Dr. Kaplan has been interested in micro-needling for some time but was scared off by dermal rollers for a variety of reasons, mainly that the topology of the face doesn’t lend itself to a one-depth puncturing device where consistency of treatment is a challenge. Depth of treatment won’t work for all areas of the face, pressure on the roller is hard to manage, and there is too much variability. He adopted Dermapen in his practice because it solves these problems. It is precise, depth is adjustable, frequency is adjustable, and users can be systematic in treatment, overall allowing for more consistent efficacy. He and his physician assistant perform all the treatments.
Having treated somewhere around 100 patients with Dermapen, Dr. Kaplan has honed his use down to scar revision primarily (acne, hypertrophic, keloid) but also uses it for the usual range of approved indications. He has pictures on his website of one notable success using Dermapen for keloid scars: the patient (female) presented with hypertrophic scarring after incision and drainage of an abscess—a wide pink scar, very noticeable due to her regular pigmentation. She underwent a series of six treatments at intervals of more than a month on average. The scar is much flatter now, less noticeable with no obvious line of demarcation or "trench" surrounding. Dr. Kaplan sees Dermapen as an ideal scar revision tool when there isn’t much in the way of discoloration problems. This is especially true for darker skinned patients for whom laser treatment is problematic. Dermapen does not replace the laser, but it enhances the armamentarium significantly, especially due to its low cost.
Dr. Kaplan also sees the virtually nonexistent downtime as a major advantage of Dermapen; fewer and fewer patients are willing to miss work—although side effects (pinpoint bleeding, redness and edema, etc. that are all very manageable) will be more prevalent with more aggressive treatment. The use of topical numbing is a factor in this because patients can go right back to normal activity if they wish, as well as drive themselves home, because one does not need narcotic analgesia.
Alex Kaplan, M.D. Dermapen Interview
How long have you been using the Dermapen?
I’ve been using the Dermapen since about February.
Could you give me a general idea about how many patients you’ve treated with Dermapen?
Over 150 so far.
What indications have you been using Dermapen for and why?
We like to use it for acne and pimple scars primarily and for hypertrophic scars or keloids.
You’ve had success with keloid scarring?
Yes. I have pictures on my website that show micro-needling before and after pictures of scars, if you go to my Dermapen page it’s on there.
Can you describe that case in general? What you did and what kind of results you got?
This was a patient that had hypertrophic scarring after incision and drainage of an abscess, and she was also dramatically pigmented and the scar was wide and pink and noticeable. She was very concerned about it. We did a series of treatments. She did a total of half a dozen, every month or two. After (I believe it says on the website how many treatments the pictures were taken at) about 5 or 6 treatments, and the scar is much flatter and less noticeable. There is no obvious demarcating line where the scar is and where the regular skin around is, whereas before it was a mountain or a hill raising out of normal skin with a trench around it.
Was there some obvious effect on quality of life there?
Well, it’s purely cosmetic in that case. It wasn’t causing her functional problems or pain, but she didn’t like the way it looked and didn’t like the texture and the appearance of the skin. It doesn’t have the same cosmetic characteristics it had before. What I like Dermapen for specifically is for scar remodeling where superficial discoloration is not the main issue. You’ve got other devices like the fractional CO2 and a Fraxel Restore as well, so for some people that have problems like sun damage and pigmentation, very fine wrinkles along with the other things like acne scars, it’s truly better to go with the range around. Especially if they’re darker skinned and more prone to complications from the laser treatments, and the texture problem like acne scars or hypertrophic scars, then the Dermapen is really the best treatment.
What are some of the other advantages you’ve experienced with Dermapen?
There is virtually no downtime. Someone getting a CO2 treatment, they have at least a couple days where they pretty much stay at home, whereas this is similar to Fraxel. They have some redness but they can go about their business the next day. It’s also less painful than even Fraxel. We use topical anesthetic prior to treatments, but we don’t have to provide any painkillers so there is no issue of drowsiness after procedure. They can drive immediately after the treatment.
In addition to what you’ve mentioned, are there any off-label uses for Dermapen that you’ve been exploring or using?
Primarily we’ve been using it for usual treatments.
This may be noteworthy also, I have given thought to micro-needling treatments and needle rollers, but I was just scared off by them. There is too much variability. Too much force is applied in a particular location, plus you can overdo some areas and underdo others. It’s hard to do 3D topology of the face and there are areas where there are boney prominences vs. soft valleys. So the cheek bones may get too much treatment whereas the area just below that might not get enough. It depends on hand pressure you use, how much hand pressure in an individual location. With the Dermapen I really like how precise it is and I can control the depth of the penetration because it’s controlled by the device. You set the depth as well as the frequency. As long as you’re systematic and total(?) areas you do and the passes you do, it’s going to be much more even.
In your office, is Dermapen treatment performed most often by you or by ancillary staff?
Most often by PA but occasionally by me.
What does the patient look like after micro needling treatment? What does their face look like?
It’s going to look raw and red and there is some pinpoint bleeding. Maybe just red and a little swollen like a moderate sunburn. It depends on how aggressive we treat them. There is no blood running down or anything like that. There is no blistering.
What about the social downtime?
Virtually non-existent. Their face is red but by the next day most of the red has subsided. It can be easily covered by make-up too.
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