Skin Needling Lesson 3: Needling Techniques

Percutaneous Collagen Induction with Needle Rollers or Stamps – Basic skin needling is also called Percutaneous Collagen Induction(PCI) or, less commonly, Collagen Induction Therapy (CIT). The needle length needs to be at least .5 mm, but 1.0mm and 1.5mm are more common. It is used to treat wrinkles, rough skin, discoloration, scars, stretch marks, and mild skin sagging and can be used on body or facial skin. PCI is usually performed with needle roller or more recently, a needle stamp. Rollers are a good choice for large areas and stamps have an almost dime sized needled area that is good to target scars and wide stretch marks. The treatment technique varies, but a general guideline is to slightly stretch the skin and make 15 passes over the treatment area using moderate pressure. Lifting and/or changing the angle of the tool after each pass slightly alters the path of the needles and spreads the pricks evenly over each square centimeter of the skin. Most rollers are used in a “star” pattern, meaning the area is rolled 5 times vertically, 5 times horizontally, and 5 times diagonally. Each pass is one time i.e. rolling the same area back and forth count as 2 passes.

PCI should never be performed more than once a month, regardless of the seller’s instructions. You may not even need to repeat the treatment at all. Many people will get substantial results after only one session. Results are not immediately apparent. After healing, which takes about a week, the skin will typically look exactly as it did before the treatment. Over the following months, the skin matrix will start remodeling. It takes around 4 months after the first treatment to see results and the tissue remodeling continues for up to a year. Results are cumulative and some severe damage, such as stretch marks, will often take several treatments.

Dense Needling and Needle Abrasion – A very intense form of needling uses a single needle or stamp to pierce the treatment area with more pricks per square centimeter than used in PCI. It should only be used to treat stretch marks and scars with hardened scar tissue. Do not use dense needling on wrinkles and depressed/pitted scars like acne or chicken pox scars. This technique is quite advanced and has a greater risk of infection and scarring and nerve damage. Not all home users feel comfortable with it, and don’t push yourself. Dense needling techniques vary, but most users find it easy once you get the hang of it.

The dense grid of needle pricks creates more collagen than PCI can on the severely damaged skin of a stretch mark. It is usually only attempted by home users on stretch marks when PCI doesn’t achieve the desired results. It’s also used on large, isolated stretch marks when the user doesn’t want to needle the surrounding skin or if the stretch mark is in an awkward place that makes rolling difficult.

When dense needling is done on hardened scar tissue it can break up and remove the abnormal type of collagen found in raised scars. This process is known as needle abrasion. It should only be used on scarred skin, not the skin surrounding it.

Here is a general overview of the process, but follow the instructions included with your needling tool. PCI is performed on the treatment area with a roller or stamp about a week before the dense needling procedure. Try to pay attention to how the skin looks immediately after the PCI treatment. You want to use more pricks per square inch than with normal needling. Follow the standard sterilization procedures with alcohol to minimize the risk of infection. Stretch the skin with your free hand and use the single needle to abrade the area with a greater prick density than normal needling. The needling depth should be between 1mm and 2mm. Since most single needles are longer than that, you can use the “toothpick trick”. Basically, you measure the needle from the tip to your desired length and tape a toothpick to the tool that ends at that point to function as a stopper that keeps the needle from going any deeper.

Dense needling should not be repeated until 6 to 8 weeks have passed. Don’t go overboard with your first treatment; you can always treat the damage again. Like other forms of needling, the improvement takes several months to see, but it is permanent.

Penetration Enhancement with Cosmetic Needling – You can use a “light” needle roller or stamp to enhance the penetration of your topical actives. Most cosmetic needling tools use needles that are .2mm or .25mm long. The process can be done on any skin but is usually performed on the face. It isn’t usually necessary to sterilize the tool with alcohol between uses, but check the instructions of your product. It should be washed in soapy water without using a sponge or rag and allowed or air dry. Sterilizing the skin with alcohol usually isn’t necessary, but check your instructions.

The technique is quite easy and painless. Roll the area in a “star” pattern to distribute the pricks evenly. Apply your skin care products immediately after cosmetic needling while the miniscule channels are still open. This ensures that the actives will reach the epidermis. Only use penetration enhancement after you’ve adjusted to the actives by strength building. Very acidic products may still sting slightly and you may develop mild irritation from the increased absorption. Cosmetic needling can be performed every other day at the most. There is no downtime and virtually no risk of infection.