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The concept of treating a variety of skin irregularities with a fractional skin injury approach is seen from the use of laser to dermaroller therapies. The basic premise is that deep small channels are cut into the skin which creates a subsequent healing cascade that causes new collagen formation in the holes and ultimately thicker skin that is smoother. Such an approach has proven useful for a variety of scar problems including those caused by acne.

A new fractional approach is that of the Dermapen. This hand-held device is about the size of a large felt-tip pen and it uses microneedles to cause the fractional skin injury. The tip of the pen as an array of 11 tiny steel microneedles that can achieve depths anywhere from 0.25mm to 2.5mm based on the head chosen. The microneedles are driven into the skin vertically by a frequency-adjustable piston for consistent wounding depths. To prevent cross-contamination between patients the microneedle tips are single use. It does require topical anesthesia to be used and is FDA cleared for acne scar treatments.

The skin microneedling effect caused by Dermapen generates no additional thermal injury to the skin like that caused by a laser. Because there is no heat generated, recovery is quicker, there is virtually no risk of after treatment hyperpigmentation and treatments can be spaced very close together and can be repeated as much as one desires. For patients with greater skin pigments this approach offers a virtually complication-free treatment option. In addition, because Dermapen technology is just a fraction of that of lasers, one would presume that the cost of an individual treatment would also be appreciably lower.

A very relevant but unknown question about Dermapen is how it’s effectiveness compares to the current gold standard of fractional laser treatments for acne scars, stretch marks, wrinkles and surgical and traumatic scars. To date, the safety and efficacy profiles between the two have not been published in any peer-reviewed journal.

Dr. Barry Eppley

Indianapolis, Indiana

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