There is a lot of science behind the results. Expectations and the results. Treatment rules and guidelines. Methods of treatment that complement one another. Warnings and things to think about. Avoiding the body’s inflammatory response People should avoid the ingredients in the products they want to buy. When it comes to “all things needling,” the Concise Guide to Dermal Needling pdf by Dr. Lance Setterfield is the best source.
Many people think that they need a needling device and a cream to get results. This is why micro-needling has so many bad things happen, including the idea that “it doesn’t work.” The Concise Guide to Dermal Needling PDF, now in an Expanded Medical Edition, talks about the science of micro-needling and how to get results. The new edition of The Concise Guide to Dermal Needling PDF has 130+ more pages covering more topics, like PRP, LMW-HA, Stem Cells, and Paraben.
From the Author
Micro-needling has exploded in popularity and is now more popular than ever. Skincare experts want to learn more but are overwhelmed by contradicting information, which comes from sources with vested interests. Many people (both distributors and practitioners) overestimated the complexity of this therapeutic approach and were baffled when things went awry.
What is the advantage of micro-needling? How does one take advantage of the beneficial routes of cell-to-cell communication? Which micro-needling products are safe to use, and why? What conditions are we able to treat, and which ones respond best? What about the complexities? What features should we look for in a needling device? How much training will we require? Will we see a positive return on my investment? So, how about the FDA? How do we integrate this treatment into the services we already offer? Is there an additional risk as a result of this?
I’ve spent years exploring these concerns and training practitioners and clinics worldwide. In this new edition of The Concise Guide to Dermal Needling, I share my research and clinical expertise in the hopes of providing the answers you need. You will master the fundamentals of dermal needling and the advanced features of the modality, acquiring knowledge and confidence to work things out for yourself based on non-industry aligned information and a far more profound grasp of the science underlying this modality.
In this edition, I’ve spent a lot of time focusing on choosing the right patient and understanding their individual needs to maximize results and avoid issues. Most essential, in our quest to learn about micro-needling, we must keep in mind that there is a distinct individual (patient) on the other end of the device. This is referred to as the “5 P’s” of micro-needling success.
Finally, some people combine micro-needling with Stem Cells, PRP, Low Molecular Weight Hyaluronic Acid, and Parabens. The most recent information on these topics has been condensed into simpler terms to help remove the fog and give you a better understanding of these complex concerns.
Hopefully, by the end of this new pdf of The Concise Guide to Dermal Needling, your passion for skincare will be reaffirmed, and you will have earned the knowledge and confidence you need to provide the best treatments possible to your patients. You’ll gain respect as an expert, your business will thrive, and you’ll enjoy the adventure of meaningfully assisting your patients.
Contents of The Concise Guide to Dermal Needling PDF
CHAPTER 1: SKIN REJUVENATION
What Is the Goal?
What Are the Features of Healthy Skin?
What Are the Benefits of Healthy Skin?
What Are the Clinical Benefits of Healthy Skin?
What Can We Do to Optimize Skin Health?
What Are the Key Goals of Skin Rejuvenation?
Regulating Cell Function
Regulating Keratinocyte Function
Regulating Melanocyte Function
Regulating Fibroblast Function
Features of Ablative and Non-Ablative Treatments
CHAPTER 2: Cell Function
Regulating Cell Function to Optimize Skin Health
What Nutrients Are Essential for Regulating Cell Function?
Keratinocyte Requirements for Optimal Function
Product Ingredients Affecting Keratinocytes
Antioxidants to Prevent Lipid Peroxidation
Melanocyte Requirements for Melanogenesis
Product Ingredients Affecting Melanogenesis
Fibroblast Requirements for Collagenesis
Vitamin C and Collagen Formation
Vitamin C and Other Functions
Vitamin A and Collagen Formation
Key Amino Acids for Collagen Synthesis: Proline and Lysine
Copper Peptides for Collagen Synthesis
Other Peptides that Target Collagen Synthesis
Zinc, a Co-Factor in Collagen Synthesis
Bioflavonoids for Collagen Synthesis
Iron as a Co-Factor
Silicon, Magnesium, Selenium, and Calcium
Alpha-Linolenic and Linoleic Acid (Omega 3 and 6)
Product Ingredients affecting Fibroblasts
What Growth Factors Regulate Cell Function?
- Navigating the New Frontier
The History of Stem Cells
What Are Stem Cells?
Types of Stem Cells
Embryo Stem Cells
Fetal Stem Cells
Adult Stem Cells (Autologous Sources)
Making a Stem Cell Product
Going Back to the Beginning
Do Plant Stem Cells Fit into the Picture?
