ASCP Skin Deep

September | October 2014

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Create your free business website! www.ascpskincare.com 17 and it should also go without saying that microneedling increases the risk of unhygienic situations being introduced during the treatment. This is one reason why the emphasis is shifting from infusion of ingredients to stimulation of the skin, which facilitates rejuvenation. How Does It Work? The effects created within the skin depend on the depth of penetration. At the depth used by estheticians, microneedling creates "microinjuries" that are not enough to harm the skin, but enough to provoke the skin to react by releasing growth factors to increase the production of new skin cells. It improves cell- to-cell communication, primarily from keratinocyte to melanocyte. As mentioned, it also increases the penetration of topical products. Medical microneedling reaches deeper into the skin and affects the dermis by mechanically breaking down scar tissue and prompting the release of cytokines, enzymes, and growth factors to rebuild skin. One of the goals with microneedling is to create scarless healing, in which new collagen is built in a normal pattern instead of the heavy, disorganized pattern of scar tissue. Microneedling does not remove the skin's barrier, which is vital for optimal skin health. Can You Do It? Before shopping for a device, make sure your state's scope of practice allows you to perform this treatment. Quite a few states stipulate that this modality is out of scope for estheticians. Other states do not mention it specifically, but their existing statutes and rules make it plain that microneedling is not within scope. As the modality becomes more popular, we can expect many more states to make specific rules about this procedure. Generally, if your state does not allow estheticians to perform treatments that use a tool to penetrate the epidermis—this can include lancets, needles, permanent makeup, etc.—you are not allowed to perform this treatment. You may need a permanent makeup license or electrologist license to use a microneedling device. Like any device or modality, you must also understand that if your state does not allow it, your professional liability insurance will not cover it and you will not be protected if something goes wrong. No liability insurance covers treatments an esthetician is performing illegally. It's essential for every esthetician to stay aware of state legislation and take responsibility for staying within scope of practice. Devices and the FDA If you are allowed to offer microneedling treatments in your state, the next step is to decide on a device. This choice will be based on many factors, but some to consider are the US Food & Drug Administration (FDA) classification of the device, the areas you will be treating, and your budget (keeping in mind what you expect to charge). There are pros and cons of both rollers and electronic devices. Rollers are easy to control with training and offer a faster treatment time. They are disposable and intended for single use only, in order to prevent cross-contamination; this is vital to remember, for hygienic reasons and because the cost (between $8–$20 for a single roller) will add up over time, like any other disposable tool. Never reuse a roller! Electronic devices have the advantages of disposable needle heads and adjustable needle length. They require a little more practice to use efficiently and are a pricier initial investment at $200–$500 and up, though they are more cost-effective long- term than rollers. Just as with rollers, the needle heads of electronic devices must never be reused on another client. If you store the

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