CIT/Dermarolling Articles and Presentations
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free skin care · Wed Jun 18, 2008 7:55 pm

I thought I would consolidate articles here since it is very difficult to find them in the Dermarolling support thread.

** You will find that some articles are far more technical/detailed than others, so please read (or not) based on your level of interest in the details**

If you add any new articles, PLEASE check the title (as opposed to the link name) to make sure that the article has not already been posted.

In order to make articles easy to find, any discussions on article content should take place in the regular Dermarolling thread:

http://www.essentialdayspa.com/forum/viewthread.php?tid=22460

===============================================

Environ® Medical Roll-CIT™ Micro-needling
Revolutionary New Approach to Medical Needling
Probably my FAVORITE rolling article - it contains frequency recommendations, as well as pre- and post-roll protocols for optimal collagen development. Also comparisons of rolling with 1mm vs. 3mm needles.
http://www.dermaconcepts.com/documents/0000/0103/Articles_-_Environ_-_Micro_Needling.pdf

Micro Needling and Injecting Platelet Rich Plasma to Enhance Collagen Synthesis and Skin Tightening.
Author: Joseph F. Greco, PhD, PA/C
This article discusses a number of needling research studies, wound healing, and mesotherapy lifts (with pics)
http://www.microneedle.com/main/MTS_Roller_PRP_Paper_by_DrGreco.pdf#pagemode=thumbs&page=1

New Life for Lips
A VERY good article focusing on above the lip lines, usage of 1.0mm vs 3.0mm needles, and the protocols used by Dr. Des Fernandes (one of the inventors)
http://www.vivida.co.za/news/show_article/3

Minimally Invasive Percutaneous Collagen Induction
Desmond Fernandes, MB, BCh, FRCS(Edin)
This article provides a great overview of how collagen is developed with the micro needling process, as well as the rolling protcol, etc. (pics included)
http://www.dermogenesis.com/roll-cit/Clinics_of_N_Am_2005.pdf

The Collagen Induction Therapy
Provides an overview (with pics) of the medical roll process.
http://www.cit-nordic.com/thetechnique.html

Euro Medi Travel
Page 8 contains CIT frequency recommendations based on skin condition:
http://www.euromeditravel.com/doc/additional_info.pdf

Environ stunned the world...
Some results pics and detailed directions on how to do a roll, including frequency of usage for the .2mm Environ home care roller:
http://www.beautymagonline.com/pages/environ_rollcit.htm

Getting The Point
An overview of the process from Dr. Des Fernandes, including some frequency recommendations:
http://www.vivida.co.za/db_files/16_IIAA_newsletter.pdf

Some results photos from a Boston doctor (with pics):
http://www.bostoncentreaestheticmedicine.com/collageninduction.html

A Miami doctor's webpage, with links to a video of him performing the procedure:
http://www.drbustillo.com/roll-cit.htm

The Dermaroller blog where I asked Horst Liebl about needle length, and his reply:
http://dermaroller.wordpress.com/2008/05/17/question-about-collagen-function/

The Dermaroller blog with a question and answer on rolling frequency:
http://dermaroller.wordpress.com/2008/04/25/question-about-treatment-intervals/

STIMULATION OF CELL GROWTH
by Horst Liebl
http://www.dermaroller.de/us/science/abstract-reflections.html

Electrical Signals Control Wound Healing (dermarollers generate electrical charges)
http://www.dermaroller.de/images/stories/Findings.pdf

Percutanous Delivery By Dr. K. Anastassakis May 2005
http://www.dermaroller.de/us/science/percutanous-delivery.html

Collagen Induction Therapy in Mouse ( IPL vs. Micro-needling )
http://www.clinicalresolution.com/main/MTS-ueljihospital.pdf#pagemode=thumbs&page=1

Skin Needling - A New Treatment for Scars and Lines
http://www.mesotherapyworldwide.com/images/pdf/Skin%20Needling%20for%20Doctors_MW.pdf

Percutaneous Collagen Induction Therapy: An Alternative Treatment for Scars, Wrinkles, and Skin Laxity
http://www.acaciadermacare.com/upload/docs/PCI%20-%20Plastic%20Surgery%20Journal%20-%20April%202008.pdf

MTS (Microneedle Therapy System) by Prof. Kim Beom Joon, Department of Dermatology
Dongguk University International Hospital
page 15 talks about delivery of ascorbic acid
Lots of pictures of scar revisions, striae, etc.
http://www.clinicalresolution.com/main/MTS-kimbeomjoon.pdf

free skin care · Sat Jun 28, 2008 8:07 am

Here is a breakdown of the Dermaroller needle lengths, as described by one of the inventing doctors:

FYI...I personally consider this to be far more reliable than info found on the many asian knockoff websites that are producing them for import.

