title: Multiple microneedling sessions for minimally invasive facial rejuvenation: an objective assessment.
abstract: BACKGROUND
  Microneedling or percutaneous collagen induction is a new modality used for skin rejuvenation, tightening, and scar remodeling. It offers a simple and effective treatment for photoaged skin with minimal disruption of the epidermis, thus limiting adverse effects and minimizing downtime.
  
  
  OBJECTIVE
  To evaluate the efficacy, coupled with quantitative assessment, of the histological changes in response to multiple sessions of skin microneedling in the treatment of aging skin.
  
  
  METHODS
  Ten patients with Fitzpatrick skin type III and IV and Glogau class II to III wrinkles were subjected to six skin microneedling sessions at 2-week intervals. Standard photographs and skin biopsy specimens were obtained at baseline and at one and three months after the start of treatment. Histometry for epidermal thickness and quantitative evaluation of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin were performed for all skin biopsies.
  
  
  RESULTS
  Skin microneedling produced noticeable clinical improvement of photoaged skin, with corresponding histological enhancement. Compared to the baseline, collagen types I, III, and VII, as well as newly synthesized collagen, together with tropoelastin showed a statistically significant increase (P < 0.05) in response to treatment, while the mean level of total elastin was significantly decreased (P < 0.05) after treatment.
  
  
  CONCLUSIONS
  Skin microneedling is a promising minimally invasive treatment option with the advantage of increased collagen production. However, multiple sessions are usually needed to maintain the improvement achieved.
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Moetaz
authors.initials: M
authors.lastname: El-Domyati
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Manal
authors.initials: M
authors.lastname: Barakat
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Sherif
authors.initials: S
authors.lastname: Awad
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Walid
authors.initials: W
authors.lastname: Medhat
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Hasan
authors.initials: H
authors.lastname: El-Fakahany
authors.affiliation: Department of Dermatology, Al-Minya University, Al-Minya, Egypt.
authors.forename: Hanna
authors.initials: H
authors.lastname: Farag
mesh_terms: D000328:Adult; D001706:Biopsy; D024042:Collagen Type I / Q000378:metabolism; D024061:Collagen Type III / Q000378:metabolism; D024143:Collagen Type VII / Q000378:metabolism; D003357:Cosmetic Techniques / Q000295:instrumentation; D004549:Elastin / Q000378:metabolism; D004817:Epidermis / Q000378:metabolism / Q000473:pathology*; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D012060:Rejuvenation / Q000502:physiology; D015595:Skin Aging / Q000473:pathology* / Q000502:physiology; D016896:Treatment Outcome; D014333:Tropoelastin / Q000378:metabolism
chemical_list: D024042:Collagen Type I; D024061:Collagen Type III; D024143:Collagen Type VII; D014333:Tropoelastin; D004549:Elastin