19 Aug The Truth About Microneedling with Hyaluronic Acid for Lip Plumping
Microneedling with hyaluronic acid for fuller, plumper lips is one of the newest trends in the aesthetics industry. The combination treatment has become so popular it’s not only offered by some aesthetic clinics, but consumers can also purchase a DIY microneedling kit that comes with a dermal roller and HA serum (but buyer beware!).
Microneedling Pen vs. Dermal Roller: Microneedling pens are medical devices used by aesthetic clinics. Pens have a motor-driven needle cartridge that moves the needle in and out of the skin vertically. Professional microneedling pens have sharper, longer needles that can precisely target treatment areas and can be adjusted to control depth. Dermal rollers are do-it-yourself, one-size-fits-all microneedling devices meant for use at home by untrained novices. They have many dull, short needles affixed to a roller’s circumference. Dermal rollers are not precise, can’t narrowly target treatment areas, and the depth of needles can’t be adjusted.
While both microneedling and hyaluronic acid (HA) have been widely used in aesthetics, are well studied, and have many benefits, the novel use for lip enhancement does have risks and limitations. In this blog post, we’ll look at the science behind microneedling and HA, the risks of microneedling to the delicate lip area, and safer alternatives that have fewer risks.
What is Microneedling and Is It Safe?
Microneedling is a cosmetic procedure wherein a pen with small, sterilized needles creates micro-wounds in the skin. The tiny wounds elicit a natural healing response, producing collagen and elastin. It’s the breakdown of collagen and elastin as we age that result in sagging, deflated looking skin. Collagen gives skin its strength and structure while elastin makes it more, well…elastic – allowing it to “bounce back”. Microneedling is also called “collagen induction therapy”. The aim of the treatment is what sciencey types refer to as neocollagenesis (new collagen formation) and neoelastinogenesis (new elastin formation). Microneedling has many medical and aesthetic uses as summarized in “Microneedling: Advances and widening horizons”: “acne scar, acne, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, stretch marks, and many more.”
In addition to microneedling, there are several other treatments that can positively influence collagen and elastin, either slowing their breakdown or stimulating formation. In “Neocollagenesis and Neoelastinogenesis: From the Laboratory to the Clinic”, the author reviewed study outcomes and found that they “lend credence to the products and procedures used in clinical practice to induce neocollagenesis and neoelastinogenesis”, namely retinoids, vitamin C, laser and IPL, microneedling, dermal fillers containing HA, dermal threads, and platelet rich plasma. The review mentions a 2006 microneedling study which demonstrated that 6-8 weeks after microneedling “New collagen and elastin fibre formation was obvious and quite dramatic. On average, an increase of new fibres of 206% was observed.”
Microneedling Safety
In a “A Systematic Review Examining the Potential Adverse Effects of Microneedling”, authors reviewed 51 study articles involving 1,029 patients and found that microneedling “is a relatively safe procedure with minimal adverse effects, including, but not limited to, expected erythema [skin rash caused by injured capillaries], pain, edema [swelling], and temporary skin irritation”. The reviewed studies included clinical trials, retrospective studies, and case reports. Only two reports of post-treatment infection were noted and “one of the two cases reported was seen in a patient who used a RMN [roller microneedling] device at home. This draws attention to the dangers of self-administered therapies and highlights the potential for self-inoculation [spread of infection by oneself]”.
What is Hyaluronic Acid and Is It Safe?
Hyaluronic acid occurs naturally in the body as a major component of skin and connective tissue. It is a humectant – a substance that attracts and retains moisture (see the Wikipedia definition of “humectant”).
HA is important to the skin’s structure and plays a vital role in healing and tissue regeneration. You can probably guess that attracting water into the skin and retaining it is a good thing, and you’re right! As we age, skin loses this natural hydration and volume and becomes slack and saggy. Because the body produces less HA as we age, it has become a popular cosmetic ingredient and treatment to increase skin’s volume and plumpness. Most commercially produced HA is derived from rooster-combs or bacterial fermentation.
There are several studies that have demonstrated the anti-aging benefits of hyaluronic acid.
