Medical Needling

  • Hans-Oliver RennekampffEmail author
  • Matthias Aust
  • Peter M. Vogt


Patients with post-burn scarring frequently request help in improving the aesthetic appearance of their residual cicatricial deformity. It is their hope to eradicate the physical evidence of a scar and to re-establish a normal appearance and texture to the site of injury. This quest has led to the application of many different topical therapies which have included carbon dioxide (CO2) laser resurfacing, dermabrasion and deep chemical peels. All these modalities share a similar mechanism of action, topically ablating the skin in an attempt to yield a more homogenous surface. This therapeutic injury destroys the epidermis and the basement membrane. Ablating the epidermis of already scarred skin with subsequent protracted re-epithelialization may render the skin more sensitive to photodamage and dyschromia and may possibly cause additional dermal fibrosis by initiating a prolonged inflammatory response. Rejuvenation of scarred skin and re-establishment of a more normal appearance require the maintenance or establishment of a normal epidermis with normal colour and a normal dermis with natural dermal papillae, good hydration, and normal resilience.


Retinoic Acid Retinyl Ester Reticular Dermis Laser Resurface Include Carbon Dioxide 
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  1. 1.
    Orentreich DS, Orentreich N (1995) Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatol Surg 21:543–549PubMedCrossRefGoogle Scholar
  2. 2.
    Fernandes D (2002) Percutaneous collagen induction: an alternative to laser resurfacing. Aesthetic Surg J 22:315CrossRefGoogle Scholar
  3. 3.
    Camirand A (1997) Needle dermabrasion. Aesthetic Plast Surg 21:48–51PubMedCrossRefGoogle Scholar
  4. 4.
    Aust MC, Fernandes D, Kolokythas P, Kaplan H, Vogt PM (2008) Percutaneous collagen induction therapy (PCI) – an alternative treatment for scars, wrinkles and skin laxity. Plast Reconstr Surg 121:1421–1429PubMedCrossRefGoogle Scholar
  5. 5.
    Aust MC, Reimers K, Stahl F et al (2008) Percutaneous collagen induction (PCI) – minimally invasive skin rejuvenation without risk of hyperpigmentation – fact or fiction? Plast Reconstr Surg 122:1553–1563PubMedCrossRefGoogle Scholar
  6. 6.
    Chapellier B, Mark M, Messaddeq N et al (2002) Physiological and retinoid-induced proliferations of epidermis basal keratinocytes are differently controlled. EMBO 21:3402–3413CrossRefGoogle Scholar
  7. 7.
    Bernard FX, Pedretti N, Rosdy M, Dequercy A (2002) Comparison of gene expression profiles in human keratinocyte mono-layer cultures, reconstituted epidermis and normal human skin: transcriptional effects of retinoid treatments in reconstituted human epidermis. Exp Dermatol 11:59–74PubMedCrossRefGoogle Scholar
  8. 8.
    Sorg O, Didierjean L, Saurat JH (1999) Metabolism of topical retinaldehyde. Dermatology 199:13–17PubMedCrossRefGoogle Scholar
  9. 9.
    Ito YL, Zile M, Ahrens H, DeLuca HF (1974) Liquid-gel partition chromatography of vitamin A compounds: formation of retinoic acid from retinyl acetate in vivo. J Lipid Res 15:517–524PubMedGoogle Scholar
  10. 10.
    Sass JO, Didierjean L, Carraux P et al (1996) Metabolism of topical retinaldehyde and retinol by mouse skin in vivo: Predominant formation of retinyl esters and identification of 14-hydroxy-4, 14-retro-retinol. Exp Dermatol 5:267–271PubMedCrossRefGoogle Scholar
  11. 11.
    Nusgens BV, Humbert P, Rougier A et al (2001) Topically applied vitamin C enhances the mRNA level of collagens I and III, their processing enzymes and tissue inhibitor of matrix metalloproteinase 1 in the human dermis. J Invest Dermatol 116:853–859PubMedCrossRefGoogle Scholar
  12. 12.
    Martin P, Leibovich SJ (2005) Inflammatory cells during wound repair: the good, the bad and the ugly. Trends Cell Biol 15:599–607PubMedCrossRefGoogle Scholar
  13. 13.
    Ferguson MW, O’Kane S (2004) Scar-free healing: from embryonic mechanisms to adult therapeutic intervention. Philos Trans R Soc Lond B Biol Sci 359:839–850Google Scholar
  14. 14.
    Tran KT, Griffith L, Wells A (2004) Extracellular matrix signalling through growth factor receptors during wound healing. Wound Repair Regen 12:262–268PubMedCrossRefGoogle Scholar
  15. 15.
    Bandyopadhyay B, Fan J, Guan S et al (2006) A “traffic control” role for TGFbeta3: Orchestrating dermal and epidermal cell motility during wound healing. J Cell Biol 172:1093–1105PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Hans-Oliver Rennekampff
    • 1
    Email author
  • Matthias Aust
    • 1
  • Peter M. Vogt
    • 1
  1. 1.Klinik für Plastische, Hand- und WiederherstellungchirurgieMedizinische Hochschule HannoverHannoverGermany

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