Tough love: should you peel to heal?


Who in their right mind would create wounds on their face with a bunch of needles? The idea may be outrageous, but it’s perfectly acceptable in the world of microneedling, a procedure that’s becoming as popular as Botox and retinol. And if you, like me, aren’t yet comfortable with the idea of injectables, this could be one way to achieve smoother, tighter skin, with minimal downtime.

How it works

“It’s popular because [when done correctly], the micro injuries cause a cascade of cytokines — a category of small proteins important in cell signalling — and growth factors to rush to the injury site for repair, thereby increasing collagen production,” says Mumbai-based cosmetic dermatologist Dr Jaishree Sharad, who was the first to bring the technique to India in 2006. She also explains that deeper needle lengths (upto 3 mm) break up fibrous bands in the skin, thereby reducing acne scars. “Lastly, the punctures create micro channels, which increase product penetration by more than 40% as compared to topical application.”

The contraindications

I’d never do it at home, since some things are best left to experts. “There was one patient with abscess in two places because she didn’t sanitise the tool properly and another developed tiny holes in the skin, caused when the device is rolled excessively in one direction.” But if you still insist on doing it yourself, Dr Sharad advises you discard the tool after one use. “Women with acne scars can begin in-office treatments in their 20s, and for anti-ageing begin in your 30s,” she says.

Even in the doctor’s office there are times when the procedure could have adverse effects. “I don’t treat melasma or active acne with this,” says Dr Meghna Gupta, Delhi-based dermatologist who performed the procedure on me. “In active acne, you’re spreading the bacteria, while in melasma, sometimes there’s a good response, but in others it could cause the condition to flare up.”

My experience

The treatment itself was painless because of the numbing cream. On Dr Gupta’s recommendation, I went for the ‘Cocktail Facial’ that utilised a Nanopure Dermapen “with hollow needles for deeper product penetration”. My ‘cocktail’ was a mix of retinol, hyaluronic acid and lactoferrin, an ingredient that helps build a skin barrier and boost elasticity. To treat shallow acne scars she used a depth of 1.5 mm needles on my forehead and 2 mm on the rest of my face. We were done in what felt like 15 minutes.

Spot the difference

  • A dermapen and derma roller are different. The latter is what we use at home and is hand-rolled, whereas the dermapen is the advanced electronic device used by dermatologists.

My face was unnaturally raw afterwards but for that the fault is mine. I had used tretinoin cream the night before. What was I thinking? I knew that strong actives including retinol and AHAS must be stopped a few days beforehand. Because my skin was already slightly peeled with the retinol, the microneedling ‘injured’ it more than it should have. Thankfully I was with my dermatologist so I wasn’t too alarmed. Also, when done correctly, more injuries mean a better scope for repair — the more you peel the better you heal.

Road to recovery

Later that night, my face started feeling uncomfortably prickly, a sensation that continued till the next afternoon. I’d be lying if I said there wasn’t a sense of regret. My skin looked great before the treatment. Why did I have to do this?

I didn’t wash my face the first night and only used a cica cream to soothe irritation. My dermatologist later added a medicated cream to go as a first layer under hyaluronic acid, squalene and cica cream. Soon, the redness turned into brown scabs. I was disciplined about being gentle, saturating my skin with moisture and applying sunscreen twice a day. Sunscreen is important, even for long term aftercare. After all, you don’t want to expose that freshly-formed skin to the sun.

The scabs flaked away on their own on day three while I was patting on some cleansing oil. The immediate difference: the lines around my eyes and the acne scars did fade a bit. As I write this piece three weeks later, my skin still looks smooth, taut and bouncy.

Vasudha Rai

Does it last?

“Microneedling at home is very temporary,” says Dr Sharad. “Electronic dermapens are more advanced.” You can also use dermapens to infuse PRP (platelet-rich plasma), which, among other things, also speeds up healing. A friend who tried PRP calls it ‘the gift that keeps on giving’ as the results keep improving upto a year.

“But the real workhorse is radiofrequency microneedling,” says Dr Sharad. “It fades scars permanently and reduces lines for a longer period of time.” It also hurts and costs more: ₹10,000 plus taxes for the Cocktail Facial vs ₹20,000 plus taxes for a session of RF microneedling at Dr Gupta’s Delhi Skin Clinic. But despite the increased pain and price I will try radio frequency next time around. It may not happen very soon, but it will happen for sure.

The writer is The Hindu Weekend’s beauty columnist

Disclaimer: Consult a dermatologist before beginning a new regimen

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