Dermaroller
Nidheesh Agrawal
Overview
Microneedling device
Based on collagen induction therapy
Used in skin rejuvenation and scar
treatments
Poor man’s laser
The Instrument
A Derma Roller is a simple hand
held skin roller
Cylindrical device which has 192
surgical steel micro-needles
Studded in 8 rows
Types
Home use (0.2, 0.3 mm) : enhanced
absorption of drugs, radiance
Clinical use (0.5 mm) : wrinkles and
pigmentation
Medical use ( 1, 1.5, 2 mm) : Scars,
stretch marks
History
Probably inspired from accupuncture
Dermaroller patented in Germany in 2000, is
the original microneedling device
Other devices such as that invented by Dr
Fernandes called the CIT-Roller followed the
Dermaroller
The latest generation of microneedle roller
patented by Medik8, uses sterile small
diameter titanium needles, reduce pain
Principle
Skin Needling or Collagen Induction
Therapy
Ultra-fine micro-needles penetrate
through the epidermis
Create microscopic punctures on the
skin’s surface
Dermal damage without removing
epidermis
It has been shown that rolling with
a dermaroller (192 needles, 200 µm
length and 70 µm diameter) over an
area for 15 times will result in
approximately 250 holes/ cm2
Dramatically increase the
penetration of any topical product,
increasing its efficacy
Allows for controlled induction of the
skin’s self repair mechanism
Yet does not pose the risk of
permanent scarring.
Release of growth factors which
stimulate the formation of new
collagen (natural collagen) and elastin
in the dermis.
New capillaries are formed
neovascularisation and
neocollagenesis leads to reduction
of scars, skin tightening
Aust MC, Fernandes D, Kolokythas P, Kaplan HM, Vogt PM.
Percutaneous collagen induction therapy: An alternative treatment for
scars, wrinkles and skin laxity. Plast Reconstr Surg.2008;21:1421–9.
Fernandes D, Signorini M. Combating photoaging with percutaneous
collagen induction. Clin Dermatol. 2008;26:192–9.
Aust MC, Reimers K, Repenning C, Stahl F, Jahn S, Guggenheim M,
et al. Percutaneous collagen induction: Minimally invasive skin
rejuvenation without risk of hyperpigmentation-fact or fiction. Plast
Reconstr Surg. 2008;122:1553–63.
Patient selection
Realistic expectations
Know what you are doing it for
Counselling about procedure
Follow up
Multiple sessions
Methods of Use
One version involves the use of
Topical anaesthetic gel to numb the
area
More aggressive use
Bleeding +
Once per 2-6 weeks
Office procedure
The second alternative, involves using
the device with slight pressure
Erythema +, no bleeding
up to 5 times per week
Home procedure
Materials required
Sterile Dermaroller
Topical anaesthetic gel (if used)
Bowl of iced cold water
Sterile cotton/ pads
Clean towel
Glass of disinfectant
Anti bacterial cream
Moisturiser
Instructions
Sterile field and instruments
Wash, dry your hands, patient’s face
Apply topical anaesthetic, under
occlusion
Leave for appropriate time
Wipe off anaesthetic
Roll Dermaroller over affected areas
Topical anaesthetics
Toplap (Ajanta), Prilox ( Neon labs) ;
prilocaine and lidocaine 2.5 % each : 1
- 2 hours
Tetralid ( tetracaine and lidocaine 7 %
each) : 15 – 30 min
Apply evenly with a spatula under
occlusion
Technique
To and fro 4 times in a direction
4 directions
16 passes
Look out for erythema/ bleeding
Wipe off blood
Move to another area
Wash with cold water, dry
Apply antibacterial cream
Moisturiser
Topical drugs (if indicated)
Minoxidil, tretinoin, vitamin rich
creams
Post procedure
Erythema
Short-term minor bleeding
Occasionally bruising for the first 1 - 2
days
Advised photoprotection
Return to work same or following day
Repeat 2-6 weeks later
Care of the dermaroller
Ideally should be disposable
Should not be shared
Rinse under hot running water
Dip in disinfectant for 30 min – 1 hr
Dry and keep in case
Complications - Rare
Minor flaking, dryness and rarely
scabbing may occur for a few days
following treatment.
Very rarely hyperpigmentation - normally
resolves after a month.
Milia may occasionally form
Keloids – prone individuals
Flare up of herpes
Limitations
Deep pitted scars
Linear scars
Hypertrophic scars/ keloids
Wrinkles/ Ageing skin
Caused by the disappearance of elastin and
collagen fibres in the skin
leading to skin depressions known as
wrinkles and lines.
occurs naturally with age.
The content of collagen in the skin decreases
by about 1% with each year of life.
Connective tissue collapses, and skin and
facial contours lose their shape and firmness.
Acne scars
Injury to reticular dermis
Due to trauma/ inflammation
Healing occurs by disorganised laying
down of collagen in the dermis
Basis of use in scars is reinduction of
collagen formation in the scarred area,
in a controlled manner
Majid I. J Cutan Aesthet Surg 2009
Jan;2(1):26-30.
Of the 36 patients
29 : excellent, 4 : good and 3 : poor
Good to excellent response in rolling
and boxcar scars
Pitted scars showed only moderate
improvement.
All patients tolerated well
Hair loss
By irritation of skin/ growth factors
Application of minoxidil after
microneedling may improve drug
delivery
Alopecia areata ?
Other indications
Stretch marks
Post inflammatory hyperpigmentation
After liposuction
Enhanced drug delivery systems
Contraindications
Open wounds, cuts, abrasions
Any active or chronic infection in the
area to be treated
Have areas of the skin that are numb
or lack sensation
H/o keloid or hypertrophic scars
H/o poor wound healing
H/o bleeding disorders
Cost to the patient
Dermaroller costs from 1500 - ….
Needles blunt out after 4-8 sittings
Topical anaesthetic : Rs 150 approx
Moisturisers and sunscreens
Plus the doctor’s fee
Approx cost of therapy : 5k- 6k
10 times cheaper than Laser treatments
Advantages
Cheap
Less downtime
Effective
Can be performed at home too
No/ minimal side effects and
complications
Take home
Microneedling technique is a cheap, simple,
and effective technique for skin
rejuvenation and treatment of scars
It has a lower downtime and fewer
incidence of side effects than other
therapies available
It should be presented as a therapeutic
option to patients with cosmetic concerns.