Quote:

The Dermaroller™ consists of a series of devices, which have both cosmetic and medical applications. Their mechanism of action is through the painless piercing of the stratum corneum of the epidermis and the subsequent tremendous increase in absorption of every substance one might apply on the human skin.

The Dermaroller™ C-8 (Cosmetic type), consists of a 12cm handle at the end of which lies a cylinder, like a small paint-roller, of 2cm diameter and 2cm length. On the surface of the cylinder, 24 circular arrays of 8 needles each (total 192 needles) are found, with a needle length of only 0.13mm (130 µm). Rolling the cylinder on the skin surface creates micro-channels on the stratum corneum, through which any kind of substance applied on the skin will gain access to the deeper and viable skin layers. The size is of the needles is more than enough to pierce the stratum corneum and allow increase in absorption of almost 10,000-fold compared to simple application to skin, but are small enough to be absolutely painless on the skin.

The Dermaroller™ C-8HE (Cosmetic model for hair-bearing surfaces, scalp - later named: Model M03) has the same size and amount of needles with the Dermaroller C-8, but the needle length is 0.3mm (300 µm). This length is still below the pain threshold, as it will be later demonstrated.

The Dermaroller™ CIT-8 (CIT: Collagen Induction Therapy, Medical model) has the same characteristics with the Cosmetic types but in this case the needle length is 0.5mm (500 µm). Rolling the cylinder on the skin surface creates deeper micro-channels on the stratum corneum, through which any kind of substance we apply on the skin will gain access to even deeper and viable skin layers. On the same time, controlled, minuscule trauma is caused to the dermis, which reacts physiologically by producing collagen. The exact mechanisms of action are described later.

The Dermaroller™ MF-8 has the same characteristics with the Cosmetic types but in this case the needle length is 1.5mm (1500µm). Rolling the cylinder on the skin surface creates even deeper micro-channels on the whole epidermis and dermis. At the same time, these longer needles will destroy scar collagen bundles, atrophic stretch marks or cellulitis bundles (orange skin).

The Dermaroller™ MS-4 is the only Dermaroller that has a smaller cylinder, 1cm length, 2cm diameter, and subsequently 4 circular arrays of needles (total 96 needles). It has the same needle length like the MF-8 model, that is 1.5mm (1500µm), it has the same indications of use like the MF-8 but mostly on areas where precision and deeper penetration is required. It is mostly used on facial acne scars.

http://www.dermaroller.de/us/science/percutanous-delivery.html

free skin care · Fri Aug 15, 2008 8:01 pm

The following study used 3 different models of dermarollers, and tested their ability to aid penetration of actives/drugs:
A) model C 8 0,13-15° - .13mm Home Care roller
B) model M 8 1,5-15° - 1.5mm regular roller
C) model M 8 1,5-30° - 1.5mm narrow roller (like the Dr. Roller 3Line)

They tested 2 different things: Flufenamic acid formulation contained 0.5% flufenamic acid, the retinol liposomal formulation 2% retinol.

I am ONLY posting results for the Retinol test. I also added roller descriptions to the quotes below so that everyone could keep the rollers straight when reading. Ex: [1.5mm regular roller]

Quote:

Investigation on the efficacy of a new device for substance deposition into deeper
layers of the skin: Dermaroller

Summary

The action of different types of Dermarollers on skin penetration enhancement was investigated with a lipophilic (retinol) and a hydrophilic (flufenamic acid) model compound. The model compounds were administrated in a liposomal formulation on the surface of skin pieces, which were pre-treated with the appropriate Dermaroller. Drug penetration was investigated across human skin using a standard Franz diffusion cell. Six hours later the stratum corneum was removed layer-wise by tapestripping. Drug amount was measured in the stripped layers by HPLC. Deeper skin was cut into thin slices using a cryotome; these slices were also analyzed for model compound content. Three types of dermarollers were tested in this study. Dermaroller M8-1,5-15° [1.5mm narrow roller] showed the highest enrichment of the lipophilic compound retinol into the deeper skin layers by a factor of 40.72 (4072 % increase) compared to skin penetration without application of the dermaroller. This increase in penetration will be even higher, as the dermaroller will be usually applied in practice after application of the drug formulation, whereas in this study the formulations had to be applied due to standardization reasons after the treatment with the dermaroller. ...
All investigated dermarollers caused also an increased deposition of model compounds into the stratum corneum.

