| Category Name | Content |
| Name | Microneedling (Skin Pen) |
| Uses | Minimally invasive skin rejuvenation procedure designed to improve fine lines, wrinkles, acne scars, hyperpigmentation, and overall skin texture by stimulating collagen production. |
| Route Of Administration | Controlled micro-injury delivery using an automated microneedling device (Skin Pen) with fine needles to create microchannels in the skin. |
| Frequency Of Use | Typically performed every 4-6 weeks for an initial series of 3-6 treatments; maintenance treatments every 3-6 months as needed. |
| Concentration(s) | Needle penetration depth based on treatment goals: - **0.25-0.5 mm**: Epidermal treatments (serum infusion, mild texture improvement) - **0.5-1.0 mm**: Moderate skin rejuvenation, fine lines, mild acne scarring - **1.0-2.5 mm**: Deeper acne scars, collagen induction therapy, stretch marks |
| Maximum Dosage (Day, Wk) | One treatment per session, using provider-recommended depths and techniques. Avoid over-treating to reduce risk of excessive inflammation. |
| Contraindications | Pregnancy, active acne or rosacea flares, keloid-prone skin, use of isotretinoin within the last 6 months, active infections (herpes simplex, bacterial, or fungal), history of poor wound healing, uncontrolled diabetes, anticoagulant therapy, recent sunburn, or skin cancer in the treatment area. |
| Possible Side Effects | Mild redness, swelling, pinpoint bleeding, dryness, mild peeling, transient skin sensitivity, rare risk of infection, post-inflammatory hyperpigmentation (PIH) in darker skin tones. |
| Compatibility With Other Treatments/Drugs | Avoid combining with deep chemical peels or ablative laser treatments within 4 weeks. Safe to combine with LED therapy, exosome therapy, PRP, and post-procedure serums (hyaluronic acid, peptides, growth factors). |
| Allergies | Assess for hypersensitivity to numbing agents (if used), post-procedure serums, or topical anesthetics. |
| Administration Time | 45-60 minutes per session, including numbing and treatment application. |
| Dosing/Settings | Customized based on patient skin type and concerns: - **Needle Depth**: 0.25-2.5 mm - **Number of Passes**: 1-3 passes per area, depending on skin tolerance and treatment goals - **Topical Infusion**: Hyaluronic acid, peptides, PRP, exosomes, or growth factors may be applied post-procedure. |
| Test Spot Requirement | Recommended for first-time patients or Fitzpatrick III-VI skin types. Perform a small test area 48 hours before full treatment to assess tolerance. |
| Pre-Treatment Guidelines | - Discontinue retinoids, AHAs, BHAs, and exfoliating agents 5-7 days before treatment. - Avoid sun exposure, tanning beds, and self-tanners for 4 weeks before treatment. - Arrive with clean skin free of makeup, lotions, and sunscreen. - Hydrate well in the days leading up to treatment. |
| Provider Clearance Guidelines | - Ensure the patient meets all clearance criteria before treatment. - If the patient has a history of keloid scarring or hyperpigmentation, proceed with caution and consider pre-treatment with lightening agents. - Document all clearance decisions in the patient’s medical record. |
| Pre-Treatment Screening Workflow | - Is the patient currently using isotretinoin? (If YES, contraindicated for 6 months post-use) - Does the patient have active skin infections? (If YES, delay treatment until resolved) - Has the patient had recent sun exposure or tanning? (If YES, delay treatment for at least 2 weeks) - Is the patient pregnant or breastfeeding? (If YES, avoid treatment) |
| What To Do If Adverse Reaction Occurs | - **Excessive redness or swelling**: Apply a cool compress, recommend soothing post-care serums. - **Persistent bleeding or irritation**: Assess for excessive depth use, apply barrier-repairing products. - **Hyperpigmentation (Fitzpatrick III-VI)**: Initiate hydroquinone 4% BID and enforce strict sun avoidance. - **Infection (rare)**: If suspected, swab for culture and start empirical antibiotic therapy (e.g., topical mupirocin or oral cephalexin). |
| Clinic Implementation Guidelines | - Ensure all consents and pre-treatment screening are completed. - Apply topical numbing cream (if used) for 20-30 minutes before treatment. - Adjust microneedling depth based on treatment goals and patient tolerance. - Provide post-treatment care instructions and schedule follow-up appointments. |
| Photographic Documentation Protocol | - Take pre-treatment photos from standardized angles (front, side, and close-up views). - Take post-treatment photos immediately after the procedure and at the 4-week follow-up. - Store images securely in the patient’s medical record. |
| Post-Treatment Care | - Avoid makeup for at least 24 hours post-treatment. - Use a gentle cleanser and hydrating serums for the first 3-5 days. - Avoid direct sun exposure for at least 1 week post-treatment; apply SPF 50+ daily. - Avoid retinoids and exfoliating products for at least 7 days post-treatment. - Mild redness and swelling may persist for up to 48 hours. - Follow-up treatments should be scheduled based on provider recommendations. |
| Additional Documentation Requirements | - Signed informed consent detailing treatment risks, benefits, and post-care instructions. - Fitzpatrick skin type assessment. - Treatment session log including needle depth, infusion products used, and patient response. - Post-treatment care instructions provided and documented. |