Medical microneedling devices are effective because they leverage a dual-mechanism approach that combines physical tissue remodeling with enhanced drug delivery. By inflicting controlled, local mechanical injuries, these devices force the body to restart its natural healing process while simultaneously creating pathways that allow therapeutic drugs to penetrate deep into the scar tissue.
The core value of medical microneedling lies in its ability to trigger the release of endogenous growth factors and collagen through controlled injury, while acting as a delivery system to maximize the transdermal absorption of scar-reducing medications.
The Biological Response to Controlled Injury
Triggering the Wound-Healing Cascade
The primary mechanism of action is the creation of controlled local mechanical injuries.
These precise micro-traumas do not destroy the skin but rather signal the body that injury has occurred. This triggers the body's natural wound-healing cascade, initiating a biological repair process in an area where healing had previously stalled or finished poorly.
Stimulating Endogenous Growth Factors
Once the healing cascade is triggered, the body responds by significantly increasing the release of endogenous growth factors.
These signaling proteins are essential for regeneration. They recruit cells to the site of the "injury" to begin repairing the tissue structure from within.
Increasing Collagen Deposition
The ultimate result of this biological chain reaction is a surge in collagen deposition.
New collagen fibers are laid down in a more organized fashion. This helps replace the disorganized, fibrotic tissue characteristic of burns and surgical scars, gradually normalizing the skin's structure.
Enhancing Pharmacological Interventions
Creating Micro-Channels
Beyond the physical trauma, the needles physically create micro-channels through the scar tissue and the skin barrier.
These channels serve as temporary tunnels, bypassing the skin's outer protective layer which typically blocks topical treatments from penetrating effectively.
Boosting Transdermal Absorption
These micro-channels significantly enhance the transdermal absorption efficiency of applied medications.
The primary reference notes that subsequent medications, particularly corticosteroids, penetrate much more effectively when applied after microneedling. This ensures the medicine reaches the depth where it is needed most.
Targeting Texture and Pliability
The combination of physical needling and enhanced drug delivery allows for precise intervention in the flatness and softness of scar tissue.
By delivering corticosteroids deeply, practitioners can more effectively flatten raised scars (hypertrophic) and soften rigid tissue caused by burns or surgery.
Understanding the Constraints
The Importance of "Controlled" Injury
The effectiveness of this treatment relies entirely on the injury being controlled.
If the injury is too aggressive, it can induce further inflammation and worsening of the scar. If it is too shallow, it may fail to trigger the necessary growth factor release.
Dependency on Adjunct Therapies
While microneedling creates structural changes on its own, its ability to treat specific scar characteristics—like extreme rigidity or elevation—is often amplified by the medications it delivers.
The device acts as a facilitator; for maximum impact on scar flatness, the concurrent use of pharmaceutical agents like corticosteroids is often the key variable.
Making the Right Choice for Your Patient
If your primary focus is structural remodeling:
- Rely on the mechanical injury aspect to stimulate natural collagen deposition and improve the general quality of the skin.
If your primary focus is reducing scar volume and rigidity:
- Utilize the device primarily as a delivery vector to maximize the absorption of corticosteroids into the deep scar tissue.
By integrating the body's natural regenerative power with precise drug delivery, microneedling offers a comprehensive strategy for remodeling complex scar tissue.
Summary Table:
| Mechanism | Action | Benefit to Scar Tissue |
|---|---|---|
| Mechanical Injury | Triggers wound-healing cascade | Replaces fibrotic tissue with organized collagen |
| Growth Factors | Increases endogenous release | Stimulates natural cellular regeneration and repair |
| Micro-channels | Bypasses the skin barrier | Dramatically boosts transdermal absorption of drugs |
| Drug Delivery | Facilitates corticosteroid entry | Effectively reduces scar volume, thickness, and rigidity |
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References
- Mikołaj Herba, Maciej Karwat. UNCONVENTIONAL WOUND-HEALING STRATEGIES: A NARRATIVE REVIEW OF THE LITERATURE, EMPHASIZING AESTHETIC MEDICINE MODALITIES. DOI: 10.31435/ijitss.3(47).2025.3730
This article is also based on technical information from Belislaser Knowledge Base .
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