Introduction

A reversible micro-perforation of the skin which puts smallest pores in the topmost skin barrier (stratum corneum) could allow a controllable deposition of substances at reproducible applicability. The study described here examines the deposition enhancement of new skin micro-perforation devices (Dermaroller) for the two greatest classes of substances for the treatment of skin (lipophilic and hydrophilic ones). In addition, the reproducibility of the Dermaroller application was also tested. For this purpose, human skin was treated with dermarollers, the formulation containing a model compound was administrated and the deposition of the drug in the different skin layers was estimated using acknowledged methods (Franz diffusion cell, HPLC).

Retinol deposition in the skin

All the three dermarollers used in this study exerted a good penetration enhancement for retinol both in stratum corneum as well as in deeper layers of the skin as compared to control experiment for the lipophilic model drug retinol.

The effect of the micro-perforation by means of the Dermaroller M8 1,5-15° [1.5mm regular roller], were the increase of deposition into the deeper layers of the skin by 4070% is particularly impressive. Similar values have been observed for the Dermaroller M8 1,5-30°[1.5mm narrow roller]. Both dermarollers have been developed for the penetration of compound into deeper layers of the skin (Horst Liebl ETS, France, personal communication).

The effect of the different dermarollers on penetration enhancement in summary (see Fig. 4 and 5):

The dermaroller C8 0,13-15° [.13mm Home Care roller]showed 1.62 times more drug in stratum corneum and 1.48 times more drug in deeper skin as compared to control experiment for the hydrophilic model compound. The values for the lipophilic compound are 2.078 (stratum corneum) and 11.34 (deeper skin layer), respectively. This dermaroller was obviously designed to improve the deposition of drug in stratum corneum. The 1.62 times higher deposition in stratum corneum as compared to control, indicated that the needle length was enough to make pores nside the stratum corneum, but was not able to make pores through the whole stratum corneum due to the length of the needles and the flexibility and lipids composition of stratum corneum. In the case of the lipophilic drug, retinol may penetrate deeper into the lipophilic environment, whereas the hydrophilic compound will remain at its deposition site.

The dermaroller M8-1,5-15° [1.5mm regular roller], which has the same number of needles but a much larger needle length (1,5 mm in comparison to 0,13 mm in the case of C8-0,13-15°), was designed to deliver the drug in deeper layers of the skin by perforating the whole stratum corneum. This roller showed a 1.49fold and 1.48times higher deposition in stratum corneum and in deeper skin, respectively, as compared to the control experiment. The results from the pilot experiment, where this dermaroller was applied after deposition of the formulation on the skin surface, showed a much higher deposition of flufenamic acid (12.4fold higher compared to control). The lipophilic compound retinol is deposited into deeper layers of the skin by a factor of 40.7 and the increase of retinol deposition into the stratum corneum by a factor of 2.38 compared to the control. The deposition into the deeper skin layers using the dermaroller shows such a high increase, that under these conditions also a significant part of the compound can be monitored in the receiver compartment (1.8 % of total dose).

In the case of the dermaroller M8-1,5-30° [1.5mm narrow roller] possesses only half the number of needles as the other dermarollers. Because of the different rolling characteristics and due to the higher pressure of a single needle at similar pressure on the dermaroller, the penetration depth of a single needle will be higher. This notion is supported by the experimental findings: the drug deposition in stratum corneum was less as compared to the other derma roller as the number of needles are only half and hence also the half numbers holes in this case. However, the drug deposition in the deeper layer of the skin was at maximum of all the dermarollers (i.e. 2.35 times more as compared to the control experiment), because the complete perforation of the stratum corneum eases the drug diffusion through this barrier. The lipophilic compound retinol does not need this enhancer effect, as this compound can diffuse through the rest of this barrier after depositioning into the stratum corneum.

