Innovative treatment: Microneedling

Microneedling Patient
Clinical trial participant. Left: baseline. Right: 3 months.

In 2017, Los Angeles-based, board-certified dermatologist Dr. Jason Emer conducted a clinical trial in conjunction with Jan Marini Skin Research to validate the impact and benefits of a unique new combination: in-office microneedling with a fixed, at-home skin care protocol. The results of the clinical trial were outstanding, and Dr. Jason Emer is now sharing his findings and this revolutionary combination protocol with the medical community and the world.

A Visionary Approach

Always in pursuit of new and improved devices and methodologies, Dr. Jason Emer envisioned a more comprehensive and complete skin care treatment to address hyperpigmentation, skin discoloration, and fine lines and wrinkles — an innovative approach that incorporates the proven benefits of both in-office treatment devices and medical-grade skin care. The solution: a new protocol combining in-office microneedling with a fixed homecare routine.

By delivering these two best-in-class, independently proven solutions at once, Dr. Emer is able to achieve superior results and consistent patient satisfaction. Many physicians have considered these protocols and even implemented them into their practices; however, no studies have yet been conducted to prove the efficacy and safety of this approach or to illustrate the benefits obtained when using these two modalities in combination.

Dr. Emer used great care to select the products and technologies used in this treatment protocol, seeking out the optimal combination of technologies to deliver maximum results for patients with moderate to severe sun damage, characterized by hyperpigmentation (abnormal pigmentation, uneven pigmentation, and age spots) and fine lines and wrinkles. Numerous studies have demonstrated how both manifestations of sun damage independently cause people to appear prematurely aged. Thus, a protocol that is proven safe and effective to reduce both hyperpigmentation and fine lines and wrinkles with minimal downtime is highly advantageous to patients.

Microneedling Results
Microneedling Treatment

Step 1: Selecting the Ideal Microneedling Device

A perfect complement to laser procedures — as well as an effective standalone procedure that provides more benefit than skin care alone — microneedling has become Dr. Emer’s most popular treatment in the pursuit of skin rejuvenation and aging prevention. A quick, minimal-downtime procedure, microneedling allows for significant enhancement in skin texture, pore size, complexion, acne, melasma, pigmentation, scarring, wrinkles, dark circles beneath the eyes, and numerous skin imperfections.

Watch: Microneedling Following Clear + Brilliant Fractional Laser Treatment

Using a portable handheld device, Dr. Emer and his nurses penetrate the desired areas with miniature needles, triggering fine pinpoint bleeding and stimulating new collagen production. This technique of traumatizing the skin to influence enhanced collagen production is known as collagen induction therapy. When paired with radiofrequency (“Microneedling RF”), heat energy is simultaneously delivered to the sublayers of the skin, eliciting skin tightening and aiding in further collagen production. For patients with irregular skin texture as a result of burns or scars, Microneedling RF typically provides superior outcomes to standard microneedling alone.

Watch: Microneedling RF for Acne Scars, Ice Pick Scarring, and Hyperpigmentation

Following all microneedling treatments, topical cosmeceuticals, growth factors, platelet-rich plasma (PRP), and stem cells are applied to the skin to activate skin healing and yield improved outcomes with regards to pigmentation, texture, and tone.

Watch: Vampire Facial Microneedling Treatment

Eclipse MicroPen®For his 2017 clinical trial, Dr. Emer utilized the Eclipse MicroPen®, a reliable, revolutionary microneedling device that delivers consistent, predictable results in a series of treatments. Safe for all skin types, the MicroPen uses a high-speed motor and rapid pen motion, resulting in a quicker, more comfortable treatment as compared to dermal rollers. The MicroPen’s variable pen position feature allows Dr. Emer to customize the treatment for each individual patient and their unique skin needs.

