One size doesn’t fit all when it comes to skin needling, and there are some important points to consider when deciding which treatment to offer, finds Georgia Seago

EF Medispa

The eternal quest for perfect skin has led many clients to go under the needle – skin needling, that is. Needling treatments can now be found on treatment menus in salons up and down the country, with therapists able to help clients achieve their skin goals through a basic principle of wound healing and regeneration. While dermal rollering is the most common form of microneedling, there are other options to look at before deciding which treatment to offer, and with mounting confusion over who can perform these treatments, it’s well worth doing your research.

Mesotherapy is one alternative to microneedling. A French treatment originally developed to inject medicine into subcutaneous fat; it is now widely used for skin rejuvenation, but is a different procedure to microneedling entirely. “Both mesotherapy and microneedling involve needling techniques; however, they differ in terms of needle length, application, depth of penetration, speed of delivery and the skin conditions they treat,” says Violeta Negrea, training manager at EF Medispa, which has clinics in London and Birmingham.

“Mesotherapy combines a bespoke cocktail of powerful vitamins, which are injected into the lower layers of the skin using a meso device with one needle, whereas microneedling gently moves multiple microscopic needles over the face to cause miniscule puncture marks, activating the production of collagen and elastin,” she explains.

To the point

Though needling treatments could sound scary to some, they’ve become star services for many skin therapists and cosmetic practitioners, owing to the impressive results they can achieve while remaining non-surgical. “Microneedling has become an integral part of my treatment algorithm over the past few years due to its efficacy, limited safety profile and significant clinical results,” says aesthetic doctor Fiona McCarthy, who practises from a clinic in Chelsea, London. “Patients are not keen for prolonged downtime and seem to be shying away from more invasive procedures, so microneedling provides that perfect balance of minimal recovery time and visibly improved outcomes.”

While both microneedling and mesotherapy work by triggering a response in the lower layers of the skin, they’re each suited to different concerns, so you could choose which treatment to invest in depending on the most common indications among your clients. Advanced skincare group Therapié Clinic, which has more than 30 sites nationwide, has both procedures on its menu because of the wide range of client concerns that can be addressed on both the face and body by offering the two.

“Needling is ideal for clients with uneven skin tone or texture, and it helps even out bits of superficial pigmentation and redness too,” says Simone Shoffman, Therapié’s UK training manager. “It’s also good for very fine lines spreading out from the eyes and around the lips – those first signs of ageing.” Shoffman suggests offering microneedling to clients considering Botox or dermal fillers, either to get the skin in great condition beforehand and therefore support the effect of the injectable, or instead of, to show them how much better the face can look just by improving skin quality. “It’s also really good for scarring and stretchmarks on the body,” she adds.

Different strokes

Meanwhile, mesotherapy is better for skin issues that present from within the lower layers, such as dehydration and advanced ageing, because a targeted active solution is being injected as the needle is penetrating the skin. “Mesotherapy is great for those who are suffering from dehydrated, dull, puffy or saggy skin, and those who want to tackle cellulite and stubborn, localised fat,” says Negrea. Most therapists at Level 3 will generally needle to a maximum depth of 2mm with a mesotherapy gun, ideal to address more advanced skin ageing signs, such as volume loss, says Shoffman: “You can inject solutions that will stimulate a much faster response than microneedling would do, and you can deliver them deeper into the skin.”

The anaesthetic issue

Recently, barriers have been put in place for many salons that offer microneedling. Some local councils have contacted the salons that operate in their borough to let them know that the terms of their licence no longer allow them to sell or apply anaesthetic to their clients prior to needling treatments.

Like most points of contention that arise from the therapist/medic divide, any actual legalities around the issue are unclear. However, some device manufacturers are changing their guidance in line with the local councils. Lee Holloway, health and safety advisor at IIAA, commented: “While there has been no direct change in legislation, IIAA has received increasing feedback about the inconsistent views of UK local environmental health authorities in relation to enforcing the Medicines Act… It now feels necessary to ask our skincare professionals to use topical anaesthetic under the guidance of a medically qualified professional.”

For more on this contentious issue, see our full report at professionalbeauty.co.uk/anaesthetic and leave a comment to let us know if these changes are causing you to adapt the way you practise.

Many mesotherapy solutions have a hyaluronic acid base for this reason, infusing hydration for a plumping glow from deep within the skin. Mesotherapy can also be used to tackle superficial fat and cellulite on the body, with therapists able to inject solutions that help break down fat at around 4mm.

Microneedling, on the other hand, is better suited to stretchmarks and scarring on the body, as McCarthy explains: “The controlled dermal wounding stimulates the wound healing cascade, resulting in the release of various growth factors to promote new collagen and elastin production, which are the building blocks of healthy skin.”

Comfortably numb

Although mesotherapy is generally done using a gun, it’s usually far more comfortable for clients than microneedling, even with a roller. “Meso is much more tolerable for the client because everything is done quicker,” says Shoffman. “It’s one single needle going into the skin, whereas microneedling involves multiple needles at once, whether you’re using a roller or a pen device.”

This means that topical anaesthetic is generally applied before microneedling but isn’t needed for mesotherapy, also indicating the amount of downtime clients can expect. Negrea says that at EF Medispa, where a pen device is used for needling, “we use anaesthetic cream to minimise any pain. In terms of downtime, clients can experience mild to moderate redness, swelling or skin sensitivity to touch for up to three days. With mesotherapy, no anaesthetic is required, and clients may experience a mild tingling sensation on the skin for up to 48 hours.”