Microneedling – Micro Skin Repair
Microneedling, also called micro skin repair (MSR), collagen induction therapy (CIT) or percutaneous induction neocollagenesis (PIN), is a non-invasive, nonsurgical method of improving skin appearance to create a younger look. This newest skin rejuvenation technique improves tone and appearance of aging skin and decreases wrinkles, laxity, and pigmentation such as freckles and age spots. It produces smoother, tighter, more youthful skin on the face, neck, or hands. Microneedling can be used on any part of the body including the décolleté area, abdomen, arms, or knees.
Microneedling targets various unsightly characteristics of aging or sun damaged skin including:
- fine wrinkles
- loose skin
- stretch marks
- age spots
The novel technology uses tiny micro needles that create channels in the skin and a special serum containing hyaluronic acid that penetrates the skin through these channels. Hyaluronic acid is a naturally occurring protein in the body and is currently also used in fillers to add volume to the face or fill in creases and wrinkles. In some patients, microneedling may be performed with platelet rich plasma (PRP) therapy. PRP uses a patient’s own blood, which is specially processed and separated into a plasma component that is rich in growth factors and promotes skin rejuvenation.
Microneedling, whether with skin repair serum or with PRP, offers the following advantages:
- minimal discomfort
- quick recovery
- beneficial to all skin types
- adjustable depth of treatment
- customized treatment plan
As a well tolerated nonsurgical procedure, microneedling is performed in the office and requires topical anaesthesia only in the form of numbing cream. In some patients who undergo a more superficial treatment, no anaesthetic whatsoever may be necessary. The treatment is entirely customized for each patient depending on their skin quality and desired results. There is no heat generated so the recovery is very quick and involves a minimal amount of skin redness which resolves within hours. In certain cases, more intense treatment which produces more significant results may also be performed as an outpatient treatment.
Most often patients will notice benefits in terms of smoother, tighter skin, less hyperpigmentation and fewer wrinkles after the first treatment. Additional sessions spaced a month apart will yield even greater benefits. Microneedling stimulates new collagen and elastin production, and this process continues over several weeks. Additional treatments spaced 4-6 weeks apart build on the new collagen that has already been stimulated, which creates even greater improvement in the appearance of the skin. Microneedling, as a non-invasive procedure, may be used as an alternative to surgery or may combined with plastic surgery procedures such as blepharoplasty, facelift and neck lift.
Chemical peels remove damaged outer layers of skin on the face to smooth texture, reduce scarring, and remove blemishes to produce healthy, glowing skin. There are three types of chemical peels, ranging from mild to strong – alphahydroxy acids (AHAs), trichloroacetic acid (TCA) and phenol – and formula strengths are tailored to each patient. Peels can be combined with other procedures such as facelifts for a younger look. They may be covered by insurance if they are performed for medical rather than cosmetic reasons.
Types of Chemical Peels
AHAs are the gentlest of the three types of chemical peel. They consist of a group of glycolic, lactic and fruit acids that smooth and brighten skin by treating fine wrinkles, dryness, uneven pigmentation and acne. AHAs are typically applied once a week, or may be mixed in a milder concentration with a cream or cleanser to be used daily; treatment takes 10 minutes or less. Patients may choose AHAs if they do not want the lengthy recovery time of a phenol or TCA peel. Occasionally AHAs, Retin-A (a prescription medication containing Vitamin A) or hydroquinone (a bleach solution) are used to thin the skin and even its tone as a pre-treatment for TCA peels.
TCAs are commonly used for medium-depth peeling (though depth is adjustable) to treat fine surface wrinkles, superficial blemishes and pigment problems, sometimes in combination with AHAs. TCAs are the preferred chemical solution for darker-skinned patients and may be used on the neck and other areas of the body. Results are often less impressive and do not last as long as with phenol peels, and multiple treatments may be required, but treatments only last 10-15 minutes and recovery time is shorter.
Phenol, the strongest chemical peel, treats deeper skin problems such as coarse facial wrinkles, pre-cancerous growths, and areas of blotchy or damaged skin caused by sun exposure, aging or birth-control pills. Because phenol can lighten skin where it is applied, the patient’s natural pigmentation is a factor in determining eligibility. Phenol is used only on the face, as it may cause scarring elsewhere. Full-facial treatment can last an hour or two and recovery can take a few months, with possible permanent skin lightening and removal of freckles.
Chemical Peels Procedure
Chemical peels are routinely performed in our plastic surgery office by our licensed estheticians. Anesthesia is not required because phenol and TCAs act as an anesthetic while AHAs produce only a slight stinging.
In an AHA peel, the skin is cleaned and the solution applied; there is no need for “after-peel” ointment or covering. During TCA and phenol peels, the skin is cleansed and solution is applied, which may cause a brief stinging sensation. Petroleum jelly or a waterproof adhesive tape may be put on the skin following a phenol treatment.
Recovery from Chemical Peels
AHA peels can cause temporary stinging, redness, irritation and flaking or crusting. Phenol and TCA peels can result in tingling or throbbing, reddened skin, a crust or scab, and significant swelling which lasts about a week, depending on the strength of the peel used. With phenol, your eyes may even be swollen shut at first and you may be put on a liquid diet and advised not to talk very much. Any tape used is removed after a day or two. All procedures require adequate sun protection for your new skin.
Risks of Chemical Peels
All three treatment types carry potential risks such as infection and scarring. In addition to the after-effects listed above, TCA peels may produce some unintended color changes in the skin, while phenol peels may reduce or eliminate the new skin’s ability to make pigment evenly or at all, thus causing a lighter or uneven skin tone that must be protected from sunlight.
Skin care is an essential part of the youth preservation and beautification routine for both women and men. A daily anti-aging routine at home will ensure the best results from any aesthetic plastic surgery that is performed, and is an important corollary to reversing signs of aging.
Topical creams and skincare products generally include:
Available as both a cream and a gel, and in several concentrations, Retin-A is the gold standard of anti-aging routine. A derivative of Vitamin A, it leads to increased cell turnover, collagen stimulation, and younger looking skin. Daily use leads to reduced wrinkles, tighter skin, and less hyperpigmentation. Retin-A may be somewhat irritating and drying to your skin, and should be used in conjunction with a moisturizing cream.
Retinoic acid derivatives are slightly less potent than Retin-A, and as such are also better tolerated, especially in patients with sensitive skin who may not be able to use Retin-A on a regular basis. The mechanism of action is similar, and results after several weeks of use demonstrate fewer wrinkles and better skin tone.
Glycolic and Lactic Acids
Alternative creams that are available for home use include various types of glycolic or lactic acid, in concentrations that are significantly lower than those used in physicians’ offices. With repeated use, these products lead to light exfoliation of the superficial layers of skin, with diminution of wrinkles and lessening of hyperpigmentation.
Prevention remains a critical component of any anti-aging routine. Daily use of sunscreen with SPF of at least 30 or 45 provides continued protection against sun damage caused by UVA and UVB radiation.
As with any home skin care routines, supplementation with occasional in-office treatments such as TCA peels, microneedling, or dermabrasion, as well as Botox, fillers, or fat injections, aids in delivering optimal skin rejuvenation results.
Dr. Hutchinson will discuss which skin care regimen is best suited for you in order to provide you with the best possible results.