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Unsure about Growth Factor and Cytokine Products for Skin Care & Microneedling?

By now, BFT readers are well familiar with our disdain for the hyperbolic and confusing marketing messages constantly foisted upon skincare product consumers. For more than a decade, marketing maestros (charlatans?) tried to hoodwink scientifically unsophisticated women by commandeering the words “stem cell” to sell products having nothing to do with stem cells, or by ginning up the argument that a plant “stem cell” can somehow produce the biologic messenger molecules that will “instruct” human skin cells to change their errant ways. Hopefully, our readers have progressed beyond such semantic innocence and vulnerability. Today we want to go beyond scientific absurdities and address the real world differences between products that actually do contain human cell-derived growth factors and cytokines. The good news is there is abundant scientific documentation that confirms that topically applied human growth factors and cytokines can provide significant benefit to aging skin. Now, with the enhanced penetration and direct access to metabolically active skin cells produced through microneedling, the nature of applied bio-signals becomes even more important, and more potent in producing benefit…or harm. Thankfully, sorting this out is relatively simple since the scientific literature contains abundant instructive data and there is a growing body of supportive clinical evidence.

A Quarter Century of Research and Use The evidence proving benefit of growth factors and cytokines in wound healing dates back to the late 1980’s. A 1987 study examined the role of platelet-derived growth factor in wound healing. In vitro (laboratory benchtop) experiments showed PDGF (platelet derived growth factor) “stimulates DNA synthesis and chemotaxis of fibroblasts and smooth muscle cells and stimulates collagen, glycosaminoglycan, and collagenase production by fibroblasts. These in vitro properties suggest that PDGF, delivered by platelets to the site of injury in vivo, may play an important role in the initiation of the wound repair process.” The study further explained that IGF-1 (insulin-like growth factor 1) and EGF (epidermal growth factor, when combined with PDGF, provided additional synergistic benefit.

This diagram illustrates the negative influences on healing of lack of blood supply, oxygen, growth factors and cytokines on top, and the positive benefits of various important growth factors and cytokines on the bottom. The influences of growth factors and cytokines, however, is actually much more complex as there are dozens in play at any time, all competing for influence. The “net” effect of the overall bio-signal pattern is of paramount importance as is discussed below.

Drgeorge’s first exposure to clinical use of growth factors and cytokines was in the operating room in the early 1990’s when PDGF saturated gauze was packed into chronic non-healing ulcers in diabetic patients with good results. Since that time, platelet derived growth factors and cytokines have found clinical usefulness in bone and joint treatments, and as pro-healing adjuvants to promote tendon and ligament repair. It is thus no surprise that more than a dozen years ago, researchers became interested in documenting the benefits topically applied bio-signals provide to aging and photo-damaged skin. As explained below, the use of platelets to obtain bio-signals for topical application to the skin has  pros and cons.

Early Evidence of Benefit

In the early 2000s, researchers began to explore the potential benefit of topically applied growth factors and cytokines to aging and photo-damaged skin. Some of the initial studies focused on bio-signals produced from cultures of fibroblasts, a reasonable cell type to consider because of its importance in production of collagen, elastin and intracellular matrix within the dermis. While evidence now shows that fibroblasts are not the optimal cell type from which to obtain such bio-signals, this early research set the stage for successful marketing of an entirely new class of topical skincare product.

Reversal of photodamage with topical growth factors: a pilot study. “The application of a mixture of topical growth factors may stimulate the repair of facial photodamage resulting in new collagen formation, epidermal thickening and the clinical appearance of smoother skin with less visible wrinkling.” J Cosmet Laser Ther. 2003 Apr;5(1):25-34.

Efficacy of novel skin cream containing mixture of human growth factors and cytokines for skin rejuvenation. “…significantly reduced periorbital and perioral wrinkles, as well as improved skin texture of the chin after one month of treatment, which confirms the beneficial use of growth factors and cytokines for skin rejuvenation reported in 2 earlier studies.”   J Drugs Dermatol. 2007 Feb;6(2):197-201.

Endogenous growth factors as cosmeceuticals. “Topical application of human growth factors in multiple clinical studies has been shown to reduce the signs and symptoms of skin aging, including statically significant reduction in fine lines and wrinkles and increase in dermal collagen synthesis.” Dermatol Ther. 2007 Sep-Oct;20(5):350-9.