Conclusions.
The examined Dermaroller are able to deposit hydrophilic and hydrophobic compounds into the
stratum corneum and into deeper skin layers. This could be shown by the Franz diffusion cell model. The scientific results support the intentions of the development protocols for the dermarollers. The Dermaroller C8-0,13-15° [.13mm Home Care roller] is particularly qualified to deposit substances into the stratum corneum, whereas the Dermaroller M8-1,5-15° [1.5mm regular roller] promotes very well the deposition of hydrophilic and hydrophobic compounds into deeper layers of the skin. The third Dermaroller M8-1.5-30° [1.5mm narrow roller] showed the best results for depositing hydrophilic substances in deeper skin layers, if the dermaroller is used before the compound is applied. The presented results can be interpreted on physical ground by the geometry of the different dermarollers.

http://www.dermaroller.co.nz/research/derma-eng.pdf

free skin care · Wed Oct 08, 2008 4:33 pm

Found in the September issue of US Elle magazine:

Skin Needling

When gardeners want to regenerate an aging lawn, they'll aerate it using a spiked wheel to draw out small plugs of dirt, which allows oxygen, water, and other nutrients to reach the roots of the grass. Skin needling uses the same premise: A handheld tool embedded with tiny steel tines is run over the face (or body) to spur collagen formation and increase penetration of topical serums.

In 1997, South African plastic surgeon Des Fernandes, MD, began to explore the idea of increasing collagen production by inducing bleeding in the skin via hundreds of tiny pricks. Using devices with needles one to three millimeters long, physicians could pierce the dermis (which generates collagen and elastin) while leaving eh epidermal layer relatively intact. "Unlike with ablative lasers, there's no risk of scarring," says Matthias Aust, MD, a plastic surgeon in Hannover, German. "And in addition to stimulating fibroblasts to make collagen and elastin, needling also releases growth factors, which nonablative lasers don't do."

Aust authored one recent study, published int he journal Plastic and Reconstructive Surgery, that found a considerable deposit of collagen and elastin in the skin six months post treatment, as well as a 40 % increase in the thickness of the epidermis. And while trauma to the skin can often induce pigmentary changes, a second study by Aust, soon to be published in the same journal, demonstrated that percutaneous collagen induction (as the treatment is also called) doesn't activate the melanocytes responsible for hyper-pigmentation. "One advantage is that, unlike lasers or chemical peels, skin needling can be applied to any skin type - even sensitive," says New York City plastic surgeon Philip Miller, MD who frequently lectures on PCI at meetings of the American Academy of Facial Plastic and Reconstructive Surgery. According to Aust, since a single dose of PCI thickens skin, it may actually make treated areas less sensitive, including to UV light.

The treatment has also been shown to help reduce the appearance of certain scars. "Needling can create collagen to fill depressions or smooth out scars that are raised," Miller says.

However, the procedure isn't without its downsides. While usually only one session is necessary to produce new collagen that will last up to seven years, a patient needs to be fully sedated when three-millimeter needles are used and topically numbed before treatment with one millimeter needles. She may require up to a week to recover from a session with three-millimeter spikes; swelling and discoloration could last one day after treatment with one-millimeter needles.

For those who are turned off by the idea of spending even a couple of days indoors recuperating, there are at-home needling options that also produce skin improvements, albeit ones that aren't as dramatic. Los Angeles plastic surgeon Normal Leaf, MD, sells the TX Roller, with needles only 0.13 mm long. "They're too short to draw blood or cause pain," Leaf says. Since they don't touch the dermis, the spikes don't stimulate fibroblasts directly, but "they create tiny channels in the epidermis, which allow any antiaging topical you apply prior to rolling to penetrate more deeply, amp up collagen production, and decrease the appearance of wrinkles," he says.

Although human studies on skin needling have thus far been performed only on the face, Leaf has had patients use the device on their cleavage and "found immense improvement in fine lines in that area." One enterprising woman applied an anticellulite cream one a day to both thighs, but rolled it in on only one leg. "Within a month the needled thigh was one inch smaller than the control," he says. "We haven't done a study, but it sounds interesting." Megan Deem.

free skin care · Tue Oct 28, 2008 9:08 pm

This is a great video that Kassy found, prepared by the Dr. Roller company. There are some other good ones by the same poster, but I would advise skipping the parasite videos. Confused

Kassy_A wrote:

I'm not sure if this has been posted here before, but I stumbled across this really good 'how to' video instruction on Derma Rolling on U-Tube.