When is a Plant Stem Cell not a Plant Stem Cell?
Back to Humans Stem Cells
Bone Marrow Stem Cells
Adipose Stem Cells
What About Products Claiming to “Stimulate” Our Own Stem Cells?
Are “Growth Factor” Products Also from Stem Cells?
Bringing It All Together
CHAPTER 3: SCAR lESS WOUND HEALING (EMBRYO MODEL)
Comparisons – Embryo vs. AdultDistinctive Cellular and Molecular Features of Embryo Wound Healing
Differences Between Wound Healing in Embryos and Adults
Other Differences and Potential Influences Unique to Embryonic Wound Healing
The Adult Wound Healing Process
The Phases of Wound Healing
Coagulation Phase (If Ablative)
Inflammatory Phase (1-3 Days)
Lag & Proliferative Phase (3-5 Days)
Fibroplastic Phase (5-20 Days)
Maturative and Remodell ing Phase (28 Days-2 Years)
Plausible Explanations for the Differences Between the Embryo and Adult Wound Healing Models
The Role of Hyaluronic Acid
Why Does Fibrosis Result with IPL, Laser, Fraxel®, Thermage®, Etc?
Conclusions and Significance
CHAPTER 4: DERMAL NEEDLING
What It Is and What It Can Do
Needling Is About Far More Than Collagen Induction
Needling Devices/Methods for Collagen Induction
RF Combined with Microneedling
How to Select a Motorized Needling Device
- PATIENT SAFETY – Cross Contamination
- PERFORMANCE OF THE DEVICE
- QUALITY OF NEEDLE CARTRIDGES
- QUALITY OF NEEDLES
Rollers vs. Electronic Devices
Studies Done with Rollers Cannot Necessarily be Extrapolated to Pens
Advantages of Electronic Devices
Advantages of Rollers
Myths Propagated by Marketing
FDA Reclassification of “Pens” as a Medical Device
Cosmetic vs. Medical Need ling
Differences in Needle Size
Cosmetic Needling: How Does It Work?
Effects on the Epidermis
Effects on the Dermis
Dermal-Epidermal Junction – A New Frontier
Medical Needling: How Does It Work?
Pinpoint Accuracy – Taking Skin Rejuvenation to a New Level?
General Observations Opposing Conventional Wisdom
Structure of the Dermal-Epidermal Junction
Which Cells Are Responsible for Production of Basal Membrane Components?
Components of the DEJ and Associated Genes Showing Influence of Microneedling
Why Cosmetic Needling May Improve Wrinkles
New Indications/Applications for Microneedling
Melanocyte Stem Cell Transplants
Melanin Deposits in Hair Follicles to Enhance Laser Hair Removal
ALA for Treating Actinic Keratoses
ALA for Photodynamic Photorejuvenation
Microneedling vs. Microinjection of Tranexamic Acid for Treating Melasma
Microneedling with Bleomycin for Treatment of Verruca
What Are the Most Effective Uses of Dermal Needling?
How Needling Improves Various Skin Disorders & Conditions
Lax Skin and Wrinkles
What Are Some of the Causes of Lax Skin and Wrinkles?
How Does Needling Correct Lax Skin & Wrinkles?
What Are Some of the Causes for This Failed Repair or Destruction/Removal?
How Does Needling Correct UV Damage?
What Are Some of the Causes for Hyperpigmentation?
How Does Needling Correct Hyperpigmentation?
What Are Some of the Causes for This?
How Does Needling Correct Scars?
Histologica l Findings
What Are Some of the Causes for Stretch Marks?
How Does Needling Correct Stretch Marks?
What Are Some of the Aggravating Factors of This Condition?
How Does Needling Correct Rosacea?
What Are Some of the Causes for Hair Loss?
How Does Needling Correct Hair Loss?
Synergistic Products for Hair Restoration in Conjunction with Needling
CHAPTER 5: TREATMENT PARAMETERS AND PROTOCOLS FOR NEEDLING
Patient History and Exam
Consultation and Treatment Records
Atopy, Asthma, Hay Fever and Allergies
Drugs and Supplements Associated with Photosensitivity
Considerations with Fitzpatrick III and Above
Ingredients to Avoid with Dermal Needling
High Risk with Needling
Alpha Hydroxy Acids or AHAs
Beta Hydroxy Acids or BHAs
Dyes and Colouring Agents
The Collagenase Story (Another Precaution)
Avoiding the Inflammatory Response
Back to Basics – Normal Maintenance and Repair in Unwounded Skin
What Makes a Fibroblast Tick?
