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Hello and welcome to ASCP's SD Talk. I'm your co-host Maggie Stasic and ASCP's education
program manager. And I'm Ella Crestman license a statistician certified organic form leader,
international educator, and content contributor for associated skin care professionals.
So we're taking a deep dive into micro-needling, Ella. I want to know, do you get micro-needling?
Do you do micro-needling? What's your thoughts? Yes, and I perform my own micro-needling on myself.
Okay. Okay. I don't go get it done because you know, you have all the tools. I love it.
I love it too. I especially love micro-needling with radio frequency.
For the tightening? Yes. For all the things, very anti-aging, I love it.
And I will admit, I've been afraid to do it to myself, but I do have a device and it is
straight out of China before all the regulation came down on micro-needling devices.
It's in this little pink and gold box. And I've got a couple little tips. It is definitely not
on par. Is this an RF one? No, it is just a regular one. Yeah, this is just straight micro-needling.
Oh, nice. Nice. Those are tools to work? I mean, I'm sure it would work, but I also feel like
I would do it to myself in the next day come in like, I don't know, Jack the Ripper or something.
I love it. Do it. And then come to my shop. I'll fix you. And then you'll fix me. Yeah, yeah,
for sure. So since this is a deep dive, let's start with talking about the history of micro-needling.
I know there are a lot of estheticians out there that already know all about this procedure,
but we're just going to share the education here. So use of micro-needling, this was first recorded
actually in 1905 and it was by a German dermatologist. His name was Ernst Krohmeier. And he used
dental burrs mounted on a motor driven flexible cord. So if you can envision this,
you got this brilliant idea. And this was how he was going to remove scars,
birthmarks, hyperpigmentation. And it took nearly 90 years later, as in 1995, that doctor
Fernandez developed a new technique and also treating scars and wrinkles. And this was with
hypodermic needles. So basically, just kind of puncturing the skin, he later developed it into
a little needle stamp. And just FYI, he also is the founder of skin care brand and virus.
Yeah. So today, these methods of application, they've changed things to new technology and FDA
regulation. And today, we have electrically powered devices, what you all are familiar with,
with tiny needles that make precise microscopic punctures on the skin.
You know, when I first started using micro-needling, when I first became certified,
what was used professionally, the rollers. Do you remember the rollers?
Do, yeah. My understanding of the rollers is that controversial isn't really the word,
but they weren't effective because it was described that as that pin rolls,
the needle then gets caught in the skin and makes a tear.
That's what they would say. There was the same thing, like there was different depths,
but there was also talk about it being different than these stamps, like you talked about
with Dr. Fernandez, or that it was going to be less painful than these stamping motions,
which is ironic because now you come into what's acceptable now, and widely available, where there's
the shorter needle depth available, or really, you can get any of these available on Amazon,
anything. But you can have these different depths at home, and even like over-the-counter
companies use them as part of their regimen. But what is it, and is it effective? Let's talk about
it. It's also known micro-needling as CIT or collagen induction therapy, and that goes back to the
original intention of Dr. Krohmeier, who wanted to puncture and stimulate new skin cells.
So it inserts these tiny needles into the skin to encourage the body's natural wound healing
response. Controlled wounding with controlled healing, one would hope. The microchannels then
fill with new collagen, elastin, hyaluronic acid, the body's natural synthesis, and it leaves the
skin looking plump. Do we fresh the lowing, young cub coin? The depth of the needle penetration is
dependent on several factors, and what you're going to use it for. What is the skin condition,
but also what is permissible in your state? You're in Colorado. It's .5 and below. You can use without
medical supervision, anything higher you do need medical supervision for, which we should talk about.
Something interesting in line of your gold and pink box, and the capabilities of that. What's
really cool about these open channels, because the new language a lot of people are talking about
is micro-channeling, is that you could potentially also, with these channels open, deliver product
deeper into the skin. It's something that's been practiced for a long time. You can see it with
like PRP, you've heard of PRP, or PRF is another one, and now you've seen exosomes, of course,
hyaluronic acid, brightening agents, anything. But there is a school of thought, there's two schools.
You're in this school that says, leave it alone, just just use hyaluronic acid, that's it, or
this one who's like pilot on, let's get everything we can out of this service. The difference is
the opportunity for granuloma, if you're putting, depending on what you're putting on top of this skin,
what's shimming down into these microchannels could encourage granuloma production or presentation.
That's the difference. When you look into the studies of that happening, it's interesting to see
the exact percentage, but that's something else that you can, you know, really going to go back to
your training. Something to consider post-CIT therapy or microchanneling is that your skin could
look like you had nothing done, or it could be very red. This is going to depend on, of course,
your genetics and how your skin responds, but also the depth of needle penetration. Because you're
inspiring these new cells, basically, there could be an opportunity for exploration of the old cells,
so you could peel. You might not, and you might. If you do peel, it could take up to seven days
for it to finish. The most important thing is post-care, what you do, the 24 to 48 hours after
these types of services. What school of thought do you land in? Pile on the product or no product or
just hyaluronic acid. I land in, gently place the product. That is intentional. So my mic and
living, I use the majority of what I do. I always consider what could happen pigment-wise.