One such study on new topical nano-hyaluronic acid, found that with nano-hyaluronic acid (HA with molecules small enough to pass through the skin and penetrate more deeply) skin improvements were dramatic: “The new nano-hyaluronic acid clearly demonstrated a significant benefit in decreasing the depth of wrinkles (up to 40%), and skin hydration (up to 96%) and skin firmness and elasticity were significantly enhanced (up to 55%) at the end of eight weeks”.
A small German study on anti-wrinkle creams containing HA found that daily application for three months resulted in a 10-20% reduction in wrinkles and 13-30% increase in skin tightness.
Many over-the-counter cosmetic products contain HA with molecules too large to penetrate the skin for maximum effect. One review of topical cosmeceuticals, states that most over-the-counter HA products are too large molecularly (3000nm) compared the skin’s intercellular space the product must penetrate (15-50nm). The “nm” unit or nanometer is used to describe the width of molecules – a nanometer, is equal to one-billionth of a meter or one-millionth of a millimeter.
A Japanese study on oral supplementation of HA found that taking HA “for 12 weeks suppresses wrinkles and improves the skin’s luster and suppleness in people aged 59 years or less who were healthy Japanese men and women over 22 years old”.
Hyaluronic Acid Safety
Hyaluronic acid has been used in over-the-counter cosmetic topical applications and for clinical applications for many years. In 2009, an expert panel assessed the safety Hyaluronic Acid, Potassium Hyaluronate, and Sodium Hyaluronate as used in cosmetic applications at concentrations of up to 2%. The panel found that “Widespread clinical use of hyaluronic acid, primarily by injection, has been free of significant adverse reactions. Hyaluronic acid and its sodium and potassium salts are considered safe for use in cosmetics as described in the safety assessment.”
The history of hyaluronic acid dates back to 1934, when it was first isolated. The first manufacture of HA as a biomedical product occurred in the 70s and 80s. Since then, HA has been used for many clinical and aesthetic applications including odontology, cancer therapy, wound treatments, eye surgeries, urology, and soft tissue regeneration, and of course topical cosmetic applications and injectable dermal fillers.
Understanding Microneedling of Fragile Lip Tissue
Compared to other parts of the body, lip tissue is thin and very delicate. If you’ve ever accidentally bitten your lip while eating, you know exactly how delicate lip tissue is and how easily it can be damaged. It doesn’t take much force to draw blood or cause bruising and swelling.
Lip structure consist of multiple thin layers of skin that are much more susceptible to damage than skin on other parts of the body.
- Stratum Corneum: The outermost layer, which is thinner on the lips (3-5 cell layers) compared to facial skin (16 cell layers).
- Epidermis: The surface layer containing melanocytes which produce melanin pigment and give lips their colour.
- Dermis: A deeper layer rich in collagen and elastin fibers, providing structural support.
Because lip skin is so thin, microneedling lip tissue can cause significant damage including prolonged swelling, bruising and scarring if not performed correctly by an experienced, licensed practitioner who understands lip anatomy. It’s vital that you know the risks and seek treatments from qualified professionals who will provide a thorough consultation and assess whether you are a good candidate for treatment. Unfortunately, there are many unlicensed or inexperienced practitioners who don’t thoroughly assess suitability and will provide lip microneedling to anyone who’s willing to pay.
The Role of Hyaluronic Acid in Microneedling Lips
In lip microneedling, hyaluronic acid is applied to the lips and is followed by microneedling, supposedly to help HA penetrate the dermal layer. In reality, because of the thinness of lip tissue, micro-wounds must be kept shallow, too shallow to elicit collagen formation or deliver HA to deep lip tissue.
