Pickin' up my needle and movin' to a different groove!
Since I am always scouring the world for you to bring back the best technologies…”oops, I did it again!” It makes me happy to bring you, all the way from Germany, the Genuine DermarollerTM (yup, first in New York City). The Genuine DermarollerTM is a microneedling device that is about the size of a toothbrush and looks like a paint-roller covered with micro-fine needles to be gently rolled on the skin surface.
Why in the world would anyone want to roll needles over their skin? Seems a bit masochistic… but, it works! Microneedling has its origins in acupuncuture and has gained medical attention over the past two decades as a method to use at home for allowing product penetration deeper into the skin surface.
The home-use cosmetic DermarollerTM has 192 micro-fine needles that are 0.15 mm in length, just the perfect length to exfoliate the superficial epidermis. Since the nerves are located well below this level, the Dermarolling doesn’t hurt, it just tickles!
Medical Dermarolling is a medical procedure performed on an outpatient basis by a licensed physician as a method for promoting collagen formation that surpasses lasers both in effectiveness and safety.
CELEBRITY ENDORSEMENTS FOR MICRONEEDLING AND A WORD OF CAUTION
The technique of microneedling has been featured on the “Rachel Ray” show, and the television show “The Doctors” and has been endorsed by such famous persons as Angelina Jolie and Brad Pitt. Please be careful from whom you purchase a “Dermaroller” because there are many, many unsafe imitations on the market that are available for purchase over the internet that are substandard copies of the Genuine DermarollerTM. The Genuine DermarollerTM series are manufactured in Germany and have extremely hard, solid (non-hollow) ice-hardened Swedish stainless-steel needles, cylindrical in shape, with a very small tip radius and a thick 35 micron base radius. The microneedle fracture force is hundreds of times greater than the skin insertion force, giving the device an absolute margin of safety. What this means in simple terms is that no matter how hard you press with the cosmetic home use Genuine DermarollerTM the needles will not bend or break. The Genuine DermarollerTM is an FDA approved medical device that can only be purchased through a physician. Other “dermarollers” that can be bought over the internet have softer needles of lesser construction that can break, or bend into the skin forming a “fish hook” that can rip the skin surface to shreds. The whole idea of microneedling the skin is to make you look younger and fresher, not like Freddy Krueger, so please, only buy your Genuine DermarollerTM from me. I am the only physician carrying the Genuine DermarollerTM in New York City!
HOW THE HOME USE COSMETIC GENUINE DERMAROLLERTM WORKS
This simple little device is such a powerful tool on the molecular level that its brilliance is inconceivable, but I will try to explain it. As you know, the skin is structured like a layer-cake. The uppermost layer is the epidermis, and this is where the pigment cells reside, so the epidermis is what gets sunburned and freckled. Beneath the epidermal layer lies the dermal layer of the skin that contains the structural protein collagen that gives skin its strength, and elastin which gives skin its stretch. The loss of collagen and elastin as we get older is what causes wrinkles and sagging skin [“oh horrible, horrible, most horrible”]! Beneath the dermal layer we find the sensory nerves, fat cells, and blood vessels that provide the skin nutrients.
The epidermal layer is the most superficial layer, and it is broken down into 5 layers [not important], let’s just say that the most important layer is the stratum corneum, it consists of compressed mature skin cells that have grown from younger “basal cells” that reside in the deepest layer of the epidermis and they are the actively dividing stem cells that give birth to new skin cells that must push their way up to the skin surface and emerge as mature skin cells [similar to the game “King of the Hill”]. These mature skin cells form a protective skin armor to keep moisture in while keeping other things out [like bacteria, or your favourite expensive moisturiser]! As we get older (past the age of 28 years) our skin makes 1% less collagen per year, while the enzyme that degrades collagen (collagenase) increases. Thus, production goes down, destruction goes up, and wrinkles form. Our skin also doesn’t exfoliate as well so the fresh, new skin cells that want to emerge from the deeper layers of the skin cannot push off the crusty cells on the surface, giving the skin a dull, grey appearance.
Basically, the Genuine DermarollerTM has multiple mechanisms of action, all of them good. The DermarollerTM will work with our without the addition of a cosmetic cream.