I don't want hyperpigmentation, and a lot of times we're in Colorado. Hyperpigmentation is huge
here, so I like to drop intentional brightening agents in. So I keep it pretty simple, but it's the
same. That's one thing where it's the same for most everybody, but I love this treatment while
you're around. I love it. It's so nice. It's the other thing that I use a device,
kind of like your device that you have, and there's different needle concentrations, the gauge,
to have a 36 or 12 or even nano. You can do that too, which is needleless, but that device is
going to depend on how much product I'm going to use, too. But most always, it's the brightening
agent and a hyaluronic acid. I fall into the different camp as you. So I am just hyaluronic acid
or no product for probably like the first 24 hours, and then I just do sensitive product until
I feel like the skin has healed. I think that's smart, and I don't think that either answer is wrong.
No, you're right. I don't think either answer is wrong because I think there's that piling it on,
right? Because I think some people can put so much on, and depending what you're putting on,
I saw one protocol where they were dropping hyaluronic acid, and they were putting on oil,
and they were putting on this heavy cream and retinoids and all these things after. When you're
looking at how those work in the skin, how they inspire different histological response in the
skin, and then you're putting them down deeper. Whoa, girl. So that's my opinion. Hold that thought.
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Okay, here we go. Let's get back to the podcast.
So let's talk about indications and contraindications in the same vein. This is used to
improve things like skin texture, creeping, scarring, fine lines, wrinkles. It can diminish
pigmentation. And there was a 2008 study that was published that showed skin treated with four
microneedling sessions. One month apart showed up to a four hundred percent increase in
collagen and elastin six months post treatment. I love this. Let me tell you why. Business building.
Totally. That being said, take a picture. This is where I describe this. The full results are
going to be in one month. And that's when we schedule our second appointment. The full results
from that will be in two months. That's when we schedule our third and so on. They're coming in,
they're bought in. Yeah. And then I have them take a before picture and a during picture
and an after picture because after the fourth treatment, they have to come in four weeks later for
another service like a gentle peel or something. Corrective facial. So I'm seeing them at least five
times. Yeah. I mean, you can sell this in a series. And I think also it's important to
educate your client here. It's not immediate gratification that skin has to regenerate and that
takes time depending on their age as well. We all know we say on average 28 days for
solid renewal blah, blah, blah. So yeah, I mean, you said it. This totally is business building
and getting them back in the door or totally. So it's important to prep the skin, obviously,
with good quality skin care leading up to the treatment, making sure that skin is healthy and
prepared to receive a service like this. And then ensure that your client is following the
proper post care. Like you said, Ella, SPF, definitely. You know what I hear? Business building.
Now that's six appointments. So that's six months of seeing this client guaranteed. Yeah. And retail.
Stop. Love it. Easy breezy. Yeah. So although this treatment is indicated really for all skin
tapes, you always want to be careful with those higher Fitzpatrick's. And be sure, again,
you're prepping that higher Fitzpatrick if necessary with skin lighteners to reduce the
melanocyte activity for several weeks leading up to the treatment. And then clients with active acne,
they are contraindicated. Be sure, first you're treating that active acne before then going in
with a microneedling treatment so that you're not spreading the bacteria. So client suffering from
rosacea. It's possible that they could experience flare ups. So again, be sure that the skin is prepped
and it's healthy and prepared to receive the microneedling treatment. You know what you could do with
rosacea is the nano. Totally nano. Great, great treatment for people like that. Other contraindications
are going to be things like bleeding disorders, active herpes. And I will say caveat there if
somebody is prone to colds or outbreak, they could go on their antivirals leading up to procedure.
Skin infections in the area to be treated, eczema, psoriasis. And when in doubt, just don't treat.
I'm 100%. It is a very broad, like it has a lot of versatility, but it's not for everyone
necessarily. The other thing about contraindications or something to keep in mind is post treatment,
explaining what they need to do for the first 24 hours. I had a client who we did a microneedling
treatment on. And she called me the next day. She had a reaction, maybe next day or two days later,
she had a reaction. And just on her forehead. And it was these bumps. So I had her come in. She sent
me a picture you couldn't really see. So I had to come in. And it was where she sprayed her bangs.
So the hairspray was getting in and irritating those micro channels. So I was like, oh, there it is.
