- Dermaroller or microneedling, as the term indicates,means the use of microneedles to achieve therapeutic effect.
- Roller system –It is a unique rolling device for the transdermal delivery of the substances that enhances the action of transdermal drug delivery and hair restoration.
MICRONEEDLING
• Microneedling, originally known as collagen induction therapy or percutaneous collagen induction, is now a well documented treatment option for many dermatological condions.
• The technique of microneedling was
innovated by Fernandes in 2006.
PRINCIPLE OF MICRONEEDLING
• It relies on the principle of neocollagenesis and neovascularisation that occurs as a result of the release of growth-factors following needle piercing of the stratum corneum.
• These growth-factors are believed to be responsible for the beneficial effects of the procedure in the treatment of different dermatological conditions like scars , photoaging ,AGA etc
• There are two hypothesis to explain the mechanism of action of microneedling.
1. Formation of microchannels with resultant healing response.
Following microneedling, thousands of microchannels or tiny wounds are produced through the epidermis into the papillary dermis of the treatedskin.These microchannels act as a powerful stimulus for the release of various growth factors such as platelet derived growth factors (PGF), transforming growth factor alpha and beta , and fibroblast growth factor (FGF),which initiate the normal process of wound healing by stimulating the migration and proliferatrion of fibroblasts that promote collagen deposition.
2. Production of a demarcation current
• When the microneedles penetrate the skin , a demarcation current is produced among cells. It is the demarcation current that triggers a cascade of growth factors that stimulate the healing phase. In resting state, the interior of epidermal cells have a negative electric potential of – 70mv where as interstitium and epidermal surfaces have a positive potential. The increase in the potential difference between the interior of the cell and the exterior environment triggers the migration of fibroblasts to the site of injury where they proliferate and lay down collagen.
INSTRUMENTS USED FOR MICRONEEDLING
• The instrument used for microneedling is known as Dermaroller.
• It is a simple hand held instrument consisting of a handle with a cylinder studded with sterile,fine stainless steel needles of 0.5- 2mm in length.
• There are 192 needles and they are spaced at
regular distances from each other.
• In order to achieve a uniform depth of penetration,the needles are placed at an inclination of 15 degrees in relation to the surface of dermaroller
• To achieve the therapeutic benefit this needle studded cylinder is rolled on the skin in multiple directions and hence thename dermaroller.
HOW THE PROCEDURE IS DONE
• Micro needling is usually performed under the
influence of a topical anaesthetic cream and is applied for a minimum of 45 mins before the procedure is started.
• For treating acne and other scars the needle length should be selected on the basis of depth of the scars present. 1.5 -2mm is usually used for acne and other scars.
• For ageing and wrinkles,the needle should be 0.5 or 1.0mm
• After achieving adequate anaesthesia, the area to be treated is washed with saline water and then ethanol solution to obtain an aseptic fied.
• The instrument is then held in the right hand like a pencil and rolled in three different directions on the treatment area
• The procedure is performed after stretching the skin mildly with the left hand, so that the base of the scar is treated correctly.
• Uniform formation of small pinpoint bleeding points mark the treatment endpoint.
POST PROCEDURE CARE
• The treated area is simply washed off with saline solution and a patient is given a non comedogenic antibiotic cream for 3 -4 days after the prtocedure.
• Sun avoidance and regular use of sunscreen is recommended in the post treatment area.
• The bleeding points heal within 2-3 days with no post treatment sequelae.
• Treatment with dermaroller is performed at 4 -8 weeks interval.
APPLICATIONS OF DERMAROLLER IN DERMATOLOGY
• Although dermaroller was initially proposed as a treatment modality mainly for scars and wrinkles, its use has also been extended to stretch marks, facial rejuvenation and transdermal drug delivery.
ADVANTAGES
• There are a number of advantages of using dermaroller.
• In a nutshell,they are,
• Far less invasive
• Quick recovery time
• Lower risk of complications
• All skin types can be treated
• No risk of permanent structural damage
• No sun sensitivity after the treatment
• No skin color loss or hyperpigmentation after treatment.
• Dermaroller can also be used on the areas that are not suitable for peeling or laser such as near the eyes.
ADVERSE EFFECTS
• A few adverse effects have been reported with dermaroller treatment.These include,
• Pain during the procedure
• Transient erythema and oedema
APPLICABLE AREA
• Face,neck, arms,abdomen,legs,hair.
COMBINATION OF DERMAROLLER WITH OTHER PROCEDURE
• To maximise the results of dermaroller,it can be combined with other procedures like subscision for acne scars, chemical peels, microdermabrasion and fractional resurfacing.
USES OF DERMAROLLER
Besides acnescars ,dermarollerhas also been used in the treatment of,
1. Varicella scars
2. Post herpetic facial scars
3. Hypertrophic and burn scars
4. Antiaging
5. Transdermal drug delivery
6. Hair disorder
7. Large pores
8. Wrinkles
9. Stretch marks
10. Cellulite
11. Facial rejuvenation
CONCLUSION
• Dermaroller is an underused treatment option
• It can serve as a cheap alternative to fractional laser resurfacing in multiple indications
• Therapeutic applications of this modality are going to increase opver the years tocome.