Back to Basics – Collagen
Back to Basics – Elastin
Back to Basics – Repair in Wounded Skin
Which Wound Healing Phases Are Necessary in Non-Ablative Rejuvenation Treatments?
Fibroblasts – Good or Bad?
Myofibroblasts -The Bad Guys
What Are the Four Possibilities of Response to Injury?
A Brief Review of Collagen During Acute Wound Healing
A Brief Review of Elastin During Acute Wound Healing
Why the Fuss? Things Look Great!
Back to Basics – Keratinocyte-Fibroblast Interaction
Combating Infiammation as Part of the Inevitable Rejuvenation Process
Platelet Rich Plasma
Safety with Neuromodulators and Fillers
IPL, Laser, Fraxel®, Etc.
Risk of Secondary Infection with Cosmetic Needling
Skin Preparation – Home (Cosmetic Needling)
Home Care Products
Cosmetic Needling (Rolling) at Home
Cosmetic Roller Instructions
Step 1: Cleansing
Step 2: Roller
Step 3: Active Ingredients Application
Step 4: Protection
Step 5: Roller Maintenance at Home
- Clinic (Medical Needling)
Topical Anaesthesia vs. Dental Blocks
What Size Needle?
Medical Needling Protocol
Best Practice Needling Technique and Procedures Using a Roller
Best Practice Needling Technique and Procedures Using a Pen
- Technique for Even Endpoint (Erythema)
- Below the Eyes
- Perioral Lip Lines
- Nasolabial and Mental Folds
- Upper Lids
- Wrinkles in Front of Ears
1 0. Scars
End Point with Microneedling Treatments
Number of Passes
Adjuncts: Platelet Therapy
How to Clean the Medical Needling Device
Post Treatment Considerations
Immediate Post Treatment Care
Home Care Considerations
Predicted Appearance After Medical Needling
Post Treatment Plan Guideline
New Post-Microneedling Protocols
Immediately after Microneedling
- Collagen Induction and Scars
Inflammatory Phase 1 -5 Days
Fibroplastic Phase 5-14 Days
Maturative Phase 1 4-28 Days to 2 Years
Immediately after Microneedling
Bringing It All Together to Avoid Failure in Microneedling Treatments
- PATIENT SELECTION
- Picking the Fights you can Win
Is This the Appropriate Patient to Treat?
Exam and Diagnosis (Depth of Pathology)
- Appropriate Product (Ingredient) Selection
- Appropriate Pen Selection
- Appropriate Penetration Depth – Needle Length
- Appropriate Period Between Treatments (Frequency)
Required Number of Treatments
Scope of Practice
Am I qualified to treat this condition?
Will this condition respond to needling?
Para ben Story Update
“Imposters” – Endocrine Disruptors
Signalling Molecules – Hormones
Breast Cell Receptors
Breast Cell Receptors – Hormonal
Breast Cell Receptors – Non-Hormonal
Receptors and Breast Cancer
HER2 Overexpression in Breast Cancer
Simplified Clinical Relevance of Receptors and Breast Cancer
Why Have Many Studies Failed to Prove Paraben Links to Breast Cancer?
Myth – Estrogenic Effect Associated with Parabens is Based on Estrogen Mimicry
If Not Direct Stimulation of ERs by Parabens, Perhaps Via HER2 Pathway??? – No!
Inching Closer to the Truth – Study Looks at “Parabens and Human Epidermal Growth
Factor Receptor Ligand Cross-Talk in Breast Cancer Cells”
Bringing It All Together
Where Do We Go from Here?
HA – No Laughing Matter
Hyaluronic Acid – Beyond Wrinkles, Moisturising, and Plumping
How is Hyaluronic Acid Made?
How is Hyaluronic Acid Fragmented?
Causes of HA Fragmentation
Biofeedback to Facilitate Homeostasis – HA Fragmentation
Biofeedback to Facilitate Wound Healing – HA Fragmentation
What Are Some of the Functions of Hyaluronic Acid?
Are the Antioxidant Properties of LMW-HA Superior to HMW-HA?
Hyaluronic Acid Directing “Life and Death” via Hyaluronic Receptors
Marketing Spin vs. Evidence-Based Science – Why the Disconnect?
The Biological Function of HA Molecules Based on Size Differs Drastically
Pathologies Associated with LMW-HA
But We Are Only Applying HA to the Epidermis. Surely There Are No Systemic Effects?
Does Dermal Infusion Occur When Products Are Applied Topically?