Human growth factor and cytokine skin cream for facial skin rejuvenation as assessed by 3D in vivo optical skin imaging. “Growth factors, in addition to their crucial role in cutaneous wound healing, are also beneficial for skin rejuvenation. Due to their multifunctional activities such as promoting skin cell proliferation and stimulating collagen formation, growth factors may participate in skin rejuvenation at various levels. […] We found that topical application of growth factors and cytokines are beneficial in reducing signs of skin aging.” J Drugs Dermatol. 2007 Oct;6(10):1018-23.

Reduction in facial photodamage by a topical growth factor product. “This study demonstrates that addition of a topical formulation of growth factors and cytokines to a basic skin care regimen reduces the signs of photoaging.”  J Drugs Dermatol. 2008 Sep;7(9):864-71.

Topically applied physiologically balanced growth factors: a new paradigm of skin rejuvenation. “Clinical studies have shown that topical application of products containing high concentrations of a physiologically balanced mixture of GF appears to reverse the signs of skin aging.”   J Drugs Dermatol. 2009 May;8(5 Suppl Skin Rejuenation):4-13.

Healing is like a Symphony Orchestra, not a String Quartet The body contains trillions of cells, divided into over 200 different individual types of cells. Of these, only the red blood cell does not participate in the complex communication system that controls cellular behavior, including growth, regeneration, inflammation, and healing of tissue.

The “words” of communication are growth factors and cytokines (among others). They function by activating cellular membrane receptors that in turn initiate cascades of intracellular biochemical interactions that reach all the way to the nucleus, up-regulating and down-regulating genetic behavior – powerful signals, indeed. Below is a simple schematic of a cell receptor being activated; below that an example of the consequential complex intracellular events of that activation that determine whether a cell divides, differentiates, migrates, or performs any one of a myriad of other possible actions. Growth factors and cytokines make tissue healing, and indeed life itself, possible.

Growth Factors and Cytokines Never Exist in Isolation

There are dozens and dozens of bio-signals in the orchestra of healing; they never exist as single substances.  Because of the complexity of cellular communications, they may have resultant complementary or opposing effects. It  is always the net “pattern” present that determines the physiologic effect. When cells are cultured in the laboratory to harvest growth factors and cytokines as an ingredient for an anti-aging skincare product, or an adjuvant useful for microneedling, the sources of the bio-signals, and particularly the type of cell cultured, is of paramount importance. It determines the type and character of bio-signals produced and their relative concentration. As demonstrated below, these are both important considerations when selecting the optimal source from which bio-signals for anti-aging and microneedling should be obtained.  As a starting point, we need a brief word on inflammation and healing, particularly in the skin.

Inflammation – Not a Good Thing when it comes to Skin Healing

By now, nearly everyone is aware that inflammation is the enemy of good health when it is of the chronic smoldering variety. Inflammation is associated with nearly every disease, malady, or debilitating condition of the elderly. It is also associated with aging of skin and all that comes with it including abnormal pigmentation, redness, wrinkles, fine lines, etc. In darker skin types, inflammation of any sort is notorious in producing abnormal pigment patterns. Aesthetic treatments that cause deliberate tissue damage in order to promote new younger looking skin may have undesirable results (fibrotic healing or abnormal pigmentation) with inflammation as the primary culprit.

inflammation should be considered a good thing except in those cases where mother nature is concerned with destroying pathogens or mopping up damaged or dead tissue – like in the very old days when a cave man was bit by an animal or cut his leg on a rock. Modern hygiene and sterile medical procedures make the inevitable inflammation seen after trauma somewhat unnecessary and potentially counterproductive to producing the most pleasant aesthetic result. For that reason, BFT considers products that are pro-inflammatory, especially when intended for chronic use, less than desirable.

Considerations as to Which Cell Type is Optimal for Culture

In choosing a product for topical skincare or microneedling that contains human derived growth factors and cytokines, there are three principal considerations as to what is the best cellular source for the bio-signals – what is the pattern, and what are the concentrations, of the bio-signals produced by that cell in culture, and how are the growth factors and cytokines being processed. While assays provide precise answers to these questions (and examples will be provided below), good insight can be gleaned by examining the physiologic role each type of cell plays in the body, and the ways in which products are produced from the cells after culture. Brand names are not important for this exercise. BFT will let that be the readers’ homework assignment.

