The Aesthetic Guide is part of the Informa Markets Division of Informa PLC

This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC's registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.

Advanced microneedling technology improves safety and profitability

Article-Advanced microneedling technology improves safety and profitability


This device’s patented needle cartridge features 33-gauge stainless steel, gamma sterilized needles that oscillate as high as 120 revolutions per second (7,200 rpm), allowing increased maneuverability for operators. In addition, the unit’s patented radiofrequency identification (RFID) system provides unparalleled and accurate needle penetration depth by automatically and consistently calibrating the needle cartridge with the device. Proprietary Advanced Oscillating Vertical Needle (AOVN) technology mechanically calibrates the motor speed, pressure and penetration, allowing the operator to perform scar treatment at 3.0 mm, which was not previously achievable in a microneedling device.

“Not only is Dermapen 4 loaded with the latest technology, clinical results include increased procedural efficacy, which promotes patient safety without the usual risks associated with other microneedling devices or rollers,” stated Tijion Esho, M.B.Ch.B., M.R.C.S., M.R.C.G.P., a cosmetic surgeon in London, U.K.

Dermapen is a go-to treatment modality for skin rejuvenation that works with all skin types, said Sheila Nazarian, M.D., a plastic surgeon in Beverly Hills, Calif. “When I started my practice, a lot of my patients had darker skin types, and I am also pigmented. Some laser-based devices burn the skin, and when pigmented skin burns, we turn brown. So, I was looking for something mechanical that I could offer my darker skin type patients that wouldn’t produce pigmentation disorders. It also
does a great job on acne scars.”

“My first reaction was ‘wow’; it is like having a Knight Rider in your hand,” Dr. Esho commented. “You have so much precision over a greater area. I fell in love with it, not just because of the design, but because of how easy the glide was and how powerful it is in comparison to other devices.”

According to Andrew R. Christie, M.D., a medical trainer and health science specialist in Paris, France, “Dermapen 4 is the fastest automated pen on the market. It has 1,920 microchannels per second. Nothing beats that. You can work a lot faster, and it makes for a more profitable procedure. Ultimately, the speed of treatment also makes it more comfortable for the patient. I can treat a full face in around four minutes and maximize the use of puncture channels that I’m actually working with, as well.”

Practical for all Skin Types

For years, Anne Wetter, M.D., a dermatologist in Stockholm, Sweden, was looking for a device that could work well with the skin’s structure and various types of scars. She had previously used a dermaroller to treat hair loss and acne scars.

“When I moved to the Dermapen, I found that it used a completely different technique: an array of needles that worked very close to the skin in an organized pattern like a fractionated laser, but without the adverse effects associated with light energy,” Dr. Wetter shared.

In Dr. Nazarian’s experience, Dermapen is a very useful tool for collagen production in the face. “What I explain to the patients is that we are basically tricking the face into thinking it is injured. We’re creating all the small microinjuries that help send in the fibroblasts, which are the collagen producing cells. And you start boosting collagen all over the place. It creates little microscars so that the wound can heal.”

Dermapen 4’s ability to treat faster and deeper is a huge benefit, added Dr. Esho.

“With the older pen, the penetration would reach 2.5 mm, but Dermapen 4 can reach 3.0 mm. Obviously, when it is set to that depth you won’t be able to glide, but you have the functionality to slow the rate of puncture at particular sites, which is amazing,” he said.

Enhanced Ergonomics Improve Efficiency

In addition to technical enhancements, Dermapen 4’s handheld ergonomics are a major advancement over earlier versions.

Improved balance and weight distribution require less pressure to achieve needle contact on the skin, which also reduces or eliminates operator fatigue and discomfort. The new device also offers integrated Bluetooth connectivity, allowing practitioners to wirelessly update Dermapen 4’s calibration tables and firmware, which secures the physician’s investment into the future as it can be continually upgraded. Additionally, it now incorporates a rechargeable battery in addition to the standard power cord; and features an onboard real-time display.

“I love Dermapen 4’s ergonomic design,” Dr. Esho expressed. “The LCD screen allows for the very visual way we work these
days, and the ability to see what power levels are being used directly in front of us makes the process a lot more responsive than when we had to turn the dial on the older pens.”