Watch: Combination Acne Scar Treatment with Subcision, CO2 Laser and Microneedling

Watch: Microneedling with PRP for Acne Scars

As part of the microneedling treatment, a topical hydrating gel is applied to the patient’s skin, acting as a lubricant and skin plumper and allowing the MicroPen to glide across the skin. In a single motion, the pen is pressed gently against the skin while simultaneously gliding back and forth. This gesture is repeated until the entire treatment area has been covered; the endpoint is typically facial redness and/or pinpoint bleeding, signifying traumatized columns of open skin that are ready to absorb any applied products. Applying products immediately after treatment allows for better absorption and more enhanced results.

Watch: Microneedling Post-Laser Treatment with PRP, Vitamins and Nutrients

Step 2: Sourcing the Best Skin Care Products

To select the most effective skin care products, Dr. Emer turned to Jan Marini Skin Research (JMSR), a longtime partner and a recognized leader and innovator in skin care. It is JMSR’s belief that “skin care should not only address current skin conditions, but should also provide the skin with the necessary ingredients for prevention and maintenance of healthy skin at any age.” From JMSR’s extensive collection of skin care products, Dr. Emer identified three solutions that would best complement the in-office microneedling treatment:

Skin Care Management SystemTM

JMSR’s award-winning skin care system combines multiple essential elements to rapidly improve the appearance of fine lines and wrinkles, pigmentation, uneven texture, acne and sun damage. Due to the comprehensive nature of this solution, the Skin Care Management SystemTM was recognized by NewBeauty magazine as the “Best Anti-Aging Skin Care System” for 8 consecutive years.

The secret to this advanced, award-winning system is the combination of ingredients working synergistically to provide maximum results and a rejuvenated appearance: Vitamin C, peptides, growth factors, multiple acid exfoliators, hydrators and broad-spectrum sunscreen. This combination sets the foundation for overall healthy skin with rapid improvement in the skin’s appearance.

The JMSR Skin Care Management SystemTM includes a Bioglycolic® Face Cleanser, C-esta® Serum, Bioclear® Lotion, Transformation Face Cream, and Antioxidant Daily Face Protectant SPF 33.

Marini Luminate Face Lotion
Marini Luminate Face Lotion

JMSR’s highly concentrated Luminate Face Lotion was incorporated to specifically target skin discoloration. In a split-face study published in the Journal of Drugs in Dermatology, this non-hydroquinone solution was found to be “equivalent if not superior to 4% hydroquinone for results and patient satisfaction.” With a high concentration of retinol, the Luminate Face Lotion also delivers superior reduction in the appearance of fine lines and wrinkles.

Marini Luminate Face Lotion combines multiple proven lightening technologies (such as arbutin, licorice root extract, and hexylresorcinol) with more specialized solutions, such as a brand-new, non-staining turmeric extract and a dedicated peptide to brighten the skin. These ingredients in combination with retinol create a perfect solution to combine with office treatments for wrinkles, texture and hyperpigmentation.

Hyla3D Face & Lip
Hyla3D Face & Lip

JMSR’s Hyla3D, an advanced new hyaluronic acid solution, takes a 3-dimensional approach to restoring hydration while reducing the appearance of fine lines and wrinkles, resulting in a youthful, contoured look. To maximize the benefits of hyaluronic acid on the skin, Hyla3D was applied after each microneedling treatment and as part of the daily homecare routine.

Clinical trial participant
Clinical trial participant. Left: baseline. Right: 3 months.

JMSR has both photographic and published results to support that these products, when used in combination, provide measurable benefits. When used in combination with in-office microneedling treatments, these carefully selected products will undoubtedly aid in the improvement of hyperpigmentation and fine lines and wrinkles.

Step 3: The Trial Begins

Dr. Emer and his team assembled 20 individuals between the ages of 25 and 60 to participate in the 15-week clinical trial. All participants met the following criteria:

  1. Participants had visible, moderate to severe facial sun damage in the form of hyperpigmentation and fine lines and wrinkles.
  2. Participants were not using any prescription medication or professional skin care products at the time.
  3. Participants had no filler or toxin injections in the past 6 months.
  4. Participants had no laser treatments, facial peels, Intense Pulsed Light (IPL) photofacials, or professional facial resurfacing procedures in the past 12 months.

