WTF is microneedling (and why is it so damn bloody)?

Photography via Instagram/kimkardashian

At first glance, microneedling could seem downright medieval: A doctor scoring your skin with, well, scores of needles. But the beauty industry has regularly revisited the resurfacing technique, which originated in the mid-’90s, hoping to eliminate unpleasant side effects such as pain, bleeding and serious downtime. The Dermapen, one of the most well-known microneedling devices, heralded the treatment’s slow creep back into the spotlight in 2010. But now microneedling’s makeover is complete, delighting needlephobes and laser fans alike, thanks to innovative combination treatments that minimize discomfort and maximize results.

Jabbing the skin with needles admittedly sounds counter-intuitive, but consider that the needles are teeny (think acupuncture-thin, but much shorter) and microneedling is based on the same concept as a fractionated laser, which creates a controlled injury that the surrounding skin then swoops in to repair. The result: Fresh, new collagen production. “Microneedling started this idea even before lasers,” says Dr. Diane Wong, owner and medical director of Toronto’s Glow Medi Spa. But pros like Wong are calling the recent marrying of microneedling and radiofrequency energy (RF) a game changer. Because the tiny needles penetrate the skin, topical RF can reach the deeper layers to better rejuvenate. “Combining these two technologies allows the energy to be delivered very directly,” says Manhattan cosmetic dermatologist Dr. Paul Jarrod Frank.

The benefits of microneedling range from youthful contours and fewer fine lines, to refined pores, improved texture and diminished acne scars. For the hybrid technology, Frank’s go-to is the Infini. The machine has a disposable tip with 49 microneedles, which puncture the skin, reach the desired depth and then deliver a pulse of RF energy. “It’s like a square stamp and the tip is moved over the face in a stamp-like motion. You’re getting the tightening of ultrasound and the resurfacing of Fraxel,” he says. Meanwhile, at Glow Medi Spa’s flagship in Yorkville and new location in Aurora, Ont., VoluDerm, a hybrid of microneedling, radiofrequency and galvanic energy, has become the lunchtime fave of professional women nearby because the half-hour treatment creates an instant glow, in addition to long-range improvement. In this case, the RF assists in the needle penetration before the two energies are emitted, with the galvanic energy working to minimize discomfort by altering the skin’s pH. “There’s no bleeding and limited discomfort because there’s very little involvement in the epidermis,” Wong says. “The activity is happening deeper in the dermal layer of the skin.” Even those who typically fear needles are becoming fans. “Some clients won’t do Botox, but they love these treatments,” she says. Results with VoluDerm and Infini, however, aren’t as instant as Botox. Collagen production gradually increases in the following months and most patients see a more visible improvement by the second treatment (a series of three to six is generally recommended). Post-treatment effects range from mild 24-hour swelling and redness to a gradual exfoliation.

For some skin tones, particularly darker ones, microneedling can be safer than lasers. “Lasers can give more dramatic effects in a shorter amount of time, but they can cause issues,” says nurse and aesthetician Natalie Aguilar of Afterglow Beverly Hills. “The skin can end up appearing waxy and, when you look at it closely in the glare of the sun, you can sometimes see circles or squares imprinted from the laser’s grid.” Some clients complain of hyper- and hypo-pigmentation from lasers, she adds. Microneedling also allows pros to zero in on delicate spots that cannot easily be treated with lasers—like crepiness beneath the eyes and lip lines in the dynamic area around the mouth. “The collagen boost you get with multiple treatments is comparable to that of a laser,” says Aguilar, who customizes treatments using a MicroPen and combines super-fine microneedling with topical RF as part of her All-In Afterglow Red Carpet treatment. (It was such a hit pre-awards season that it’s been added to the menu year-round.) One key reason for its success: The glow-inducing treatment, with its skin-drenching hyaluronic-acid-mineral mask and lengthy oxygen blast, takes advantage of one of microneedling’s biggest benefits, which is enhancing ingredient delivery.

“Microneedling creates tiny channels for better product penetration,” says Jamie Sherrill, founder of the Nurse Jamie brand and owner of Beauty Park Medical Spa in Santa Monica. “We microneedle as part of our Bloodless Anti Vampire Facial and then infuse targeted skincare.” Hyaluronic acid and plant-based growth factors are used for anti-aging, while ingredients like kojic acid treat pigmentation issues, and azelaic acid and anti-inflammatory agents target redness. “We really get dramatic results with it,” she says, adding that the spa is a hit with male celebrities and young female celebrities alike for its conservative, 360-degree approach to treatments. To that end, Sherrill devised the Nurse Jamie Beauty Stamp, a new-and-improved OTC microneedler, which clients are sent home with, that’s quashing the dermaroller competition. Far from scary, it requires a double-take to even see the needles on it. “The needle depth is .25, the shallowest, and the needles go in vertically rather than at an angle, which can tear the skin. I have every tool at my disposal and I use this at home before applying my serum,” she says.

Wong found herself similarly inspired to innovate. In a spin on vampire facials, Glow Medi Spa has added platelet-rich plasma (Selphyl) to the VoluDerm procedure. “We draw some of the client’s blood, centrifuge it in office and then massage on the remaining platelets and plasma to stimulate growth factors within the skin,” says Wong, adding that it diminishes any swelling and redness, and improves results. “Once clients do their face, they want to do their hands, arms and knees.”