Microneedling PRP

At A Glance, Microneedling PRP

  • Best Results4-6 sessions
  • Treatment Recovery1-3+ days
  • Procedure Time30 minutes
  • Skin SpecialistNurse, therapist
  • Duration of ResultsVariable
  • AnaestheticNumbing cream/gel
  • Back to Work1-2 days
  • Cost$-$$

Microneedling PRP

Microneedling & PRP is a favourite combination offered by many cosmetic clinics as a treatment option for wrinkles, scars & more. I do believe the ‘microneedling’ part can be effective, however addition of PRP gives marginal results at best. I do not routinely offer PRP, however it can be effective in other skin conditions such as hair loss & wound healing.

FactsFacts on Microneedling & PRP

  • This treatment involves the use of tiny needles to break the surface of skin
  • Microneedles provides controlled injury & miniature channels in the upper skin
  • PRP stands for platelet rich plasma & is derived from your own blood
  • PRP has growth factors & cytokines that in theory can improve healing & stimulate new tissue including collagen
  • As PRP is derived from your own blood, there are no issues in the context of allergies or contamination
  • Microneedling can address skin concerns including scars, wrinkles, sun damage, enlarged pores, & stretchmarks
  • 4-6 treatments are performed, 2-4 weeks apart for best results
  • Read more on how I perceive platelet rich plasma/PRP

What is microneedling?

Microneedling is a broad term to describe the use of small needles to break the upper layers of skin. This ‘micro injury’ of skin results in remodelling of the lower dermis. This can increase collagen resulting in improvement of wrinkles, skin texture, reduction of pore sizing & scars.

Microneedles can be delivered in 4 ways. The simplest is a roller mechanism consisting of 128-256 plus needles (depth varies between 0.1 to 2+ mm). These can be purchased online from eBay or Amazon for about $3 to $8 USD.

The second way of needling involves stamping or ‘derma stamp’. This provides vertical entry of needles in a stamping mode. Stamping is safer, but it is limited in the capability of treating angular areas such as the nose.

Thirdly microneedles can be delivered with a pen, called Dermapen, or Skin Pen. This is the most common mode of delivery as it is motor driven.

The fourth variation of microneedling is called energy microneedling or RFM; radiofrequency microneedling. This involves the use of insulated or non-insulated bipolar needles. RFM has the advantage of providing heat. This results in more collagen remodelling compared to ‘cold needling.’

Type Derma RollerDerma PenDerma StampRF microneedling
MechanismRollingVertical needles, motor drivenStamping

Vertical

Needles -predetermined

depth

Vertical insulated vs non-insulated needles
ProsCheapFastCheap, safeMore collagen remodelling
ConsNeedle entry not vertically orientatedDragging or poor technique can induce scarsDifficult to treat

Areas such as the nose, eyelids

Expense, difficulty, patient selection

What is PRP?

PRP is concentrated platelet cells from your own blood. It involves taking your own blood, processing it, spinning it down to give platelet cells (clotting cells) and then reinjecting or applying back to your skin after it has been micro needled. The micro wounds left following needling allows the goodness of concentrated platelets & growth factors to enter your deeper layers of skin, stimulating collagen production. 

Unfortunately, the commercialisation of PRP has made this procedure an ‘upsell’ for many clinics, almost to the point of associating microneedling with, you guess it ‘PRP.’ Concentrated platelets & growth factors have been shown to improve joint pain & speed up recovery. PRP has been shown to be effective in the management of hair loss. PRP has conflicting outcomes when it comes to skin. Some cases show improvement with scarring, many cases do not.  As a guide I used this extensively in the majority of scar revision procedures from 2015 to 2018. I do believe it has extremely marginal improvements when it comes to healing times, but little or no advantage when it comes to overall outcome. Hence, I am reluctant to offer this treatment to patients however I can add this to your treatment, should you feel that your research has shown advantages. PRP is harmless, however the question is, does it add anything to the revision process?

What conditions can microneedling PRP treat?

PRP & microneedling has been reported to treat-

  • Scarring including traumatic & acne scars
  • Stretch marks
  • Wrinkles & photoaging
  • Melasma
  • Pigmentation
  • Dark circles
  • Hair loss
  • Enlarged pores

I still perform microneedling daily (reasons given below), however rarely utilise PRP. I did use this treatment heavily from 2015 to 2018 however I found it was marginally effective in reducing downtime. PRP did not contribute to overall improvement beyond the microneedling procedure. If you would like this treatment based upon your own research, you can discuss this with my clinical team @cliniccutis. Please read the relevant FAQs below in the context of skin concerns.

Is microneedling PRP a good treatment for acne scars?

Yes. Microneedling can be a good non-targeted way to address acne scars. Mild to moderate early acne scars can improve with this treatment. It is the microneedling part that works, the PRP is onselling a treatment. More on that later.

Microneedling has been shown to improve scarring by collagen remodelling in the deeper layers of skin. It can also release growth factors known as cytokines from the upper layers of skin (epidermis). A third mechanism is creating an electrical potential between the cells, leading to cell migration. There is no evidence that super deep treatments work better, however the deeper one goes, the riskier the treatment (scars, bleeding, bruising, infection). A sensible depth is 0.25 to 1.0 mm conducted with traction & counter traction. Performed correctly, a derma roller or derma stamp can be just as effective. This can be done at home if you are careful. Most dermatologists would agree, if sensible selection of depths with good technique, the risks of scarring is remote. A sensible at home depth is 0.25 maximum.

Stamping is safer than rolling. Perform every 3-6 weeks, 6 to 8 passes depending on the number of needles.

Microneedling & PRP combined: Davin’s Viewpoint

The former works well for some skin conditions whilst PRP is probably ‘upselling’ the large Coke & Fries.

I still employ microneedling in the day and age of lasers & RFM (radiofrequency microneedling). The latter provides controlled heating with microneedling and hence it generates more collagen remodelling, especially in the context of scar revision.

Lasers are much more precise, especially ‘small dot’ lasers such as Fraxel, LaseMD, Clear & Brilliant & eCO2. I prefer these treatments over microneedling – RFM when the ‘target’ or problem is small (eg pores). My preference for microneedling only is in the treatment of some types of scars, hypertrophic & sensitive keloid scars are examples. This is when I want punctate entry wounds without ‘char’ so I can deliver drugs into the deeper layers of skin.

Provided it is correctly performed, I don’t agree with the illustrations of ‘tearing’ the skin with derma rollers, once again this is in the context of depth of needles & technique. Using 0.1 to 0.25mm with adequate counter traction is a safe DIY, dragging microneedles can also result in idiosyncratic & iatrogenic scars. Possibly derma stamping is safer esp if longer needles.

As for PRP, there is so much absolute crap in the literature- especially in the context of melasma. We see more treatment worsened post inflammatory hyperpigmentation & melasma flare ups post microneedling than any other procedure. PRP has been shown to marginally improve healing times. The use for hair loss is appropriate as adjunctive management with LLEDs, Thulium, & most importantly medical therapy including finasteride, cyproterone acetate, spironolactone & topical – oral minoxidil.

Does Cutis Clinic still employ PRP? Yes, in select patients. I do not routinely offer this as I don’t like to upsell or upsize treatments. Regardless PRP still has a high patient satisfaction rate- that cannot be denied.

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