--The fine needles of the DermarollerTM, since they are a metal, have their own natural electrical charge. The skin cells also have their own natural charge. When the DermarollerTM is rolled across the skin, the epithelial stimulation causes the nerve cells to send signals to the surrounding skin cells that then sets off a cascade of molecular reactions that leads to the release of growth factors that stimulates stem cells to proliferate and the newly produced fibroblasts migrate to the area to build more of your body’s own natural collagen. All this, from a little tickle!
--The more specific benefits and mechanism of action achieved from the DermarollerTM directly correlate to the length of the needles. The home-use cosmetic DermarollerTM has a tiny needle length of 0.15 mm and is an excellent tool for the enhancement of active substances, improvement in skin texture, and thickening of the epidermis (which thins with old age). The medical use DermarollerTM has needles ranging from 0.5 mm to 1.5 mm in length and is used in the medical office by licensed physicians to treat pigmentary problems such as melasma and post-inflammatory hyperpigmentation (dark spots from acne scars), administering mesotherapy products, and to initiate Collagen Induction Therapy (CIT) that surpasses the results of fractionated laser resurfacing (FRAXEL) with only one or two treatments and less downtime. There is even a DermastampTM that has been shown to improve the appearance of chickenpox scars by up to 70% after one use! Finally, the Beauty Mouse Body DermarollerTM is a cute, little home use device designed to allow for increased absorption of your favourite body treatment creams!
HOME USE GENUINE DERMAROLLERTM and BEAUTY MOUSE BODY DERMAROLLERTM
Home use Cosmetic DermarollerTM Indications: Anti-aging (increasing epidermal regeneration), increasing product absorption, shrinking pore size and decreasing overactive oil production, hormonal acne that does not respond to prescription drugs.
The home-use DermarollerTM has a tiny needle length of 0.15 mm and is an excellent tool for the enhancement of active substances, improvement in skin texture, and thickening of the epidermis (which thins with old age). Although the epidermis is extremely thin, about 10 to 20 microns thick, even moisturizers with the tiniest of liposomes (200 microns or less) cannot penetrate through the stratum corneum to deliver their precious cargo to the deeper layers of the skin where it is needed. Findings from the University of Marburg clearly show that even moisturizers with the best liposomes cannot penetrate the stratum corneum, with only about a 0.3% success rate (99.7% wasted). Using the home-use cosmetic DermarollerTM prior to product application forms fine penetration channels that allow for about 200 times more substance to penetrate the skin. The stratum corneum reacts so fast and flexibly that the small channels created by the needles are closed within a few minutes. No bleeding, no bruising. The active substances are delivered to their proper layer in the skin and locked in tight for a good night’s work while you sleep. You wake up with glowing skin in the morning. Used alone, the home-use Genuine DermarollerTM has been scientifically proven to increase the epidermal (uppermost layer of the skin) thickness by over 30%. This is amplified further by the use of appropriate topical peptides after the DermarollingTM session is complete. Simply use the device three times a week. You WILL notice a positive change in your skin.
The Beauty Mouse Body DermarollerTM was invented simply because we couldn’t ignore the body! The Beauty Mouse is a fun gadget that looks like a computer mouse and has 3 heads of the same needle length as the home use Genuine DermarollerTM and is designed to allow for deeper penetration of your favourite body treatment products. Indications: cellulite, enhancement of active substances, improvement of skin texture, epidermal thickening.
The genuine DermarollerTM is not available for purchase on the internet, and I am the only physician in New York City with the Genuine DermarollerTM. Both the Home-Use Genuine DermarollerTM and the Beauty Mouse Body DermarollerTM are available for purchase through my office to established patients. Simply call us at 212-799-1411 and we will ship you your starter kit today!
HOW COLLAGEN INDUCTION THERAPY WORKS
Remember when I said that “this simple little device is such a powerful tool on the molecular level that its brilliance is inconceivable, but I will try to explain it.” Well, now that we are moving on to medical DermarollingTM and anti-aging, it is only appropriate to steal a quote from that fabulous movie about an aging Hollywood Starlet-- All About Eve (1950), “fasten your seatbelts, it’s going to be a bumpy ride!”
The main thing to keep in mind as I explain the medical procedure that uses the Genuine DermarollerTM is that our skin loses the ability to heal without scar once we are born. If the developing fetus is injured in utero, the skin will heal perfectly normally. But, once we are born the skin loses this capacity, and when the skin is cut, the body does a slap-dash job of patchwork quilting the collagen back together again. It’s reasonably effective and the skin is sealed again, but the new collagen is laid down in a “Three Stooges” kind of fashion, not perfect like it was before. This resultant imperfect collagen structure is known medically as “fibrosis.” This is evidenced by how the skin heals either slightly darker, or slightly lighter than the surrounding skin (post-inflammatory hyperpigmentation or hypopigmentation, “PIH” among friends).
