What is dermal rolling? Does it really get rid of acne scars? And most importantly, is it safe and effective to do it to yourself at home?

Show notes

The Cosmetic Categories Game

Tune in as I try to stump Randy in a new game that features beauty products, beauty brands and beauty ingredients.

Question of the week: Will dermal rollers get rid of acne scars?

Chris asks…Does dermal rolling really work to remove acne scars and can you do it at home?

How does dermal rolling/micro needling work?

A dermal roller is one of the devices used in micro-needling which is the process of pricking tiny holes in the skin to stimulate collagen production. The technical name for this is “Percutaneous Collagen Induction Therapy” which is abbreviated as PCI or CIT). It’s been used by dermatologists for the last decade or so as a way to reduce wrinkles and scar tissue without significant side effects.

Basically, the process involves numbing your face and then poking it with fine needles a few millimeters long. These micro perforations trigger increased collagen synthesis. For some conditions it’s supposedly even better than lasers or dermabrasion because those procedures can cause a loss of skin elasticity.

Here’s how it works: Micro needling takes advantage of the skin’s normal response to any kind of inflammatory wound. If you cut your skin, for example, the platelets and neutrophils in your blood release growth factors which increase the production of components of the intercellular matrix of your skin. With micro needling, you prick the skin with a specially designed device that creates hundreds of micro wounds down in the dermis. These micro wounds cause this superficial inflammatory response which increases fibronectin production which sets up kind of a scaffolding where collagen is deposited. And over time this collagen goes through a conversion process where it naturally tightens up which reduces wrinkles and helps resurface scars. And because these needle holes are so small, there’s little risk of side effects from things like exposure to air or infection. Better still, there’s no post inflammatory hyper pigmentation like there is with some kind of wound healing.

What are the proven benefits of micro needling?

Acne

Chris asked specifically about acne scars and there have been studies which document that it really works. Here’s one example:

One 60 patient study published in the Journal of Dermatological Treatment in April 2014 showed an average 31% reduction in acne scars as measured by silicone replicas of the skin. They concluded “PCI offers a simple and safe modality to improve the appearance of acne scars without risk of dyspigmentation in patients of all skin types.” http://informahealthcare.com/doi/abs/10.3109/09546634.2012.742949

Anti-aging

As we already mentioned the procedure boosts collagen so it can reduce wrinkles. And there are even studies which indicate it can help anti-aging ingredients penetrate better. Here’s another study, this one from a 2011 edition of the Journal of Plastic, Reconstructive & Aesthetic Surgery. It’s called “Percutaneous collagen induction–regeneration in place of cicatrisation?” (sick-uh-try-zation.) This particular study involved four groups of rats:

Group 1 the control group received no treatment

Group 2 received topical vitamin treatment Vitamin A retinyl palmitate 1% and Vitamin C ascorbyl tetra-isopalmitate 10%

Group 3 received needling only.

Group 4 received needling plus vitamin treatment

After treatment they looked for changes in epidermal thickness, expression of the genes that control collagen production, increase in collagen, fibronectin, glycosaminoglycans (GAGs) and some related growth factors. The results were interesting – across all these parameters they saw a trend that the vitamin treatment alone showed a small improvement, needling showed a bigger improvement, but the combination showed an even BIGGER improvement.

Stretch marks

And finally here’s a study from a 2010 issue of Plastic & Reconstructive Surgery showing PCI even helps reduce stretch marks.

22 women with Striae Distensae were micro needled for a single 30 minute session. They were then assessed after 6 months and the needled area showed “improved skin texture, skin tightening, dermal neovascularization, and no change of pigmentation.” They even took biopsies which showed an increase of collagen I and elastin.

Can you needle yourself? The importance of needle size

Can you micro needle yourself? Actually, it’s not as simple as that. Depending on what benefit you’re trying to achieve, self-micro needling may not be such a good idea. Part of this concern is that not all dermal rollers are the same. The first thing to understand is the importance of needle size.

Short needles (0.1 to 0.3mm)

These are used for cosmetic needling only. They can improve penetration of active ingredients but will NOT stimulate collagen production or affect scars. They require no special skin preparation other than proper cleansing and, as I said, the use of anti-aging creams or lotions.

You can use these at home but they won’t boost collagen or treat scars and if you’re not using this type of roller with a truly functional anti-aging ingredient, you won’t see any improvement at all.

Medium length needles (1.0- 2.0 mm)

These are used for “medical needling.” These needles WILL activate collagen synthesis as long as they puncture enough capillaries. This is what is called a “petechial hemorrhage” and it’s required to trigger the anti-inflammatory response that we talked about earlier. 1.5mm needles will even work on some shallow acne scars. When this kind of needle is used properly you’ll have tiny red-purple blood dots all over your face. And, since you’re wounding the skin to a great extent, these needles require a topical anesthetic. These needles are sold for use at home but if done properly they are painful to use and remember – you need to bleed.

