What is Microneedling and Platelet Rich Plasma?

Also called collagen induction therapy, microneedling has been used in Chinese medicine for centuries. In the United States, it was first used in the 1990s when hair transplant pioneer and dermatologist Dr. Norman Orentreich introduced it as a novel way to treat scars and wrinkles. It produces microscopic channels in your skin to trick your skin into healing itself and create more collagen and elastin. These channels are also good for infusing any liquids such as platelet rich plasma, growth factors, vitamins, or to deliver drugs to the skin.

Microneedling can be used to treat a variety of different skin issues. It is primarily used for facial rejuvenation as well as the neck and décolleté. It helps improve fine lines, wrinkles, some pigmentation problems, and leaves skin glowing and smoother. It is a very natural way to improve your appearance. This is a good option for patients seeking rejuvenation without the use of relaxers such as Botox, Dysport, or Xeomin or fillers like Juvederm, Restylane, or Radiesse.

It is also recommended for the improvement of scars, such as some acne scars, surgical scars, flat and hypertrophic scars, and even old scars. I have a burn scar on my right calf from a motorcycle accident over 15 years ago and it has significantly improved with treatment.

Microneedling is also indicated for hair restoration. Male pattern baldness affects 35% of the male population with as high as 58% in men ages 30-50 years old. Female pattern baldness affects about 13% of premenopausal women but affects over 70% of women over the age of 65 years.  Microneedling helps stimulate the hair to grow thicker and healthier strands. It does this by releasing growth factors that help stimulate hair growth and by activating hair stem cells. I usually combine this with platelet rich plasma injections (PRP) for better results.

I have had success with using microneedling for the treatment of stretch marks. I also usually combine this with platelet rich plasma injections (PRP) for better results. Stretch marks are harder to treat and need more treatments.

Microneedling is beneficial for a lot of people but not for everybody. I will not perform it on pregnant women because of the increased risk of infection. It is safe for breastfeeding moms, but I usually forgo the numbing cream due to systemic absorption. It is also not recommended for people taking isotretinoin or accutane due to the increased risk of scarring with these patients. If you have melasma, I would proceed with caution. Some studies indicate that it may improve melasma but there is always a chance that it may reactivate the hyperpigmentation.

For about 10 days before the procedure, I have my patients discontinue any aspirin-containing products or any non-steroidal anti-inflammatories like Advil, Motrin, Aleve, or Naproxen because these make your platelets less sticky and make you prone to bruising. I also have them avoid any alcohol, (especially red wine), salmon, green tea, or omega fatty acids for the same reason.

If you are using a vitamin A product such as retinol or Retin-A on your skin, make sure you discontinue use 3 days prior to the procedure. This is so your skin barrier is intact before the procedure.

The procedure is very simple. Here are the approximate steps we do if you are going to get this procedure in my office:

1. We consult you and consent you for the procedure, going over the procedure, risks, and benefits. We also take photos of the treatment area to monitor your progress.

2. We apply topical numbing cream to the treatment area if applicable.

3. We draw your blood if we are doing PRP

4. We prepare your plasma in the lab

5. We clean the area thoroughly.

6. We inject PRP if applicable

7. We use a microneedling device with 14 tiny needles. We use the remaining plasma and infuse it if available. Otherwise, dry microneedling is acceptable or using a hyaluronic acid gel as a lubricant is fine as well.

8. We discuss post-procedure care with the patient.

Avoid touching your face for at least two hours. Avoid any strenuous physical activity for 24 hours. I recommend using nothing on your skin for 24 hours. After 24 hours, use a gentle cleanser such as Cetaphil, a barrier repair moisturizer such as PCA Silk Coat balm, and a physical sun block such as Skinmedica Essential Defense Physical or PCA Sheer Tint if you want a tinted SPF. You may resume your normal skin care regimen after 7 days and your retinol after 8 days.

Facial rejuvenation: 4-6 treatments

Scars: 6-8

Stretch marks: 6-10

Hair loss: 4-6

Treatments are typically done every 2-6 weeks depending on the patient and the area of treatment. Average is every 4 weeks.

The most important thing is to go to a healthcare provider that is experienced in the procedure and performs microneedling on a daily basis. I do this everyday and have achieved great outcomes for my patients. We also practice aseptic techniques, which are very important for patient safety.

It is also important to know what microneedling device is used by the practitioner because not all devices are made equal and not all microneedles are made with the same quality. I would stay away from the dermal rollers as they are unable to penetrate deep enough where it is effective.

Finally, patients who are consistent retinol users seem to get the best results. This is because retinol also boosts collagen and elastin and just optimizes their results.

I recommend microneedling to a lot of my patients because of all the benefits. It is safe, effective, and very affordable. Make sure you consult and get treated by a very experienced health care provider to see if you are a good candidate.