When the body tries to heal itself from an injury, it goes through the “wound-healing cascade”-- Inflammation, Proliferation, and Tissue Remodeling. The blood vessels around the injured area secrete a variety of molecular signals that cry “all hands on deck!” Specialized cells come to the area to clean up the debris, and then the fibroblast cells arrive to spin more collagen in response to the inflammatory signals. The fibroblasts spin Type I and Type III collagen initially which is converted to mature, Type I collagen over the period of six months and voilá, “a scar is born” [sorry, couldn’t help it, would you believe I just made that up right now]?
We know that skin loses collagen as we age, and that is why we get wrinkles and saggy skin. As physicians, the scientific process is always diagnosis and cure. If we know that the skin loses collagen as it ages, and people don’t like that, then the cure is to get the body to make more collagen. One way to get the body to make more collagen is to trick it into thinking that it has been injured and launching the wound healing cascade. Controlled heating of the skin is one way to do this, if the skin is heated to 42 degrees Celsius, the heat-shock protein is released from the cells, the wound healing cascade is initiated, and the fibroblasts come to the area to make collagen (they can’t help it, it is a reflex they can’t resist). So, as cosmetic laser surgeons, we take advantage of this using lasers to exfoliate and heat contract the collagen in the skin at the same time. It works pretty well, although depending on the type of laser used, there can be significant social downtime, and there is also a risk of the skin healing a different color than normal because of the PIH I mentioned earlier. This is the reason that not all skin-types can be treated with lasers, and definitely not the neck because it lacks the appropriate number of healing cells to heal normally from a strong laser treatment.
HOW MEDICAL DERMAROLLINGTM DIFFERS FROM LASER TREATMENTS LIKE FRAXEL
I love lasers. Lasers were a great boon to surgical science because we could cut and cauterize (burn) blood vessels at the same time with the laser beam, which leads to faster healing with less bruising and swelling (edema) after a surgical procedure. Lasers fry shut the blood vessels in the operative field, thus diminishing the bleeding, which can be pesky and you can’t see what you are doing, a real annoyance to surgeons in general. A laser also causes less damage to surrounding tissue because there is no pressure exerted on these tissues like is necessary when cutting with a scalpel. Lasers are a surgeon’s best friend.
Later on, we started to use lasers to resurface the skin in an attempt to erase wrinkles and sunspots and make Park Avenue ladies look younger than their mystified peers. The original laser was the CO2 laser which adopted a carpet-bombing effect on the skin by burning off every single cell of the protective epidermal layer and tightening the underlying dermal collagen layer. The recipient was then placed on house arrest in their penthouse until the epidermis regenerated itself. Pretty harsh, but effective enough at the time.
Since the downtime of the CO2 full face laser was so socially unacceptable, fractionated lasers were invented that removed every other cell from the skin surface, giving the skin a jump-start on regenerating itself from the spared skin cells and also offering some protective barriers to the environment with a somewhat intact epidermis.
Now, this is important what I am going to tell you next, so pay heed…
Remember what I said about lasers sealing off the blood vessels as they go about their business cutting and resurfacing? Well, nature has played a cruel joke on us laser surgeons in that, when it comes to forming collagen in the skin for beauty purposes, you need a little blood (just a touch, just a hint). Here’s why…
HOW THE MEDICAL USE GENUINE DERMAROLLERTM WORKS
Collagen Induction Therapy with the Genuine DermarollerTM causes the formation of new collagen that is in a microscopically normal network, not a muddled fibrotic scar like that laid down in response to laser treatments. Let me say that again, Genuine DermarollerTM = normal collagen, laser treatments = scar (fibrosis).
