Microneedling technologies, including energy-based as well as oscillating, rolling, or dermal penetrating with a reservoir, are gaining popularity for fractionally rejuvenating the skin. In the energy-based systems, microneedles (sometimes of variable depth) are used to penetrate the dermis and usually a bipolar radiofrequency current is added. Both skin tightening on the face and body and acne scar treatments have been done with some success. Most systems recommend three treatments spaced approximately four weeks apart, with best results coming about three months after treatment, as neocollagenesis and remodeling occur. Some of the offerings are Invasix Fractora™, Endymed Intensif™, Lutronic INFINI™, Syneron Candela ePrime™, and others.

An oscillating microneedling system (Dermapen 3) has 12 microneedles that are spring-loaded and can penetrate between 0mm to 2.5mm. This creates multiple channels and can also be combined with topical products. This appears to be a good device for treatment of acne scars, fine wrinkles, and scars. It may have less possibility of post-inflammatory hyperpigmentation than energy-based systems, but its main applicability appears to be on the face.

Dermarollers have been on the market for a while and offer the least expensive entry into the microneedling category. Aquagold™ was noted in this column in the last edition as a microneedling technology with a reservoir to directly disperse into the microneedle channels.

It may appear that I am “Needling” you to get into the game.


Nine states have proposed legislation to make medical licensing more portable. Easing restrictions would allow physicians the ability to practice in multiple states and allow easier access to underserved populations. Kudos to Iowa, Minnesota, Nebraska, Oklahoma, South Dakota, Texas, Utah, Vermont, and Wyoming for putting forth this proposal. Make some of the red tape easier to cut through: A novel idea. Hopefully it is the wave of the future.