Microneedling and the Vampire Facial

 

vampire.jpgVampire facial, what the heck is that?  The name certainly sounds intriguing.  Who doesn’t want to be a vampire these days, am I right?  Well, the term vampire facial is actually a nickname for a skin rejuvenating procedure involving micro-needling and platelet rich plasma.  The treatment is so-called primarily because it uses the patient’s own blood (platelet rich plasma) to make improvements in the skin.  But also when combined with micro-needling, because the many fine needle punctures in the skin leave the patient looking rather bloody immediately afterward.   

kardashian-vampire-facial.jpgThe vampire facial has gained significant popularity over the last year or so, as it is something that certain celebrities (ie Kim Kardashian) have been known to apparently undergo regularly as part of their skin care regimens. 

The procedure itself is quite straightforward.  After applying a good thick layer of topical numbing cream and letting that absorb for an hour or so, the skin is then cleansed and a device with multiple fine needles that rapidly punctures the skin is passed over the treatment zone.

The needles are used to puncture the skin to a precise depth, creating controlled skin injury, and are passed over the skin until pin-point bleeding is noted from hundreds of micro injuries.   

How does it work?  Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin.  New collagen and new elastin are essential for youthful healthy appearing skin.  Through the process of healing and new collagen growth, there is improvement in skin texture, tone, and firmness, as well as reduction in scars, pore size, and stretch marks.

Now, lets go back to the first.  How does one’s own blood get used to rejuvenate the skin?  Well, before removing the numbing cream and cleaning off the skin, the patient’s blood is drawn, just enough to fill up a small tube.  Then while the micro-needling is being performed, that blood is being spun down and separated into what is know as platelet rich plasma or PRP.

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PRP contains a wealth of growth factors and cytokines, chemicals that signal healing to the body.  Thus, PRP works on the simple principle of utilizing your own natural platelets to instruct the body to create new collagen for tauter, smoother and better toned skin.  

Once this golden yellow platelet rich portion of the blood is obtained, and the completed micro-needling has created many fine fresh channels into the deeper layers of skin, it is then applied and absorbed into the dermis where it can be of most benefit.   

While both PRP and micro-needling are effective rejuvenating therapies on their own, the combination is synergistic, with greater improvement achieved by combining them together.  (1,2)

On a slightly more scientific note:

While there are some detractors from this procedure online, it is only when the procedure is labeled the vampire “facelift” that I agree with them. Calling it a vampire “facelift” is misleading and frankly incorrect.  It is not a facelift, nor does it take the place of dermal filler.  Which means it is the wrong choice for patients that have volume loss and skin laxity as their primary problem.  However, it has been extensively studied in the treatment of various skin textural and color issues, such sun damage, fine lines and wrinkles, as well as acne scarring. (3)

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The above pictures show before and after results of micro-needle therapy alone, without PRP.

On a more personal note:

My experience has been overwhelmingly positive.  The downtime associated with this procedure is extremely small. Mild redness lasting for 1-2 days for most people is the average healing time, and makeup can be worn the next day.  No swelling, no peeling.  This is less downtime then any conservative laser “resurfacing” modality.  And even less then most chemical peels which do much less collagen production by comparison.

In my experience, It is this great blend of results and minimal downtime which make this procedure ideal to perform on occasion for skin health maintenance, or in a treatment course for more targeted correction.

References:

  1. Asif M et al. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016 Jan 8.
  2. Chawla S. Split Face Comparative Study of Microneedling with PRP Versus Microneedling with Vitamin C in Treating Atrophic Post Acne Scars. J Cutan Aesthet Surg. 2014 Oct-Dec;7(4):209-12.
  3. Hou A et al. Microneedling: A Comprehensive Review. Dermatol Surg. 2016 Oct 13.

     

Stretch Marks

Stretch marks are noticeably lighter and less visible after only five laser treatments from Dr. Smart at The University of Utah's Department of Dermatology
Before and after 5 treatments of the Fraxel laser

The Stretch Mark

Why do stretch marks form? Well…. from stretching right? Probably, but the precise cause of stretch marks, also known as striae, is not quite understood. While many believe that mechanical stretching of the connective tissue causes rupture and their subsequent appearance, there is more to it than that. And even normal growth associated with high levels of steroid hormone may be the cause.

Whatever the cause, many of us have a stretch mark or two. They are a very common cosmetic concern and more than twice as likely in women, compared to men.  But regardless of gender, they can be frustrating to us all.

Keep in mind, we divide striae into two groups, striae rubra (SR) and striae alba (SA). SR are a little bit pink, red, or purple, relatively new, and may be raised. SA are typically older, light colored and slightly atrophic or thinned. These categories are important because they are treated a little differently.

How to treat your stretch marks:

Treatment of stretch marks includes a variety of topical and injectable medications and laser therapy and resurfacing techniques.

Tretinoin and similar topical creams have shown to clinically improve the appearance of SR in clinical trials. Daily application over the period of 3-4 months may help exfoliate and tighten the mark. Other topical therapies that show benefit are glycolic acid and Trichloroacetic acid (10-35%) These are typically applied at monthly intervals.

Another proven therapy is microdermabrasion. By carefully and gently abrading the superficial layer of skin, deeper new collagen regeneration is stimulated and the texture of the striae can be smoothened and strengthened.

There are also a variety of laser and light devices that have been studied to treat these pesky stretch marks. By using a combination of different lasers, such as the V-beam and Fraxel lasers, Good to great results can be achieved in both newer red stretch marks and older white colored ones.

Personally, I like the results I get with laser resurfacing. Fractionated laser resurfacing will help tighten the skin and improve the appearance of stretch marks both new and old.

A few technical details:

 The PDL 585-595nm lasers have perhaps the most evidence and are able to achieve good results when treating the early SR. Their effect is less impressive on mature SA.   Though caution should be used on much darker skin types with this laser. And in darker skin types one might consider a different wavelength such as a 1064nm ND: YAG. This provides increased safety when treating dark skin types, while still provided collagen regeneration and targeting vasculature.

The treatment of SA is more difficult and less predictable.  Studies show conflicting results with various fractionated laser modalities. but both ablative and non-ablative fractionated lasers have shown improvement. And both should be considered options in patients with mature striae.

Another consideration in SA may be the 308nm excimer laser. Multiple studies have documented improvment and repigmentation in white or light colored areas with the excimer.