Major Bio-signals of Interest

This chart lists the growth factors and cytokines primarily involved in healing and regeneration of tissues. Of particular note is that nearly all can be categorized according to their impact on inflammation, either acutely or chronically pro-inflammatory, or anti-inflammatory. These distinctions are important when one determines if a growth factor and cytokine “cocktail” in a product is likely to promote inflammation or quench it.

Cytokine Patterns Produced by Cell Cultures differ Dramatically

It is not surprising that cell culture growth factor and cytokine outputs vary dramatically because the cells cultured perform completely different physiologic roles. It is also not surprising to learn that stem cells, in particular, are prolific producers of cytokines and growth factors since that is an important function they serve in tissue, influencing the behavior of other cells. Adipose (fat) derived and bone marrow derived mesenchymal stem cells are cultured but produce dramatically different growth factor and cytokine patterns, consistent with the fact they perform markedly different functions in life.

It is now well recognized that fat is a pro-inflammatory “endocrine organ”, associated with increased incidence of many diseases that increase in incidence with age, most notably cardiovascular disease, diabetes, cancer and others. Bone marrow mesenchymal stem cells, on the other hand, are now recognized as the body’s commander-in-chief of healing in all tissues. Although these cells originate in the bone marrow, like red and white blood cells and platelets, they enter the vascular system enabling them to “patrol” all tissues.

When injury is encountered, bone marrow stem cells can differentiate into specific types of repair cells (e.g. bone, muscle, cartilage, skin, etc.) but that appears to be a secondary role. Their more important function is to orchestrate the healing process by acting as smart mini-drugstores, essentially instructing other cells how and when to participate in tissue repair. A chief function is modulating and dampening the inflammation associated with injury and the early healing phases. The growth factor and cytokine patterns of adipose and bone marrow mesenchymal stem cells in culture are below and consistent with their very disparate physiologic functions. The “teeter-totter” schematic is useful in demonstrating the comparative difference in the pro-inflammatory and  anti-inflammatory nature of the growth factors and cytokines produced by adipose and bone marrow stem cells. As discussed above, if the effort is to provide anti-aging benefit, particularly in a product intended for daily use, an anti-inflammatory bio-signal pattern is clearly preferable. Which brings us to PRP (platelet rich plasma), now popular for use with microneedling.

As mentioned above, PRP presents a conundrum of sorts. While true that platelets contain beneficial growth factors and cytokines, they also are sources of some of the most powerful pro-inflammatory cytokines, specifically TNF-α, Il-1, and Il-6. Furthermore, medical microneedling (at depths capable of producing injury to dermal capillaries) results in varying degrees of tissue bleeding that will itself result in platelet cytokine activation. Recall that the first phase of healing, whether a wound is sterile or contaminated, involves inflammation from platelet activation. The question: Is there value in promoting more robust inflammation through the use of topical PRP during microneedling? BFT is not convinced that is a good idea.

Nor is Dr. Lance Setterfield, the author of The Concise Guide to Dermal Needling, whose opinion is that inflammation should be minimized, not promoted. His hypothesis is that the injury of keratinocytes within the upper layers of the skin is sufficient to stimulate release of pro-healing stimulatory growth factors and cytokines and that deliberate use of pro-inflammatory topical adjuvants may be ill advised  and potentially detrimental.

For an in depth discussion of the science supporting the microneedling, BFT highly recommends his book which can be purchased through amazon.com or his website, www.acaciadermacare.com.

Fibroblasts, the First Cells Cultured to Obtain Growth Factors and Cytokines for Skincare is a Questionable Choice

Fibroblasts are poor producers of bio-signals. In a study that compared the production of important growth factors and cytokines by fibroblasts to that of bone marrow mesenchymal stem cells determined that the latter produces 15 to 50 times more bio-signals. The same study showed that bone marrow stem cells use bio-signals to promote fibroblasts to “proliferate, migrate and increase expression of genes important in wound repair.” It is clear from this study that fibroblast are the corporals taking orders their orders from bone marrow stem cells. (Mesenchymal stem cells induce dermal fibroblast responses to injury; Experimental Cell Research Volume 316, Issue 1, 1 January 2010, Pages 48–54 This is yet another article pointing to the important role bone marrow mesenchymal stem cells play in skin healing.  A number of earlier articles gave similar insight.