Are There Biological Effects at an Epidermal Level That Induce Dermal
Effects or Systemic Effects?
What About Contradictory Studies?
Surely Products Approved by Health Agencies Meet Safety Specifications?
But the Results Are Great!
If Injury Creates LMW-HA, Why is it Safe to Microneedle?
The Platelet-Rich Plasma Story
What is PRP?
The Upside of PRP
PRP and the FDA
How Does PRP Work?
How is PRP Prepared and Does It Really Matter?
History of PRP
PRP Use in Veterinary Medicine
PRP Use in Orthopedics and Sport Medicine
PRP Use in Dental Surgery
PRP Use in Dermatology – General
PRP Use in Dermatology – Alopecia
- Impossible to standardize – Too many variables
- Disrupting the balance (Homeostasis) of nature – Agonists and Antagonists
- “Shotgun Therapy” vs. “Cruise Missiles”
- Flawed evidence – When is a “study” not a study?
The Downside of PRP
PRP Studies – Past and Future
PRP – Fact or Fiction?
PRP – What Does the Future Hold?
CHAPTER 6: CASE STUDIES
Expectations and Outcomes
Review of Complications with Microneedling
Case Study (In the Patient’s Own Words)
CHAPTER 7: OVERVIEW OF SYNERGISTIC TREATMENT MODALITIES
The How’s, When’s & Why’s of Combination Therapy
The Concept of Corneotherapy – Back to the Future
Light-Emitting Diode (LED)
Intense Pulsed Light (IPL)
Alpha Hydroxy Acids (AHA)
Mandelic Acid (Alpha-Hydroxybenzeneacetic Acid)
Beta Hydroxy Acids (BHA)
Beta-Lipohydroxy Acid (C8-Lipohydroxy Acid) (LHA)
Trichloroacetic Acid (TCA)
Bromelain or Papaine
Desquamation Due to Epidermal Cell Turnover vs. Exfoliation Due to Ablation
Ablative Treatments (Continued)
Laser Resurfacing (Ablative)
Pulsed Dye Laser
Other Modal ities
Hyperbaric Oxygen Therapy
Radio Frequency (RF)
Summary of Appropriate Combination Therapy
CHAPTER 8: ADVANTAGES & DISADVANTAGES OF NEEDLING
Why Consider Microneedling in Your Practice?
The Role of Keratinocytes in Collagen Induction
Frequently Asked Questions
Q&A: Interesting Question and Answer
Author of The Concise Guide to Dermal Needling
Dr. Lance Setterfield graduated from the University of Stellenbosch in Cape Town, South Africa, in 1 983 and emigrated to Canada in 1 988 after completing five years of post-graduate training. His personal experience with skin cancer prompted a specific interest in the subjects of cancer, skin health, and anti-aging. Dermatology accounted for a significant portion of his practice in rural Canada.
One of the first doctors in Canada to use medical needling in his practice was Dr. Setterfield. He started his clinic in 2004 to study the effects of needling on the skin with pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients, after working as a co-founder and medical director of laser clinics in the Victoria area. His main focus has been on cell-to-cell communication, specifically the effects of dermal needling on the epidermis and dermis, emphasizing the significance of epidermal injury as an alternative to dermal injury rejuvenation.
With this paradigm shift toward the epidermis and away from the concept of prolonging inflammation to stimulate collagen creation, his study resulted in a partnership with clinics and firms all over the world, allowing him to be at the cutting edge of micro-needling technology. “Dermal Needling and Wound Healing” is a subject many people want to learn more about, so he made training courses and started a lecture tour to teach people about it. He did this in countries like the UK, the US, and Canada.
Dr. Setterfield wrote the first book on dermal needling (201 0), “The Concise Guide to Dermal Needling – Medical Edition,” which was later updated in 201 3 as an “Expanded” edition. This current book (2017) is a “Revised and Expanded” version with significant information on critical areas in the cosmetic industry about micro-needling. There is also a Spanish version available. Dermal needling has grown in popularity rapidly, and thousands of practitioners worldwide have benefited from the instruction he gives through his books, Online Microneedling Course, and live classes. (See www.needlingguide.com for further information.)
Pros & Cons
- Book Name: The Concise Guide to Dermal Needling Third Medical Edition – Revised & Expanded
- Publisher: Acacia Dermacare; 3rd edition (December 22, 2017)
- Language: English
- Paperback: 296 pages
- ISBN-10: 0992060419
- ISBN-13: 978-0992060411
- Item Weight: 1.62 pounds
Download The PDF of The Concise Guide to Dermal Needling 3rd Edition
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