Deep Dive into Microneedling with Energy-Based Devices

At the Aesthetics Biomedical’s Perspectives: The Evolution of Aesthetics symposium, Victor Ross, MD, a board-certified dermatologist and dermatologic surgeon, San Diego, California, spoke about the newest advances in technology for both microneedling and energy-based devices. 

The goal of these new technologies is to maximize the results of the procedures while minimizing patient downtime. With traditional radio frequency (RF) devices, physicians must think about RF, energy flow, and tissue resistance and how that amounts to heat accumulation. The overall results were modest as a large volume of area was being heated, resulting in a small change in temperature. 

What has replaced the bipolar technique of RF is fractional RF. In fractional RF, the needles are insulated and isolated in place into a predetermined depth causing more heat to be created deeper and resulting in restored skin elasticity. This also did not have results Ross was satisfied with.

According to Ross, one of the most predictable ways to achieve some skin tightening is with RF microneedling.

An issue that Ross brought up is heat vs no heat. Heat can cause pain for the patient, but many times is needed for results. Also, there can be a recall caused by a gap between the needles and the skin and many companies claim that their devices go deeper than what may be reality. 

He went over the Vivace (Aesthetics Biomedical) microneedling device. The system offers ergonomic pieces and has LEDS, noninsulated or insulated needles, and offers settings to change power levels to make microneedling easier. When using the device, physicians can change frequency from 1 to 2 megahertz. 

Another device he went over another microneedling device, that uses 5 needles to go into the desired depth and has a long heating time of 4 seconds. They are larger than the typical microneedling device and it offers a cooling tip. It can make procedures longer due to low frequency of the needle.

The Agnes device (Agnes Medical) was also discussed. It uses a single needle to treat the face and the negative of this device is that each time the needle is used, the physician must push it down with their hands which can be tiring, according to Ross.

Combination therapy was something Ross does a lot of, using a laser, along with a RF microneedling device to treat the skin. This decision on whether to use this type of therapy will be decided on how long the patient can have downtime as it is an aggressive treatment.

To make microneedling better, in Ross’s opinion, would be better control of needle sharpness, better motors to push the needles down into the skin, and have reliable endpoints for their depths.

Tixel (Novoxel), a thermal mechanical action for fractional treatment, was the last device that Ross highlighted, and it is a fractionating device, the size of a postage stamp, and made of titanium alloy. It can heat up to approximately 400 degrees Celsius, but because contact time is so low, it does not hurt the patient. It can repair skin very quickly and efficiently. Currently, it is available overseas.

“So, Tixel was a new exciting way to use a new practice and fight key that adds to our weaponry that you can use to make your skin fresher and better,” Ross concluded.