  • “A significant number of bone marrow cells traffic through both wounded and non-wounded skin.” J Cell Physiol. 2003 Aug;196(2):245-50
  • “The bone marrow contribution to normal skin and healing of cutaneous wound is substantially greater than the previously recognized.” Stem Cells. 2004;22(5):812-
  • “BM-MSC-treated wounds showed rapid closure and increased collagen synthesis, cellular proliferation and angiogenesis, and decreased expression of pro-inflammatory cytokines.” Tissue Eng. 2007 Jun;13(6)
  • “Bone marrow-derived cultured stem cells delivered in a fibrin spray accelerate healing in murine and human cutaneous wounds.” Tissue Eng. 2007 Jun; 13(6)
  • “Bone marrow stem cells participate in tissue repair through remodeling and regeneration of damaged areas.”  Stem Cell. 2008 Spring

An important article, supportive of the use of bone marrow stem cell conditioned media in anti-aging skincare products and microneedling, concluded: “…evidence shows that administration of BMSC-derived conditioned media can produce the same beneficial effects that are observed after stem cell therapy.” In other words, the nutrient broth from cell culture, after the cells had been filtered out completely, had the same efficacy as the cells themselves. Bone Marrow Research, Vol. 2011, Article ID 207326

Not Fish, Not Fowl

Which brings us to an interesting way in which to deliver cell culture-derived growth factors and cytokines to skin – and one BFT does not consider scientifically valid – slather on some hamburger! What, you say, can that possibly mean? Consider this: if one were to grow a large number of cells in culture, then discard, not keep the conditioned media in which they were grown, then freeze and thaw all the cells until they ruptured (scientifically termed “lysed”), you would have replicated the technique used by some companies to create topical skincare products. So instead of applying growth factors and cytokines, you’d be applying all the parts of the cell (membrane, cytoplasm, organelles, RNA, DNA), exactly what is in hamburger – all the cell and cell parts.

BFT sees two major problems with this as a concept in general, and one when considered as a strategy for use in microneedling.

1) The cell remnants applied to the skin, on a molecular basis, would be huge, unable to penetrate the stratum corneum to any meaningful degree.

2) As discussed many times on the blogsite, cells communicate using specific molecular bio-signals called growth factors and cytokines (and others.) Cell secrete these molecules into the fluid in which they live, which then diffuse to nearby cells, activating cellular membrane receptors and thereby influencing the behavior of the nearby target cells. This type of signaling, called paracrine signaling, is not likely to happen if the bio-signals secreted into the nutrient broth during culture are flushed down the drain and only the cellular “puree” is applied to the skin. Nature does not work that way.

3) When used with microneedling, such large molecular substances will have ready access to deeper layers of the skin since its barrier function has been temporarily breached by the thousands of tiny needle perforation. Such a scenario could possibly lead to genetically foreign material gaining access to the skin, leading to potential immunologic attack. Such attack is inflammatory in nature, not a good thing to promote improved aesthetics.

Fibroblasts from fetal skin and parthenogenic embryonic stem cells (unfertilized human ova chemically induced to proliferate), are used to make lysed cellular ingredients for skincare. On intact skin, BFT is of the opinion that improvements may be as much related to the “spackle” effect (like patching plaster cracks in a wall) as opposed to cellular responses to growth factors and cytokines. We are willing to learn, however, if someone affiliated with the companies making these products would care to discuss the science further.

What Should you Do?

A general consensus is beginning to develop among experts in the microneedling field and that is material foreign to normal human skin should not be applied during or for the first few hours after microneedling. In this way, the potential of foreign substances, a.k.a. “troublemakers”, entering into the skin will not exist, hence they will not be able to initiate adverse reactions. (Keep watching BFT, as we are now receiving more and more examples of adverse reactions from microneedling misadventures where substances foreign to human skin gained access, producing nasty allergic and inflammatory conditions, some quite severe and likely to lead to permanent disfigurement.)

What the BFT docs did.