Long needles (3.0mm)

These are used for “surgical needling” and they penetrate deep enough to work on deep scar tissue. They MUST be used by a physician or trained medical personnel and may even require general anesthesia. They produce a LOT of blood. Obviously you can’t do this yourself.

Device quality and the importance of proper application

There are differences between the “at home” versions and the professional versions. The “professional” needles, like the Environ® Medical Roll-CIT, are made from surgical grade stainless steel and they are gamma sterilized so you know they are safe and clean. Products like this have some kind of disclaimer like “This product is highly specialised, for use by medical doctors and trained medical staff only. Professional training at one of Environ’s institutes is therefore required before this product may be used in treatments.”

Now should you decide that you want to try this for yourself, there are 3 dangers of DIY dermal rolling that you should be aware of:

1. Beware of misinformation

Needle size is critical. It looks like some companies who make these rollers are very clear about the difference between the professional models for medical use and the home models for cosmetic use. But other companies blur the difference and imply that the home model will provide all the benefits of the medical treatment model. Here are two examples of dermal rollers you can buy for use at home:

The Scientia Dermal Roller

Dermal Roller Systems (http://www.dermarollersystem.com) This is one the featured on Rachael Ray.

Their websites provide usage instructions but neither say anything about the petechial hemorrhages and the Dermal Roller System doesn’t even tell you to use a topical anesthetic gel!

2. Practice good hygiene

Another important point to consider is hygiene – whether you’re doing it at home or even more so if you’re having it done in a salon. I saw an article “Salon workers often skip the sterilizing process in between sessions and continue using rollers which can become bloodied after one session. This can expose clients to risks such as HIV and hepatitis.” http://www.truthinaging.com/review/beware-of-micro-needling. So this is nothing to screw around with.

3. Watch out for skin damage

Finally, there are those who say that rolling needles can tear the skin and that you should use stamps and pens which are provide “Vertical PCI.” These are supposedly superior because they can apply controlled pressure rather than requiring you to judge how hard to push the roller. They also poke holes perpendicular to the skin to they don’t tear as much. Also, needle cartridges are disposable and so are safer and more sanitary.

The Beauty Brains bottom line

Does micro needling really work? The preponderance of data indicates that when the correct needles are used properly it IS effective for reducing scars, wrinkles and stretch marks and it can help with anti-aging treatments. According to the scientific literature, the procedure has to induce some bleeding to be effective.

On the other hand, you have companies selling the do-it-yourself versions which claim they only cause a little transitory reddening of skin. That sounds suspiciously like “cosmetic needling” which is not intense enough to trigger collagen production and heal scars.

So if you want to give your skin care regimen a boost these at home devices seem like they can help ingredients penetrate but if you have serious scars that you want to remove, you’ll more likely to have the treatment done professionally.

References:

Derma-Roller FAQ’s: http://www.derma-rollers.com/24/derma-roller-faqs

Oral Maxillofacial Surg Clin N Am 17 (2005) 51 – 63 Minimally Invasive Percutaneous Collagen Induction Desmond Fernandes, MB, BCh, FRCS(Edin) The Shirnel Clinic and Department of Plastic Reconstructive Surgery, University of Cape Town, 822 Fountain Medical Centre, Heerengracht, Cape Town 8001, South Africa

American Academy of Dermatology 67th Annual Meeting March 6–10, 2009 P3514 Skin collagen induction and photoaging Gabriella Fabbrocini, Department of Dermatology University Federico II of Naple, Napoli, Italy; Antonella Tosti, Department of Dermatology University of Bologna, Bologna, Italy; Giuseppe Monfrecola, MD, Department of Dermatology University Federico II of Naple, Napoli, Italy; Maria Pia De Padova, MD, Ospedale Privato Nigrisoli, Bologna, Italy

Percutaneous collagen induction–regeneration in place of cicatrisation?, Journal of Plastic, Reconstructive & Aesthetic Surgery

Volume 64, Issue 1 , Pages 97-107, January 2011 http://www.jprasurg.com/article/S1748-6815(10)00179-8/fulltext

Percutaneous Collagen Induction Therapy as a Novel Therapeutic Option for Striae Distensae Plastic & Reconstructive Surgery: October 2010 – Volume 126 – Issue 4 – pp 219e-220ehttp://journals.lww.com/plasreconsurg/Fulltext/2010/10000/Percutaneous_Collagen_Induction_Therapy_as_a_Novel.79.aspx

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