alopecia and hair thinning for hair regrowth get benefitted. For acne scars thicker and deeper needles are required and to tighten the pores short needles are required. For hair regrowth, microneedles of 0.5mm are sufficient in most of the cases. The needle length of 1.5mm and above may require professional expertise.

Microneedling induces wound healing cascade with minimal damage to the epidermis, which, allows enhanced absorption of topical medicines across the thick stratum corneum. Microneedling as novel, simple, well-tolerated and cost-effective treatment is increasingly popular among the dermatologists. The procedure also allows cosmetic and therapeutic benefits for the topical delivery of medications in the treatment of atrophic scars, alopecia, actinic keratoses, photoaging, and disorders of pigmentation such as melasma. Hence, it can be used to treat localized diseases of inflammation, dyschromia, and photodamage by using as adjunctive therapy for enhanced drug delivery.

While varying dermarollers with different needle length are freely available in market and online, a dermatologist’s expertise is needed:

  • To understand whether the condition would benefit from dermaroller or some other procedure is required.
  • The technique is tough to perform on your own face and scalp so need expert handling as inefficient use can potentially lead to scarring or inadequate coverage of the area to be treated.
  • Self-application of pressure is always inhibited due to pain sensation experienced while dermarolling.

At Dr. Divya’s Skin and Hair Solutions, we have hundreds of treated patients who have benefited immensely from Dermaroller treatment for hair loss and scars. The experienced staff takes the utmost care to deliver treatment following scientific methodology, safely and hygienically.

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