The participants were given the 3 high-quality, medical-grade JMSR skin care products: The Skin Care Management SystemTM, the Marini Luminate Face Lotion, and the Hyla3D Face & Lip solution. The Skin Care Management System and Luminate Face Lotion were applied daily with a 3 to 5 day interval following the microneedling treatment. The Hyla3D solution was applied daily and immediately following the microneedling treatment.

All participants received 3 microneedling treatments at 4-week intervals under the care of Dr. Jason Emer and his staff.

Protocol Schedule

Baseline — Begin home care regimen (participant acclimation and pre-treatment)
3 Weeks — Microneedling treatment #1 and continued home care
7 Weeks — Assessment #1, microneedling treatment #2, and continued home care
11 Weeks — Assessment #2, microneedling treatment #3, and continued home care
15 Weeks — Final assessment

Conclusive Results

Dr. Emer’s clinical study showed statistically significant results after the first follow-up with continuing improvement over the course of the 15-week study; the most significant results were visible at the final visit, three months following the initial treatment. The study measured improvement in two major concern categories — wrinkles and hyperpigmentation — both of which were scored by Dr. Emer’s office to determine quantitative improvement. Study subjects were also asked to subjectively rate their own self-perceived improvement in wrinkles, hyperpigmentation and overall skin quality.

Office assessments used a 0-5 scale to determine severity, with a “0” being flawless skin and a “5” being severely sun-damaged skin. Study participants were enrolled with moderate to severe facial sun damage and had average baseline scores of 3.47 for hyperpigmentation and 3.27 for wrinkles. Upon completion of the study, severity scores dropped 30% for hyperpigmentation and 37% for wrinkles. Improvement was observed across multiple ages and ethnicities.

Microneedling Results

Quantitative physician-assessed scores provide an unbiased, professional assessment of improvement, but the clinical trial participants’ self assessments are also critical, as it’s essential that the results are evident to the patients themselves.

100% of the clinical trial subjects treated with Dr. Jason Emer’s unique combination of in-office microneedling and the fixed at-home skin care protocol noted an improvement in skin brightness, texture, and overall skin quality. Rapid results were visible at the first follow-up by nearly all study participants. In this study, there were no reported complications or adverse effects.

Discoloration Improvement

93% of subjects noted brighter skin than baseline at Assessment 1
93% of subjects noted brighter skin than baseline at Assessment 2
100% of subjects noted brighter skin than baseline at Final Assessment

Wrinkle Improvement

93% of subjects noted smoother skin than baseline at Assessment 1
93% of subjects noted smoother skin than baseline at Assessment 2
100% of subjects noted smoother skin than baseline at Final Assessment

Overall Skin Quality

93% of subjects noted overall improvement at Assessment 1
100% of subjects noted overall improvement at Assessment 2
100% of subjects noted overall improvement at Final Assessment

VISIA®’s rotating capture module easily captures left, right and frontal facial views.

In order to track and evaluate progress over time, changes in hyperpigmentation and fine lines and wrinkles were evaluated by a physician and studio-based technology, including the VISIA® Complexion Analysis System (pictured right), which captures high-quality, multi-point facial images to measure discoloration, redness, pore size, wrinkles, and overall improvements.

The Conclusion

Dr. Emer’s clinical trial verifies the safety and viability of a comprehensive protocol for hyperpigmentation, fine lines and wrinkles, and long-term aging prevention: Combining in-office microneedling treatments with high-quality, medical-grade skin care products produces statistically significant improvement and overall patient satisfaction with zero complications.

  • Significant, rapid results
  • High subject satisfaction (100% perceived improvement)
  • No complications with concurrent use of Hyla3D with microneedling treatment

Clinical trial participant
Clinical trial participant. Left: baseline. Right: 3 months.

