Dry needling
A casual conversation with one of my patients introduced me to a relatively new upcoming treatment. My prediction is that this one is going to be “big.” Bigger than microdermabrasion and permanent makeup! Maybe even beating out “resurfacing lasers!” With my basic understanding of wound-healing and collagen remodeling, this “new” treatment stunned me because I can’t understand why it hasn’t been “discovered” before. This one is based on real science and, well, it just can’t miss.
All the various treatments to minimize wrinkles are based on selective skin injury. Such injury “kicks up” the healing process and ultimately stimulates fibroblasts to remodel the skin’s collagen. Chemical mediators do exist in the epidermis (only as thick as a piece of paper) that will somewhat call forth the healing process. Indeed, this is what micro-dermabrasion is trying to do, but in my opinion it’s not successful — except to cause temporary edema, which gives the client the impression of fewer wrinkles. See, if I slap you hard in the face, your face turns a nice rosy color, swells up a bit and your wrinkles puff up. Retin-A, pretty much does the same — although there are long-term benefits, if you don’t mind prolonged skin sensitivity and flaky skin.
However, for real remodeling you need to go deeper. True dermabrasion removes the epidermis and a good portion of the dermis (it’s a bloody procedure). Although the skin gets somewhat thinner, deep scars (acne) are beautifully remodeled. “Resurfacing” lasers are similar, but less invasive — chemical peels, again, are less invasive. Still, they all aim for the same result: inducing the skin to rebuild itself into a better more beautiful structure. And now, “dry needling!” I’m amazed at the potential.
(Here’s a question for the Hairtell folks: If the entire epidermis is removed during a dermabrasion procedure, how does the epidermis grow back?)
Okay, back to our story: Clinically, a physician noticed that scars seemed to be minimized by permanent (makeup) tattoos! Experimentation showed that using a tattoo machine without ink engendered the same result! Presently there are several kinds of instruments that will accomplish this “needling effect.” There are little needle rollers and needle stamps — but my choice is for the full tattoo-type machine that will really get in and stir things up. What I like especially is that the skin is not being removed at all and there are no chemicals used — and no burning laser. It’s a very “natural” procedure. Our skin has evolved for millions of years and it knows exactly what to do with a “puncture wound!” (Micro-dermabrasion, by the way, causes facial telangiectasia!)
Promoters of such needling devices say that they are only “needling the epidermis” … but this is absolutely not the case. As you know, the epidermis is bloodless. and even in their promotional literature they show that the skin gets pretty bloody from the procedure. Bloody? Well, that’s why I like the treatment! Since they are (actually) going where the normal tattoo needle goes, they are going to have a magnificent result. That is where you need to be! The entire healing process is going to get started, fibroblasts are going to remodel the collagen layer and wrinkles and scars are going to be “filled.” — long-term or permanently It just can’t miss.
The big danger, of course, is for potential infection. Pre-op skin preparation absolutely must be followed to avoid serious problems. I suppose tattoo artists are following appropriate procedures, but I can’t imagine the horror if the patient already had staph on their skin and then got “needled.” Of course, reported infections from tattoo and permanent makeup is remarkable low — so, this will probably not be a big concern. (I would even go the full Betadyne or Hibiclen pre-surgery prep.) Certainly, as this treatment gets rolling, Health Authorities will develop clinical protocols to follow. I’m sure this treatment is going to find itself in the offices of estheticians and, in California, our State Board will have multiple heart attacks and strokes trying to regulate the procedure. This technique is going to work and it will rival the best laser treatments. This is going to be a case or “low tech” beating out “high tech.” It’s coming folks and (maybe) you heard it here first?