The versatility of having both corded and battery power is highly desirable, Dr. Christie added.

“I do a lot of traveling, so I’m not always that familiar with the surroundings of the treatment room that I’m in. In addition, you now get the same level of power from the battery as what you get from the main cord,” he pointed out.

Protocols for Scar Treatment

A traditional treatment modality of microneedling addresses scars, and this is where Dermapen 4 really shines, Dr. Esho stated.

“We have a lot of patients suffering from acne scarring, and there is a big psychological connotation associated with this indication. These patients become depressed and very anxious because they have already tried several other therapies, including peels and skincare products, and the scarring hasn’t improved,” he explained.

Dermapen 4 offers dedicated treatment protocols for scar revision, including deep, atrophic scars, striae and post-acne scars.

“It is important to look at the origins of how people have worked on scars over the last 30 or 40 years,” Dr. Christie noted. “I like the fact that Dermapen 4 has this specific scar treatment setting. I have utilized some of the pioneering techniques of subcision and some angled techniques that get to the very core of hardened hypertrophic scars. A benefit of this device is that it includes some stamping innovation for changing the angle so that I can minimize downtime and pain to the patient while maximizing needle penetration.”

Beyond scar procedures, Dermapen 4 can be customized to expand the number of indications that can be treated.

“A single needle cartridge stretches over a large surface area, which makes the treatments very affordable for patients coming in to get a full-face procedure from the forehead down to the chin,” noted Dr. Christie. “I can also treat the neck, décolletage, backs of the hands and thighs in the same session while still using the single needle cartridge. I just change the glide or the products I’m infusing into the skin for these areas. I like that flexibility. In addition, there’s no scabbing, grazing or bruising.”

Versatile and Combination Applications

“Of my patients, 99% are eligible for procedures using Dermapen, and I like that flexibility,” Dr. Esho reported. “It means I can treat the face and other body areas in a single session. This device gives the practitioner so much range in depth. There’s physically nowhere that I cannot use it.”

The company is also very open to helping practitioners create new treatment protocols, noted Dr. Esho.

“I’ve engaged in a dialogue with the developers to suggest how to make the product even better. They have really responded well, and I’d say they have included nine out of the ten new features and functionalities that I wanted in Dermapen 4 before I even mentioned them; and surprised me with a few others,” he said.

Part of the dialogue has involved new ways to employ Dermapen in combination protocols. Users have found that the system works synergistically with various modalities such as energy-based systems and other therapies.

As stated by Dr. Esho, “We are combining the pen with more treatment modalities. For instance, I will combine the Dermapen with a fractional laser to achieve some amazing results. In the future, we will move away from single modality pens. I think the trend is towards dual or triple modality devices.”

Dr. Christie agrees that microneedling has logically moved away from straightforward collagen induction into novel aesthetic modalities and unexpected areas of medicine. “The challenge with microneedling is that it has always been associated with collagen induction therapy, but we must remember that a fibroblast produces not only collagen and elastin, but also hyaluronic and glycol proteins,” he said. “I see so many new innovations with microneedling. It has certainly developed above and beyond just scar tissue treatment.” 

Another area where Dermapen 4 pushes the envelope is in tattoo removal where integration of the separate Dermapen Tattoff Activator Infusion Device, and a new Tattoff Needle Cartridge allow for non-laser, all color tattoo removal that can be used alone or combined with standard laser-based techniques to achieve full tattoo clearance. Furthermore, the device’s fast treatment times can be helpful for clinics that experience patient attrition due to the number of sessions needed to achieve full clearance using other modalities, such as lasers.

“Look at traditional tattoo removal using a Q-switched laser,” Dr. Christie began. “It is very easy for a patient to turn up for a single appointment, but it can be more difficult to get them to come in for subsequent sessions. It could be because the treatment is painful or too time consuming. Dermapen eliminates many of these kinds of problems.”

Whether practitioners use Dermapen as a standalone procedure or in combination with other modalities, “it is far quicker and effective, as well as more comfortable and affordable for the patient, and they come back,” Dr. Esho stated. “I look at the modern patient and they are a unique phenomenon. They want the world, they want it now and at minimal cost. They also want it with minimal pain and without any downtime at all.”