Dr. Emer’s Personalized Combination Treatments

A master of custom-designed combination treatments designed to address the specific needs of his patients, Dr. Emer will often pair microneedling and at-home skin care protocols with complementary treatments and procedures:

  • For patients with discoloration and hyperpigmentation, Dr. Emer will often begin with a non-inflammatory facial peel, a highly valuable preparation for laser treatments that prevents “rebound hyperpigmentation” and may be repeated several times throughout the year for proper skin management.
  • Photodynamic LED Light Therapy (LightStim) uses targeted, UV-free, LED lights in different wavelengths (or colors) to reduce redness and inflammation, energize and regenerate cells, increase circulation, decrease inflammation, destroy acne bacteria, and accelerate the healing process. Dr. Emer often employs LED Light Therapy before and after microneedling, laser treatments, and fillers to aid in the healing process and to increase blood flow.
  • The Intense Pulsed Light (IPL) photofacial improves skin tone and complexion as well as acne, general scars, sun spots, skin damage, and varicose, reticular and spider veins.
  • For patients with hyperpigmentation, skin discoloration, and melasma, Dr. Emer advises low-energy, low-density laser treatments, such as the Venus Viva (a fractional laser) and Clear + Brilliant (a non-ablative fractional laser). Venus Viva employs radiofrequency (RF) energy, resulting in tighter skin, fat and cellulite reduction, and improved complexion, fine lines and wrinkles. Dr. Emer adds microneedling to all laser treatments to enhance outcomes and allow for optimal penetration of topical skin care, growth factors, antioxidants, and stem cells applied both in the office and at home.
  • For patients with significantly aged skin, deep lines and wrinkles, and severe scars — or for those seeking a more aggressive, preventative treatment — Dr. Emer uses facial resurfacing lasers, such as the CO2, the Erbium (ablative laser), and the Fraxel (non-ablative laser).
  • For patients with scars, or for those seeking additional collagen production, Dr. Emer will combine fillers (such as Sculptra or Bellafill) with facial resurfacing lasers to achieve enhanced textural results, plump and lift scars, and improve any superficial irregularities.

Watch: Tribella with Venus Versa – IPL, Anti-Aging and Skin Resurfacing Combination Treatment

The Benefits of Skin Care

Dr. Jason Emer works directly with esteemed aestheticians to develop customized skin care protocols to prepare the skin prior to cosmetic procedures. These custom protocols can also promote collagen remodeling, address ongoing conditions, heal and nourish the skin post-treatment, and provide textural improvements long-term with daily regimens. Dr. Emer and his team of aestheticians employ all of the following in-office treatments to improve the life and appearance of your skin:

Watch: How Dr. Emer Prepares the Skin for Laser Resurfacing Treatments

Who should get microneedling with an at-home skin care protocol?

This treatment is effective for all ages and ethnicities, and there were no complications or adverse effects reported as part of the 2017 clinical study. As with all of his procedures, Dr. Emer evaluates every patient thoroughly to determine if they are an ideal candidate for the treatment. To schedule an in-person consultation with Dr. Emer, please call 310-299-9247 or email [email protected].

What kind of results can I expect?

Ideal candidates for this treatment may experience:

  • Visible reduction in hyperpigmentation and skin discoloration
  • Visible improvement in fine lines and wrinkles
  • Noticeable improvement in overall skin texture and quality
  • Overall skin brightening and rejuvenation
  • Improvements in scars and indentations
  • Significant pore reduction

Of course, results vary depending on a range of variables, including the severity of the skin condition(s), the number of treatments received, and adherence to the at-home skin care routine.

How do I schedule an appointment?

To schedule a consultation with Dr. Emer in Beverly Hills / Los Angeles / West Hollywood, California, please reach out to our concierge: call 310-299-9247 or email [email protected].

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