Medical DermarollingTM is performed under sterile conditions and consists of a drum shaped roller stud with 192 fine micro-needles from 0.5 mm to 1.5 mm in length and 0.1 mm in diameter that is rolled over the skin to penetrate the dermis repeatedly about 20 times. The skin cells react to these micro injuries and stimulation with the release of various growth factors. These in return stimulate the proliferation of stem cells and results in neo-collagenesis (new collagen formation) and neo-angiogenesis (new blood vessel formation). New collagen and elastin fibers are integrated into the existing upper dermal layer without any fibrotic traces. Although numerous needles with a diameter of 0.1 mm penetrate the dermis repeatedly in the same spot (about 15 to 20 times) down to a maximum depth of 1.5 mm, no wounds in the classical sense occur, and traces of fibrotic tissue could not be detected in histological (microscopic) examination. The tiny micro-bleedings after DermarollingTM originate from the punctured capillaries that are “emptied” and noted as tiny little red spots beneath the skin’s surface. But the needles do not cause bleeding in the classical sense, and the red spots go away.
After a DermarollerTM therapy we always observe the same reactions: neo-collagenesis and neo-angiogenesis. No ablative LASER procedure will stimulate neo-angiogenesis, and that includes fractional lasers (FRAXEL). The “hot” laser beam “fuses” the capillaries and other tissue, and the stimuli for sprouting of new blood vessels are suppressed. The laser beam transforms collagen into necrosis that finally transforms into fibrotic (scar) tissue. These subdermally set fibrotic points become confluent (merge) after several treatments and result in an upholstering effect below wrinkles. In addition, the laser beam suppresses bleeding by fusing capillaries, and this in turn stops the release of growth factors from blood platelets. The laser beam also destroys the stem cells as well as other non-differentiated cells and obstructs their potential for proliferation.
So, you can see how exciting this technology is for me from both a surgical and molecular viewpoint. To recap, the Medical DermarollingTM works via the following mechanisms:
----The fine needles of the DermarollerTM, since they are a metal, have their own natural electrical charge. The skin cells also have their own natural charge. When the DermarollerTM is rolled across the skin, the epithelial stimulation causes the nerve cells to send signals to the surrounding skin cells that then set off a cascade of molecular reactions that leads to the release of cell signals that that stimulates stem cells to proliferate.
--the drum shaped roller stud with the fine micro-needles is rolled over the skin to penetrate the dermis repeatedly about 20 times. The skin cells react to these micro injuries and stimulation with the release of various growth factors, resulting in neo-collagenesis.
-- The tiny micro-bleedings from the punctured capillaries that are “emptied” release growth factors from blood platelets resulting in neo-angiogenesis.
After a DermarollerTM therapy we always observe the same reactions: neo-collagenesis and neo-angiogenesis. New collagen and elastin fibers are integrated into the existing upper dermal layer without any fibrotic (scar) formation! No ablative procedure will stimulate neo-angiogenesis, and that includes fractional lasers (FRAXEL).
MEDICAL DERMAROLLERTM INDICATIONS AND PROCEDURE
Indications: melasma, hypopigmentation, hyperpigmentation, skin resurfacing, sun damaged skin, wrinkles, large pores, scars, stretch marks, deep wrinkles, deep acne scarring, chicken pox scars (DermastampTM).
All medical DermarollerTM procedures are carried out under sterile conditions in the doctor’s office. A numbing cream is placed on the area to be treated and left in place for approximately 45 minutes to one hour. Additional medications may be administered depending upon the sensitivity of the particular area and the depth of needle to be used. Even the deepest procedure is usually tolerable with just some pain pills with or without a valium.
The numbing cream is removed and the skin is cleansed with povidine iodine for sterility. The skin surface is then rolled in several directions until little red spots appear beneath the skin surface. The skin is then cleansed with sterile saline and the patient recovers in a comfortable chair with fluffy pillows for about 30 minutes until the micro-channels have closed. They then leave the office looking as if there is mild sunburn. This sunburn effect will last about four days. Usually, by the second day the skin is smooth and the patient can use make-up. There is no permanent injury to the dermis and there is no sun-sensitivity. All patients are able to return to work after one week. The treatment can be repeated without any restrictions, and on any skin type without any risk of pigment changes to the skin.
In general, 3 treatments are required, 6 weeks apart. As skin continues to age, it is advisable to go for an annual CIT refresher. That’s it!
Thank-you for taking the time to read all of this complicated information. It will be worth it to you. We have been having great success with the Genuine DermarollerTM in my office, and my colleagues from Brasil, France, England, Argentina, and Canada have been having similar success with the device before it hit our shores. I wouldn’t have written so much if I weren’t as passionate about this technology. However, I have aged about 10 years trying to compile this for you all, so I am going to go Dermaroll myself right now! I have a party to go to tomorrow!!
Stay Beautiful!
-Dr. Zdinak
