Micro-Mechanical Fractional Skin Rejuvenation

Purpose:  As the population ages, there is an increasing demand for safe and effective skin rejuvenation.  Laser Skin resurfacing is the most commonly performed procedure; however, it has known side effects as well as significant expense.  Percutaneous collagen induction therapy, the application of solid needles to the skin, has a favorable side effect profile, but limited efficacy.  We have developed a novel device that utilizes micro coring needles, which remove tissue in a fractional pattern.  In this study we compare the efficacy of these needles to standard needles, in a pig model.

Methods:  A MGH miniature swine underwent treatment with three needle types: standard hypodermic needle, solid hypodermic needle, and our novel coring needle. Both 23 and 25 gauge needle sizes were tested. Treatment sites received either 20% or 40% coverage by area. Photographs and punch biopsies for collagen and elastin staining were performed at day 0, 7, 28, 56 and 84. Collagen content was assessed at the conclusion of the experiment.

Results:  The needle therapy was well tolerated, with none of our treatment sites showing any sign of infection or scar. The sites healed quickly, with resolution of erythema at two weeks. Histologically, all the treatment sites demonstrated re-epithelialization by one week. Treatment sites were easily indentified by histology and contained increased fibroblast activity and fine, newly synthesized collagen. At one month, we found the papillary dermis of our coring sites to be up to 209% thicker, when compared to our untreated, control sites (p<0.001). The coring sites had enhanced undulating rete ridges increasing the epidermal-dermal junction—a sign of youthful skin. The 25g needles demonstrated a 2 fold increase in epidermal thickness. At three months, the coring groups exhibited newly aligned and augmented elastic fibers and an 89% increase in collagen content when compared to controls (p<0.001).

Conclusions:  We found this novel needle type to be safe and more effective than other needle types at inducing the microscopic and biologic endpoints of skin rejuvenation. This is a promising new modality for the safe and cost-effective treatment of age related rhytides, skin laxity, photo damage, scaring and striae.

Collagen Content at 3 months. Error bar represent standard deviation. (***) indicates p<0.001.