“Practitioners will tend to combine microneedling with their own serum or growth factors, which can be more affordable to patients, especially when utilizing the unique protocol products developed specifically for microneedling,” Dr. Nazarian reported. “Patients see a glow to the skin and a little bit of tightening or shrinkage.”

Dermapen 4 can infuse PRP, mesotherapy and other serums utilizing the company’s new Meso-Infuse Needle Cartridge, which promotes pinpoint delivery and precision. “So, we’ve seen great success in dealing with acne, melasma, hyperpigmentation, hypopigmentation, even alopecia. Therefore, microneedling, and the Dermapen 4 in particular, are quite versatile,” Dr. Christie continued.

PRP Infusion Applicator

Dr. Esho noted that Dermapen 4’s implementation of PRP infusion is novel.

“One thing I discovered about delivery of PRP is that when you use it with a syringe it just wants to go everywhere,” he said. “When that would happen I kept thinking, ‘why can’t there be a way for the PRP to stay inside the chamber and made available only when it is needed?’ One of the new Dermapen 4 needles actually has an applicator that allows you to pump the PRP into the microneedling chamber through a tube and directly into the skin, so that the fluid is confined to a specific target area. It is such a simple alteration, but it is ingenious. I can see a lot of practitioners using that, including myself.”

In Dr. Christie’s experience, using the Dermapen to infuse PRP takes less time than other methods, “And that translates into more money for me,” he said. “I’ve had great success with PRP, taking into consideration the time needed to administer a single technique. Also, when it is at that level of treatment time, it increases comfort for the patients.”

Responding to Contamination and Cost Concerns

With microneedling, an important concern among both patients and practitioners is needle sterility. Dermapen 4’s gamma-sterilized cartridge and needles include retention valves that alleviate the build-up of procedural pressure within the needle cartridge. The new cartridge also has an anti-contamination management system built in to every unit, guaranteeing there will never be any fluid back flow into the device itself. These innovations remove the risk of cross-contamination while confirming pressure-free contact with the skin during procedures.

According to Dr. Christie, “With rollers we would reuse them. I’ve never been a fan of that practice, and thankfully we saw the industry advance into automated devices. One of the first things I would look at was making sure the needle cartridges were sterile and only single use.”

“As microneedling developed into what you could say is a blood treatment and for infusion of mesotherapy and PRP, etc., one concern has also been related to protection for the device and the patient,” Dr. Christie continued. “My question was, ‘so where is that fluid actually going? Is it going into the pen or onto the pen?’ Dermapen 4 contains mechanisms to guarantee that there is no contamination. Fluid cannot get into the needle cartridge, which means there is no compromise in quality or safety from patient to patient, and it is less expensive for the practitioner, too.”

Furthermore, some of the microneedling-related expenses are affordable when compared with other modalities, Dr. Christie added.

“The nice thing about microneedling is the cost of consumables is quite low,” he stated. “If I can treat a whole face in four minutes, then theoretically I could see more than four patients an hour. The cost of that treatment is just the needle cartridge. This translates into an incredibly small investment. We’re not paying the high cost of a laser or a vial of filler. In my  view, it is the easiest and quickest way for a practitioner to add revenue.”

In addition, DermapenWorld cares for its customers very well, expressed Dr. Wetter.

“The company’s technical support is excellent. They not only listen to the customer, I do a lot of clinical studies and they are very open to helping me. For instance, I’m doing a study right now about how to stimulate collagen growth in the décolletage area for skin rejuvenation. They support this work 100% and make it very easy for clinicians to advance and create new Dermapen protocols.”

Overall, Dermapen is poised to advance microneedling therapy in innovative ways, said Dr. Esho.

“My patients that have had microneedling procedures in the past and now receive Dermapen treatments comment on how easy it is on their skin, how easy the glide is and the quality of results,” Dr. Esho expressed. “If I didn’t believe in this technology, you could pay me all the money in the world and I wouldn’t use it. I’m getting great results with Dermapen.”

As stated by Dr. Nazarian, “I'm very happy with microneedling technology. It offers a very quick, easy procedure. Also, microneedling with PRP is on everybody’s mind right now. Whenever I give my talks about return on investment on devices, I always say microneedling systems will get paid off quicker than any other device you’ve ever purchased.”