While professional microneedling pens used by experienced clinicians can reduce the risk of lip damage, microneedling lips still has risks – even when done by a professional. At-home lip microneedling with a dermal roller has even greater risk of damage and infection. Dermal rollers are often more marketing hype than truth – some promising “instantly plump lips”. Most consumers don’t realize that dermal roller needles are much shorter and duller than professional microneedling pens, so can’t deliver HA into deep lip tissue or create micro-wounds deep enough to result in collagen formation. It’s more likely that plumpness or fullness experienced by DIY microneedling is temporary, caused by superficial injury (inflammation) or increased blood flow from rolling than by increased collagen or the application of HA. Pinching your lips for a few minutes each day or strapping on the boxing gloves and going toe-to-toe with yourself may provide similar results (Please don’t do this! We are definitely kidding).
In an American Academy of Dermatology article, “Microneedling: experienced hands can improve the face”, Tina Alster, MD, FAAD – a professor of dermatology at Georgetown University Medical Center – said the following about the shorter, duller needles of home-use roller devices “while they may stimulate blood flow to create a temporary brightening effect, they can’t deliver the same results”. The doctor added that home-use microneedling devices ”are difficult to clean and maintain, with needles that dull quickly. If these device do penetrate the skin, she says, they could do so in a way that leads to injury or infection, rather than rejuvenation.”
Types of Hyaluronic Acid Products and Their Longevity
There are two main types of hyaluronic acid used for aesthetic treatments:
- Non-Cross-linked HA (also called linear HA): This raw form of HA is more fluid and breaks down more easily. It’s commonly used in anti-aging cosmetics and over-the-counter treatments. It is quickly absorbed, doesn’t provide long-lasting effects, and isn’t used in injectable fillers because its consistency is too thin to remain at the site of injection.
- Cross-linked HA: This form of HA is found in many dermal fillers. Cross-linking results in HA molecules of greater size, density and permanence. Cross-linked HA lasts longer because it resists breakdown, and has a thicker consistency, so it will stay near the site of injection.
Read this study comparing cross-linked versus linear HA.
Despite the appeal and hype of HA in enhancing lip volume, the reality is that microneedling with non-crosslinked HA found in most consumer products will not offer the long-term plumping effect that many desire. The temporary fullness observed post-treatment is primarily due to swelling from the microneedling process itself, not the HA’s lasting presence.
The Importance of Microneedling Device Quality and Health Canada Approval
Not all microneedling devices are created equally. Using substandard or non-authorized devices can pose significant health risks, including infection and inconsistent results. In Canada, microneedling devices must be licensed by Health Canada for professional use only, to ensure they meet safety and efficacy standards. Some companies circumvent these regulations by marketing “needle” cartridges that don’t actually penetrate the skin or by misrepresenting the capabilities of their devices.
It’s concerning that consumers can so easily buy dermal rollers online. As previously mentioned, DIY microneedling increases the risk of adverse effects (e.g. infection, bruising) and will not provide the same benefit as medical devices. Recently, Health Canada issued a warning regarding all models of one such “at-home” microneedling device – the Dr. Pen Auto Microneedle System – out of concern that it may pose health risks. In the U.S., the FDA has issued a similar warning about dermal rollers that are marketed illegally. The safety and efficacy of these devices have not been reviewed by the FDA. FDA also states that microneedling devices should not be used by people that do not have appropriate training and experience.
When seeking microneedling treatments, it’s imperative to verify that the devices used are authorized by Health Canada, which indicates that the device has undergone rigorous testing and meets the necessary health and safety requirements. Always consult with licensed professionals who use licensed equipment to ensure the best possible outcome and minimize potential risks.
Microneedling is Great, but There are Safer, Effective Options for Lips
While Halcyon Cosmetic & Skin Clinic provides microneedling treatments to improve skin texture, fine lines and wrinkles and acne scars, we don’t offer lip microneedling because we understand the inherent risks for what are often only modest or temporary improvements. At our medical spa, we prioritize your safety and satisfaction, offering only the most reliable, safe and effective treatments.
There are other ways to enhance lip fullness and beautify lips that that have fewer risks and longer lasting results, such as lip fillers and dermal fillers containing HA, and permanent lip blush.
If you’re considering lip enhancement, we invite you to consult with our experienced professionals to explore the best options tailored to your needs. Our clinic is located in Port Moody and is convenient to people living in Coquitlam, Port Coquitlam.
Sorry, the comment form is closed at this time.