SkinPen Microneedling: Clinical Basics
Microneedling is an extremely safe, minimally invasive skin resurfacing procedure that uses 12 automated microneedles penetrating 0.25-2.5mm depth to create controlled microtrauma, triggering neocollagenesis and neovascularization for treatment of fine lines, wrinkles, and skin texture concerns with only 24-48 hours downtime. 1
Mechanism of Action
The device delivers a vibrating, stamp-like motion at 3,000-5,000 RPMs, creating microchannels that stimulate three phases of wound healing: inflammation, proliferation, and remodeling. 1, 2 This controlled injury activates platelet growth factors (PDGF, TGF-β) that stimulate fibroblasts to produce collagen type 1 and elastin, improving skin thickness and hydration. 1, 3
Key Advantages Over Alternative Treatments
- Minimal downtime: 24-48 hours versus weeks for lasers or deep peels 1
- Universal skin type safety: Can be used on Fitzpatrick types III-VI where lasers are contraindicated 1
- Minimal complication risk: Very low risk of post-inflammatory hyperpigmentation or scarring since maximum penetration is only 2.5mm 1
- Effective for high-risk patients: Safe for smokers and those exposed to environmental pollutants 1
- Preserves epidermis: Nonablative approach reduces inflammation and dyspigmentation risk 4
Treatment Protocol
Pre-Treatment Preparation
- Apply compounded topical anesthesia (pharmacy-based, not over-the-counter) for minimum 30 minutes prior to procedure 1
- Completely remove anesthetic before beginning treatment 1
- Map out problem areas (scarring, acne scars) for targeted stamping techniques at greater depth 1
Treatment Specifications
- Initial series: 3-4 sessions spaced 1 month apart 1, 3
- Maintenance: Every 6-12 months thereafter 1, 3
- Needle depth: 0.25-2.5mm depending on treatment area and indication 1, 3
- Lubrication: Ensure skin is well lubricated during procedure to avoid dry tugging sensation 1
Critical Contraindications
- Do not microneedle over tattoos or permanent makeup 1
Enhanced Results with Adjunctive Therapy
Combining microneedling with autologous platelet concentrates (PRP or PRF) produces significantly superior outcomes compared to microneedling alone, with mean improvement of 70.43% versus 39.71% for microneedling alone. 3, 5 PRF demonstrates 3-fold higher therapeutic response than PRP when combined with microneedling. 3, 5
When using PRF, note that it will clot within 20-40 minutes if left in the syringe, and exposure to oxygen accelerates clotting. 1
Post-Treatment Care
- Avoid sunlight for 24 hours post-procedure 1, 3
- Avoid heavily scented facial creams/products for 24 hours 1
- Use gentle, non-drying cleansers and non-comedogenic products during the 24-48 hour healing period 3, 5
- Expected transient effects include erythema, mild pain, edema, and temporary skin irritation 6
Safety Profile
Microneedling demonstrates excellent overall safety with minimal adverse effects across 1,029 patients reviewed in systematic analysis. 6 The procedure is well-tolerated with expedient recovery and limited side effects. 7 Permanent adverse events are uncommon, though transient erythema and post-inflammatory hyperpigmentation are occasionally reported. 8
Important Clinical Caveats
- Patient age and chronicity of skin damage may negatively correlate with degree of improvement 3
- The technique is easy to master and represents a convenient office procedure with minimal overhead cost 1
- One documented case exists of fractional microneedling radiofrequency inducing rosacea in a patient treated for wrinkles, highlighting the need for cautious treatment in susceptible patients 5