Dr. Lopez offers the the latest in microneedling devices. It delivers controlled injury to the skin which in turn causes the skin to produce new collagen and rejuvenation. It is FDA indicated for aging skin, wrinkles, acne scars, stretch marks and keloid scar formation.
PRP or platelet rich plasma can also be delivered for efficiently into the skin.
The Microneedling device is small and light, and is available in two models. The Medical Model penetrates up to 2.5 mm into the skin. The tip is a disposable spring- loaded piston with 11 microneedles at the end. Needle penetration is between 0.25mm and 2.5mm in thickness and the speed can be as high as 90 Hz which produces 1,000 microwounds every second. There is minimal downtown and safe to use.
Microneedling is a form of Percutaneous Collagen Induction or PCI. There are many studies in the literature that describe how PCI works. MC Aust has done research and published studies on PCI. He showed that on histologic exam the there is 140% increase in epidermal thickness and it is present at 6 months after treatment. This increase was mostly due to thicken collagen fibers that were present in both layers of the dermis. This results in improvement in fine lines and wrinkles and softening of stretch marks and old scars.
Aust did another important study that showed why PCI did not cause scarring like laser treatments. Inflammatory markers were studied and a certain marker called TGF -beta 3 or transforming growth factor isoform beta 3 is essential to prevent scarring. This growth factor is present in increased amounts for 2 weeks in patients that have PCI. This is a regenerative therapy that does not cause scarring like some laser treatments.
Acne scarring is common and difficult to treat. There are generally two types of scars. Hypertrophic or keloid scars are thicken and atrophic scars are thin. The atrophic scars include ice pick, boxcar and rolling scars. Most patients all a combination of all three. There are various treatments for these scars. These include various resurfacing procedures such as lasers, chemical peels, lights and cryotherapy. Surgical treatments include dermabrasion, subcision (excising the scar tissue under skin) or punch biopsy.
We frequently use the Microneedling for acne scars. It causes new collagen formation and improves the appearance of the scars. Dr. Lopez feels the the CROSS treatment in combination with the Demapen is the best treatment available for atrophic acne scars.
CROSS stands for chemical reconstruction of skin scars.
Dr. Lee in 2002 described his treatment of scars by placing high concentration TCA or trichloroacetic acid to area of the scar. He was able to get improvements in 80 to 90 percent of his patients. Other studies have shown that with 3-4 treatments the acne scars improve by 60-80%.
Leheta in 2012 compared deep phenol peels to PCI or a Microneedling type procedure with CROSS. They had a series of 4 treatments and both had 68% to 75% improvement in acne scars.
At the Aesthetic Laser Center Dr. Lopez combines Microneedling with Cross but uses a higher concentration than the study and she also sees a 60 to 80% improvement in acne scars. We do not see problems with hyperpigmentation in darker skin people or scarring from the treatments.
The treatment takes about 15-20 minutes to perform. Topical anesthetic is placed on the face or areas to be treated and left on for 20 minutes. The procedure is then performed and topical serums and creams are placed to calm, soothe and protect the skin. A low level laser is performed after the procedure to help for the inflammation and healing. The skin is red after the procedure and this usually subsides by the 2nd or 3rd day. Swelling will be most noticeable on the second day and will subside by the 3rd day. Products are provided to help with the healing process. Active skin care can be resumed on day 3.