2015年12月10日 星期四

Skin needling


Mechanism of action:
The microneedles penetrate through the epidermis but do not remove it; the epidermis is only punctured and heals rapidly. The needles seem to separate the cells from each other rather than cut through them, and thus many cells are spared. When a needle penetrates into the skin, the injury causes localized damage and minor bleeding by rupturing fine blood vessels. A completely different picture emerges when thousands of fine needle pricks are placed close to each other. Most authors consider that skin needling induces normal wound healing. Recently, a new hypothesis has been proposed to explain the PCI mechanism of action: when CIT is performed using a high-quality device, the fine microneedles do not create a wound in the classic sense. The wound healing process is cut short, as the body is somehow ‘fooled’ into believing that an injury has occurred. According to this new theory, bioelectricity (also called ‘demarcation current’) triggers a cascade of growth factors that stimulate the healing phase. Although the mechanism of action is still unclear, the final result is deposition of new collagen in the upper dermis.

Depth:
l   Home skin needling: 0.2-1mm
l   Beauty/clinical: 1-1.5mm
l   Medical: 1.5-3mm

Indications:
l   Best form of treatment for melasma.
l   Pigmentation
l   Uneven skin
l   Acne, rosacea
l   Stretch marks
l   Can be done during pregnancy if no anaesthetic is used. Further down the track of pregnancy, do shallower depth as pregnant ladies bleed more easily.
l   Because it puts a controlled wound through the epidermis into dermis, there is low risk of PIHP and short down time.

Contraindications:
l   Infection
l   Pregnancy, lactation (if local anaesthetics is being used)
l   Heart conditions
l   Blood thinners (fish oil is still ok)

Treatment regime:
6 sessions, every 6 weeks. If concern is about pigmentation then ongoing.

Procedure:
1.          Double glove.
2.          After face is cleaned, put on topical anaesthetic + cling wrap and leave on for 45 minutes.
3.          When time is up, wipe off with face wipe, then clean with chlorhexidine.
4.          Wipe down the dermapen and screw on the needle.
5.          Put on hyaluronic acid gel (or PRP platelet rich plasma for even better effect) to hydrate the skin treatment area.
6.          Treat in cross hatching technique: 4 directions (horizontal, vertical, diagonal), 50% overlapping.
7.          Forehead: 0.25-0.5mm, depending on how meaty the forehead is.
8.          Nose: 0.5mm.
9.          Under eyes: 0.25mm (just 1-2 strokes under eye, following orbit to get the crow feet too)
10.      The rest of the face: 1.5mm.

A journalist's personal experience with Dermpen:
http://www.smh.com.au/lifestyle/beauty/is-it-worth-it-this-week-the-dermapen-20140326-35jjw.html






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