Update on Frequency and Needle Length for Percutaneous Collagen Induction Therapy (CIT), Skin Needling or Dermarolling (however you refer to it) by Deborah Tosline
Deborah Tosline wrote and published “Skin Remodeling DIY: An Introduction to the Underground World of Do-It-Yourself Skincare” in 2015. Her approach to skin care is based on a scientific background, love of research and over 30 years of DIY skincare experience.
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I began giving myself DIY skin needling treatments about 12 years ago in 2008. Needling treatments were not locally available at med spas or dermatologists offices. In 2010, while at physical therapy I met a plastic surgeon who stated that he had received micro needling training and that he was the first doctor in Tucson, Arizona to provide the treatment.
My skin needling journey began when I had access to information about advanced Do-It-Yourself (DIY) skin care practices and products on the Internet. I researched micro needling for months, pre-treated my skin with vitamins A and C, acquired a dermaroller and tackled my first DIY microneedling treatment. From about 2008, I’ve given myself one-1.5 millimeter (mm) needle length treatment about every 2-3 months for a total of about 4-6 microneedling treatments per year. I primarily used a dermaroller but in recent years I’ve used the Derminator®2 mechanized device.
My primary source of information was Dr. Desmond Fernandes’s publications. Dr. Fernandes is a Board-Certified Plastic Surgeon and Skin Care Specialist who published his findings in references accessible on the internet. Dr. Fernandes built on the work of others to invent the Percutaneous Collagen Induction Therapy (CIT) and the Environ™ Cosmetic Roll-Cit. When I began reading Dr. Fernandes’s articles and viewed his extensive before and after images showing the effectiveness of the PCIT treatment I came to the opinion that he is one of the most talented, innovative and transparent Skin Care Specialists in the world. Dr. Fernandes’s process, theory and results were scientifically persuasive to me and I became a fan and follower. Dr. Fernandes has deservedly received numerous awards including:
“Environ founder Dr Des Fernandes has been announced as the winner of the INNOCOS 2016 Innovation Leader of the Year in the Product category”
"Top Medical Skin Care" in the Aesthetic Everything® Aesthetic and Cosmetic Medicine Awards 2020”
Recently on 9/4, a Friday evening entering into the long (for me) holiday weekend, I gave myself a 1.5 mm skin needling treatment using a Derminator®2 with a 12-needle head. This is an “owie” type of treatment, not for the faint of heart but doable with numbing cream. Based on my past experience, I follow self-prescribed protocols (based on Dr. Fernandes and others research) to give myself safe and painless microneedling treatments.
I use vitamin C serum, retinoid cream with vitamin E regularly and retin-A intermittently to prime my skin for maximum collagen production. I use high-concentration, non-aggressive DIY products prior and subsequent to a microneedling treatment. I consume anti-oxidant nutraceuticals regularly.
Ongoing debates through the years about microneedling frequency and needle depth left DIY’ers wondering how to best treat ourselves. I followed my original treatment plan, completing 4 to 6 deep needle rolls (primarily using 1.5 mm and some 2.0 mm length needles) per year spaced at about every two months and thought that I was current with Dr. Fernandes’s recommendations.
Until recently.
In the days after my 9/4 needling treatment I began researching skin needling for any new information and found a 2020 article by Dr. Fernandes publishing his findings titled:
Current concepts on how to optimise skin needling 2020: A personal experience.
Dr. Fernandes changed his treatment frequency protocol in 2004 and experienced improved effectiveness. His previous guidelines for maximum collagen and elastin production suggested that a microneedle must penetrate the dermis, located beneath the epidermis, to stimulate a cascade of biochemical healing processes. From what I remember, a 1.5 mm needle length was suggested to be sufficient to promote collagen production at a frequency of about every 2 to 3 months. Dr. Fernandes found that a new more frequent protocol optimizes skin needling results.
The new protocol is based on a process described using medical nomenclature; let’s try to break it down.
When the body is injured it produces a healing cascade of biochemical processes.
Microneedling does not produce scarring.
In 2020, Dr. Fernandes reported that he had been thinking about how the growth factor cascade impacts scarring. A team of scientists (Ferguson, and others) found after a skin wound, growth factor TGFB3 regenerates a collagen framework and causes scarless healing but disappears within 24 hours whereas TGFB1 and TGFB2 remain available and result in normal healing with scar formation. Other scientists (Aust and team) found that skin needling induces TGFB3 (no scarring, collagen builder) to remain in the system for 10 to 14 days. They found that “four 1.0-mm needlings done in 3 weeks gave better results than four 3.0-mm needlings done in 3 months.”
Dr. Fernandes reports that 4 to 6 sessions, with 1.0 mm needling at 4 to 10-day intervals has provided the best patient outcomes. For optimum collagen production, skin must be primed and maintained with high concentration, non-aggressive forms of vitamin A, C, and E products to experience the best outcomes.
Dr. Fernandes produces a line of supportive skin care products called “Environ™”. These were the most effective products that I’ve tried, in my limited experience; I make most of my own products. It is vital to avoid aggressive products following skin needling.
Remember the 1.5 mm skin needling treatment that I did on 9/4/20? After reading Dr. Fernandes’s article I decided to follow the new suggested protocol. I completed additional 1.0 mm needling treatments on 9/9, 9/16 and 9/23 for a total of 4 skin needling treatments in 3 weeks. I find the 1.0 mm to be an easier treatment to perform than the 1.5 mm, but I still need numbing cream. For me, the 1.0 mm needling has a recovery time of about 2 to 3 days superficially, however on a deeper level, the skin may still look slightly pink.
I’ve decided to try 2 more needlings over the next 9 days to complete 6 needling treatments in 5 weeks.
I am currently able to telework full-time and am home bound. It has been relatively easy to complete a treatment in the evening and be healed before my next virtual meeting.
For me, the first day after a 1.0 mm needling treatment is a little rough, my face is sore and inflamed and appears sunburn, I take good care of my skin and my health. The second day my skin is no longer sore but still red and by the third day my skin appears to be back to normal but remains slightly pink on a deeper level.
Completing 4 needlings in 3 weeks has taken a committed effort. I was motivated to test Dr. Fernandes’s current suggested protocol and evaluate how the protocol works for me. Of course, the final results will not be apparent for 3 months to a year as the collagen production and conversion process occurs over time. For now, during this skin needling process I experience a couple of days in between needling treatments when my skin glows from the attention and antioxidants.
I’ll provide an update with photos in about 3 months to check out my anecdotal observations from using Dr. Fernandes’s suggested skin needling protocol.
Dr. Fernandes reports that a frequency of 4-1.0mm needlings in 3 weeks combined with high concentration, non-aggressive antioxidants A, C, and E and peptides can increase collagen production and thicken skin.
In fact, skin needling can be used in the medical treatment of skin burns with good success.
“Medical needling offers a treatment that for the first time in medical history can cause regeneration of tissue and soften burn scars, reduce contractures. When done repeatedly and intensively then burn scarred tissue can seem to be almost normal unscarred skin.”
Skin needling is a non-invasive, skin stimulating process that effectively increases collagen under the right treatment conditions.
If you need more information, go to the library, search the Internet, read my past Blog articles, or it would be an honor if you purchased my book “Skin Remodeling DIY: An Introduction to the Underground World of Do-It-Yourself Skincare”
Take good care of yourselves!
Deborah
This article is intended to be used as general information only and is in no way intended to replace medical advice, be used as a medical treatment program, diagnosis, or cure of any disease or medical condition. There are no warranties, expressed or implied, regarding the effectiveness of the practices described in this article. Products or substances discussed herein are for educational purposes only and are not intended as recommendations of the author.