title: Fractional Microneedling: A Novel Method for Enhancement of Topical Anesthesia Before Skin Aesthetic Procedures.
abstract: BACKGROUND
  Skin microneedling or fractional microneedle therapy is a recent approach used for skin rejuvenation or to enhance transdermal delivery of topical medications.
  
  
  OBJECTIVE
  The authors evaluated the efficacy of skin microneedling, using an automated device, to enhance the numbing effect of topical anesthesia, used before minimally invasive aesthetic approaches.
  
  
  METHODS
  Fifteen patients, looking for treatment of atrophic acne scars, were subjected to randomized split-face study comparing automated fractional skin microneedling (0.5 mm depth) followed by application of topical anesthetic cream (Lidocaine 2.5% + Prilocaine 2.5%) on one side of face, with topical anesthesia alone on the other side, followed by full face fractional microneedling treatment for postacne scars (2.5 mm depth).
  
  
  RESULTS
  The treated sides (fractional needling + topical anesthesia) had significantly lower pain scores when compared with the nontreated sides (topical anesthesia alone). The scores of pain sensation, during the whole procedure, were statistically significantly (p < .0001) less on the treated sides (3.10 ± 1.09) of the face when compared with the nontreated sides (5.37 ± 0.99). There was also a statistically significant (p < .0001) difference in pain sensation scores between the 2 sides of the face after horizontal passes, as the mean scores of the treated and nontreated sides were 3.93 ± 0.59 and 6.20 ± 0.41, respectively.
  
  
  CONCLUSIONS
  The small number of patients, yet the results show a significant difference.
  
  
  CONCLUSIONS
  Application of topical anesthesia for minimally invasive aesthetic procedures can be enhanced with fractional microneedling pretreatment.
authors.affiliation: *Dermatology Department, Al-Minya University, Al-Minya, Egypt; †The Dermatology Clinic, Doha, Qatar; ‡Clinical Pathology Department, Al-Minya University, Al-Minya, Egypt.
authors.forename: Hasan
authors.initials: H
authors.lastname: El-Fakahany
authors.forename: Walid
authors.initials: W
authors.lastname: Medhat
authors.forename: Fahd
authors.initials: F
authors.lastname: Abdallah
authors.forename: Hamza
authors.initials: H
authors.lastname: Abdel-Raouf
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abdelhakeem
mesh_terms: D000152:Acne Vulgaris / Q000150:complications* / Q000628:therapy; D000328:Adult; D000772:Anesthesia, Local; D002921:Cicatrix / Q000209:etiology / Q000628:therapy*; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D058748:Pain Perception; D063465:Skin Cream; D055815:Young Adult