Why Collagen Induction Treatments Like Microneedling are Best Spaced Weeks Rather than Months Apart


Thank you for your question. You submitted a question without a photo but you’re describing in your question that you have an issue with pores on the cheeks as well as some minor acne scars in the temple and chin. And you’re asking if you were to get the optimal results comparable if you spread out the treatments rather than 4-6 weeks apart but rather by every 5 months, would you get comparable results as long as you maintain the ongoing treatment.

Well, I can certainly share with you the way I explain to my patients the strategy of treatments such as Microneedling based on some essential foundational principles that are relevant to skin treatment.

A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon.

I have been in practice in Manhattan and Long Island for over 20 years. Microneedling as well as lasers and other non-surgical solutions are a significant part of my practice and I can certainly understand why this question comes up because it is very important to try to envision what’s happening in your skin with these treatments. So to begin with, let’s start with simple strategy of what does a Microneedling procedure do. Microneedling has essentially become more and more popular after a very long period, I would say, it began in the mid-90s of a very high obsession of our profession whether it’s dermatology, plastic surgery, cosmetic surgery with the magic of lasers. And lasers are excellent devices and have evolved and we have really wonderful tools.

But interestingly, many of the greatest proponents for lasers have started to really embrace Microneedling and there’s a lot of reasons for that which we don’t have to necessarily go into but just as an understanding that Microneedling is also a tool like lasers that can be adjusted depending on what you want to achieve.

So the principle is called collagen induction therapy and what you are doing is you are creating very precise injuries at specific depths of the skin and the skin responds to that injury. And it responds with a best outcome by improving the quality by the induction of collagen and repair of the skin, blood supply, etc. That being said, we have to think of the mechanism of wound healing. So when you think of wound healing, the first phase is an inflammatory phase that eventually goes into what’s called a proliferative phase.

And the proliferative phase is when a lot of collagen is being produced, blood supply and a lot of tissue remodeling begins right after that. So a strategy of induction like that takes 4-6 weeks depending on the level of aggressiveness and is more likely to achieve better results than a strategy where you do a treatment and then you wait 5 months. Essentially in between, you’ve missed opportunities to build on those previous treatments. And so I help people understand this by essentially making a comparison like going to the gym. If you want to build muscle, you have to stimulate muscle in a consistent way in order to get growth.

If you just go to the gym every 5 months, you’re not going to get the same results as someone who goes to the gym with more regularity. Obviously, there’s a big difference between muscle building and skin healing but the concept is still, I think is more understandable for people who have trouble envisioning what’s going on in the skin. Customization is critically important.

And I would say that it’s important to have this discussion with your doctor about what the expected outcomes will be. In our practice, if someone wants to improve pores, I don’t always go straight to Microneedling.

I actually use a Q Switch laser to help people with pores. And I can certainly combine modalities such as Q Switch laser with Microneedling for other complementary processes to accomplish an outcome. Another principle of treating skin which I do which is I don’t always make assumptions, I treat and I observe the response and then I counsel my patients as to what the next step will be. So, there are a lot of ways to do these treatments to accomplish a goal and all those approaches are based on an individual doctor’s experience with the modalities they’re most comfortable with.

So again, I think it’s very straightforward that you won’t get the same results if you wait, if you do a treatment today and you do another treatment 5 months from now as opposed to maybe doing a treatment today and then doing another one in 6 weeks and another one after that.

So have this discussion with your doctor and hopefully, you’ll get a better sense of what kind of outcome there will be and understand that skin does require maintenance. So even if you achieve a certain plateau of result, then you may not have to come in as frequently but it does makes sense to periodically come in for a particular treatment or combination of treatments to maintain and maximize your appearance. So I hope that was helpful, I wish you the best of luck and thank you for your question..

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