There it is. So it was it was interesting. But being careful to just keeping anything, you
know, no sweating, no wedding, no heavy petting. That's my guidelines for especially this service,
but any kind of ablative or corrective treatment. Speaking of, there are different types of
devices, I guess we can say. We already talked about the rollers. They're also used to be, you know
what? In antiquity, they were talking about they had these like primal stamps that they would use
for rejuvenation they thought or tattoo it, which could be. But they have they had these stamps
or derma rollers. Those are still used by the public now. I haven't seen anybody using them
professionally. Have you? No, no, no, I haven't. Yeah, I think we've we've advanced. I think so too.
Those were hard because they were very expensive. And so you had to work that into when you look at
the the cost per treatment of the ROI first on those tips on the tips that fit in a device versus
these rollers. It's about half or a fraction depending on Marie what country you get them from.
So the other thing with those is as Maggie said, there was commentary on they don't go straight in
and straight out. It would roll in and roll out. And so the simulation, but also the risk of tearing
this skin. I never had anybody tear. I never had anybody get a granulom or anything, but the
potential is there. The other that we've kind of talked about is nano needling. So this is
needless needling. And it's not channeling either. This is more pushing. So they have these tips,
these specific looking tips. A lot of them have this pyramid shape or this patented pyramid shape
that they use. And it pushes in theory, pushes serums or such into the skin. So this would be an
opportunity to pile it on. Yeah, if you wanted to, because it's epidermal, you have no risk of dermal
whatsoever, because this is just really stratum cornea, maybe a couple of years in, but no big deal.
Then you have the electronic handheld devices. And wow, have this as this technology come a long
way. Certainly in the last six years, seven years. As you mentioned, you were able to get it online.
A lot of people can get theirs online. The price is remarkably a lot less than before. But these have
pins. And you have tips. And the tips have the stamping mechanism or the handheld device has
a stamping mechanism that works with the tips. And you have the ability to switch depths,
which is interesting. So if you have a pen, be sure that you're only going up to the
depth permissible by your state, unless you have medical supervision, because it's just the
stamping. It's very tempting, unless you're doing it on yourself, then go for it. But the thing
about that is those tips, you can have the different, the 36, the 12, I think you even had a 64.
I never use it. I usually use the 12. And then you have radio frequency microneedling,
which is your favorite. And where the microneedling tips are attached to the device and the device
pushes the tips into the skin. And then radio frequency energy is released. What that does is it
adds an element of heat to potentially the dermis. And it tightens the skin. This could help with
that reduction, but it also could inspire melanin production. So something to keep in mind,
like Maggie was saying, pre-care is really important here, depending on where you're
having this done. Very, very effective for the body, for stretch marks, for a lot of different
applications. And I think that something else we can say is these types, these microneedling can
be head to toe, can be face, it could be chest, it could be arms, it could be anywhere that you
don't want to address laxity or hyperpigmentation. Yeah, stretch marks even.
Stretch marks 100%. So with so many different types of devices as well as needle depth that's
important to know your scope of practice, effective in 2018, the FDA started classifying all
microneedling devices for aesthetic use into class two. So knowing that, you could have a state
where your rules and regulations dictate that estheticians cannot use a class two device unless
they are working with a medical director, there could also be an amendment to the rules where
you can specifically use microneedling devices, even though they are class two devices.
What is California? Do you know? California, I think that microneedling is out of scope.
And dermal planning is out of scope too. Yeah, California is very strict about the rules for
estheticians. States that do not directly address microneedling, the law needs to be interpreted
to determine whether estheticians can again, like I said, use class two devices or operate below
the stratum corneum. Some states have rules outlining the use of microneedling devices with or without
a medical director and the depth at which you can penetrate the epidermis. So depth is really
important, especially when it comes to rules and regulations. LA, you were talking about this earlier
like in Colorado, for instance, you can go to a depth of 0.5 millimeters without a medical director.
If you can perform microneedling with a medical director, it'd be up to the delegation of that
director in terms of how far you can penetrate. What are you going to do with your device at home?
Are you scared? You've got to do at least 0.5. You've got this. It's not, it doesn't. Nothing.
Put an anotip on. Order an anotip. You know how old that device is. It's like when microneedling
first came on the market, this thing's probably from like Alibaba. Oh, we'll see if it goes first.
Let's see what it'll turn on first. And then try it. Try it on your arms or something.
Yeah, that's what I'll do. Take a picture. And then I'll text you and pile on product.
To book an appointment. Yeah, that's a good idea. I will needle you of no problem. Yeah.
Now listeners, we want to hear from you. Have you incorporated microneedling to your treatment menu?
What kind of results are you seeing? Share with us on social media through Instagram,
Facebook, or by emailing GetConnected at ASCPSkincare.com.
Thank you for listening to ASCPS you talk. And as always, for more information on this episode,
or for ways to connect with Ella and myself, or to learn more about ASCP, check out the show notes.