It goes into good detail for skin prep and numbing, and then shows the rolling.. Shock

http://www.youtube.com/watch?v=wvwhjcTkwmc&feature=related

free skin care · Sun Nov 16, 2008 9:49 am

Here is a very simple, easy to understand overview of dermarolling, how it works, and topicals used with it. (Thanks Rileygirl!)

Skin needling: Youth by a thousand needle pricks
Dr. G. Todorov
http://www.smartskincare.com/treatments/noninvasive/skin-needling.html

free skin care · Tue Nov 18, 2008 8:29 pm

New Life for Lips
A VERY good article focusing on above the lip lines, usage of 1.0mm vs 3.0mm needles, and the protocols used by Dr. Des Fernandes (one of the inventors)
http://www.vivida.co.za/news/show_article/3

Wed Jul 29, 2009 7:00 pm

Keliu wrote:

To the Moderators - could this thread please be made into a sticky so that it doesn't keep disappearing? Thanks!

Keliu, This thread in the EDS Hot! Library, the link for which can be found at the top of the browser screen. It's also just been added as a new section to the DIY Skin Care—Recipe Index, Dermarolling, Facial Exercise sticky:

Dermarolling Information & Discussion Threads
http://www.essentialdayspa.com/forum/viewthread.php?p=474343#474343

At the request of members, discussion posts have been moved out so that this thread can remain devoted to CIT/Dermarolling Articles and Education. Thank you!

Fri Aug 14, 2009 7:24 am

barefootgirl wrote:

Here's a link that will take you to updated articles:

http://www.dermogenesis.com/clinical/

These articles will answer many of the most frequent questions that come up on this thread.

BF

free skin care · Thu Jul 11, 2013 11:44 pm

Not sure if anyone will reply but the link below doesn't seem to work or doesn't exist (Not sure if its my computer, will double check on my Mac tonight) but its the the one regarding :

Environ® Medical Roll-CIT™ Micro-needling
Revolutionary New Approach to Medical Needling .

I tried to google it but can't find the actual article just people saying how good it is. Any other links to it would be appreciated

TYIA Smile

free skin care · Fri Jul 12, 2013 3:33 am

dionie wrote:

Not sure if anyone will reply but the link below doesn't seem to work or doesn't exist (Not sure if its my computer, will double check on my Mac tonight) but its the the one regarding :

Environ® Medical Roll-CIT™ Micro-needling
Revolutionary New Approach to Medical Needling .

I tried to google it but can't find the actual article just people saying how good it is. Any other links to it would be appreciated

TYIA Smile

Yep, the link is not working anymore - but try this one, it's a pretty good article:

http://www.microneedle.com/main/MTS_Roller_PRP_Paper_by_DrGreco.pdf#pagemode=thumbs&page=1

I think I may have the article you want on my other computer. Will check and get back to you.

free skin care · Fri Jul 12, 2013 2:20 pm

dionie wrote:

Not sure if anyone will reply but the link below doesn't seem to work or doesn't exist (Not sure if its my computer, will double check on my Mac tonight) but its the the one regarding :

Environ® Medical Roll-CIT™ Micro-needling
Revolutionary New Approach to Medical Needling .

I tried to google it but can't find the actual article just people saying how good it is. Any other links to it would be appreciated

TYIA Smile

Here you go...give it a minute for the article to load.

http://www.scribd.com/doc/46025449/Environ-Micro-Needling

free skin care · Fri Jul 12, 2013 3:54 pm

I'm hoping it's okay to put this here. It's really just a 245 pg add for Environ products.. But good info, and the rationale for use is covered (kind-a.) (DIY'ers, might find it particularly helpful, for their dermarolling endeavors!)

http://www.docstoc.com/docs/84676090/English

free skin care · Fri Jul 12, 2013 7:22 pm

You ladies are awesome. Thanks so much, hope its okay to reply. Smile

free skin care · Fri Jul 12, 2013 8:21 pm

dionie wrote:

You ladies are awesome. Thanks so much, hope its okay to reply. Smile

You are welcome!

free skin care · Sun Sep 22, 2013 8:20 pm

Bumping for all in the same boat as me, and in need of a refresher course...lol

A million thanks again to Bethany for putting so much info all in one place.

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