STICK A PIN IN IT
We give microneedling a try.
In movies about a woman trying to get pregnant, there’s always that scene in which the protagonist looks around and sees nothing but infants in strollers, swollen bellies and signs advertising schools for toddlers. I have a similar obsessive streak, but in my movie, I’d be faced with a sea of Rihannas, Cate Blanchetts, Pharrells — flawless visage after flawless visage. I’d stroke my own imperfect cheek and weep.
My skin problems began in puberty with a case of cystic acne that haunted me right up until last year, at age 25. (Aczone, my friends: ask your doctor about it.) Even though I’ve now got my blemishes and pimples more or less under control, I’ve been left with enlarged pores and scars around my cheeks and mouth. For this, I’ve tried all manner of over-thecounter peels, exfoliants and “miracle” witchy cures (apple cider vinegar shots, anyone?), to no avail.
Then, via Instagram, I caught wind of the microneedling craze. Microneedling is a process that’s exactly what it sounds like — tiny needles penetrating the skin hundreds of times, usually at the hands of a wand-wielding dermatologist or aesthetician. Popularised in the ’90s by a Canadian plastic surgeon after he found he could fade surgical scars with an inkless tattoo gun, it’s used to treat all kinds of textural woes, from acne scars to enlarged pores. According to Dr Mary Stevenson, an assistant professor of dermatology at NYU Langone Health in New York, the process, also known as collagen-induction therapy, is thus: the needles create wounds that trigger an “inflammation cascade”, the same natural healing process that occurs when scar tissue is formed after, say, a scraped knee — rendering skin, to steal from Ernest Hemingway, “strong at the broken places”. But because the needles are so short (0.25mm to 4mm, tinier than a garden ant), the process is very controlled.
While clinical assessments of microneedling are in their relative infancy, the results are promising: a 2015 study in the Journal Of Clinical And Aesthetic Dermatology showed “a noticeable enhancement in skin appearance, postacne scars and patient satisfaction” in all 10 patients after six bimonthly sessions. And although lasers are more prone to causing accidental hyperpigmentation in darker skin tones, microneedling does not.
While microneedling isn’t exactly new, it’s only in the past couple of years that at-home devices have flooded the market. Most DIY treatments involve running a small manual device (like a spiky paint roller) over the skin. Experts agree that at-home rolling should never be done with needles exceeding 0.5mm — the risk of infection is too high — yet those same
experts will tell you that, at that particular length, little damage is being done to the skin, and therefore little actual collagen-building is being triggered. But that’s not to say that at-home rolling is useless. “It creates a channel in the skin for active ingredients to penetrate deeper into the dermis, for increased efficacy,” says Natalie Abouchar, a registered nurse and founder of Sydney’s Privée Clinic. “The client can roll their skin in the evening and apply different products depending on their skin concerns, such as retinol, vitamin C and hyaluronic acid.”
New York-based dermatologist Dr Joshua Zeichner notes that if you’re looking to reduce post-acne hyperpigmentation, the exfoliation “likely may give some effect. You’ll notice I put in three qualifiers there.” After a few weeks experimenting with a 0.3mm at-home roller, I notice my skin feels softer but not markedly changed. I want my pores teeny and my acne scars gone — now. And so, on the recommendation of New York’s superstar dermatologist Dr Dendy Engelman, I make my way to Jeannel Astarita, the founder of medi-spa Just Ageless.
A single microneedling treatment costs between $640 and $970, and it’s rarely sold as a one-off (patients with deep scars often opt for a series of three to six treatments). But for my rosacea and acneprone skin, traditional microneedling could spell disaster (inflammation! Exacerbated breakouts!). It turns out I’m in luck: Astarita can offer the Endymed Intensif, a relatively new device that couples microneedling with radio frequency to treat both active acne and acne scars. Delivered via 12 highly conductive gold-plated needles, the heat kills acne-causing bacteria and lessens inflammation. After cleansing, exfoliating, numbing and disinfecting my skin, Astarita starts stamping the thicker skin on my cheeks, nose and chin, programming the needles to go to a depth of 2.5mm, followed by my delicate undereye area and forehead at 1.5mm. It’s no more uncomfortable than a pinch — for the first few pulses. Then the discomfort gradually increases until tears stream down my cheeks. (Astarita explains that because the Intensif uses a slower in-out motion for its needles rather than straight microneedling, it’s considered marginally more painful.)
But almost as soon as it begins, it’s over, and Astarita is applying post-procedure topicals — an antioxidant and a skin strengthener. When she finally hands me a mirror, my face is a shocking shade of burgundy. It subsides to that of a particularly bad sunburn by the time I get home, and the pores on my chin — this isn’t for the squeamish — look like they’re purging sebum. In actuality, “It’s a result of the inflammation,” Astarita texts me the next day during a check-in. “The pores weep.” Per her advice, I slip two damp muslin cloths into the freezer and apply them periodically, feeling not unlike Norma Desmond in Sunset Boulevard’s gruesome makeover scene.
Everyone’s skin reacts differently to these procedures, but it’s typical to be red, dry and flaky for a few days. I’d planned to work from home on the Friday following my treatment, and at the earlymorning sight of my swollen, pink visage, I’m glad I did. I commence a weekend of extreme moisturising, and by Monday, one colleague remarks upon my smooth skin (hallelujah!).
It’s now been a month since my treatment and my pores look definitively smaller, and the scars that have bothered me for years are far less noticeable. Time will tell as to how much collagen-induced filling and tightening I’ll experience — I’m told the effects continue to develop for up to six weeks post-procedure — but for now, I’m basking in my own glow.