We’re not secretive about our day jobs – we are physician/scientists who work with bone marrow mesenchymal stem cells. Our approach to microneedling was to create a topical product that contains only substances normally found in the skin: hyaluronic acid, growth factors and cytokines from laboratory culture of bone marrow stem cells, and for some product, additional TGF-beta 3, the superhero molecule of anti-inflammation. Many thousands of treatments over the past several months, very impressive results, and not a bad reaction among the lot.

20 Comments

  1. Mike says:

    What do you recommend for someone who has all kinds of scarring. from deep pits to shallow ones and pigmentation and rolling scars. Will micro needling and using a product containing “hyaluronic acid, growth factors and cytokines” help improve the appearance of the skin for someone who had acne in his early teens? I do not want to go the Laser route because the risks are too great at this point and I have come to accept my skin for what it is, but it doesn’t hurt to try and improve things. What size micro needle works best for scars? I have been using RETINA for the past 4 years everyday.

    • Cristina says:

      Microneedling with growth factor or with PRP Platelet Rich Plasma (vampire facial) Amazing results for acne scarred skin, stretch marks, anti-aging a collagen boster.
      Microneedling, way to go!

  2. Scott says:

    I’m hoping you can help clear up some misconceptions for what and when b-FGF should be used. This question is in regards to micro needling in particular.

    Many post-micro needling serums contain b-FGF, and others claim to promote it eg. snail snot cream.

    95% of micro needling treatments, however, are in hopes in increasing collagen, yet in every study I have seen regarding b-FGF it has been shown to directly inhibit collagen production.

    b-FGF has been shown to heal wounds particularly well and without scarring, so this leads me to believe that it should only be used when healthy skin is broken and the hope is to repair it back to the same condition before the immediate cause of breakage eg. after surgery to prevent a hypertrophic scar from forming at the point of incision.

    Is my thinking correct? And if so, would it also be beneficial following micro needling of a hypertrophic scar to reduce localized collagen and shrink the scar (similar to localized cortisone injection)? Or are collagen builders still preferred even when micro needling hypertrophic scars?

    Thank you for your guidance.

    • drjohn says:

      Scott- b-FGF is angiogenic (promotes blood vessels) and is not as collagenic as TGF. Good in an anti-aging mixture, but not so much on its own. The real star of the show in terms of scarring is TGF-B3. It is the single growth factor responsible for scar-free (non-fibrotic) healing in fetuses. It also shuts down TGF-B1, which is inflammatory, and responsible for all sorts of problems in skin. Collagen builders are good, because scars require remodeling. Chew up the old fibrotic tissues, and replace with fresh new collagen. Thus there needs also to be MMP’s (proteinases) and TIMP’s (inhibitors of proteinases) in the right balance to achieve aesthetically pleasing remodeling.

  3. Patrick says:

    Great article! You deliver scientific info in a way that most can easily understand – thanks! Everything I have read here is positive…my question is concerning the possibility of these GF overproliferating and potentially causing cancer. Most of the research I’ve read are studies based on short-term research (usually 3 months or less). Can you direct me to longer-termed data that could help ease my fears that long-term use of GFs can result in this unwanted adverse event? Thanks.

    • drjohn says:

      Patrick – great question. The honest answer is this – it depends on the source of the growth factors (and cytokines, and miRNA’s, etc). In fact, I cannot reassure you if the growth factors come from fat(adipose) stem cells, as there is a rapidly growing literature linking these to certain cancers. On the other hand, a cocktail of anti-inflammatory growth factors from bone marrow stem cells seems to have a tumor suppressive effect and is even being used to treat certain cancers. The difference lies in the secretome – which growth factors and cytokines are being released. Inflammatory or anti-inflammatory.

      It is time for us to address this topic more fully in a complete post. As a starting point I am going to link here to a very new scientific reference. But this is the tip of the iceberg. We will be revealing the whole picture in a post in the next few days.

      Leptin produced by obese adipose stromal/ stem cells enhances proliferation and metastasis of estrogen receptor positive breast cancers

      Contrast this with:
      Exosomes from bone marrow mesenchymal stem cells contain a microRNA that promotes dormancy in metastatic breast cancer cells

      The best long term safety data comes from the fact that growth factor products have been in the marketplace for over a decade – and as far as I am aware there is not a single case report of a cancer of any sort being linked to such topical treatments. Of course, these are from fibroblasts and bone marrow stem cells; we are just now seeing the first adipose-based products hit the market. As you can guess, we have major concerns about those being applied daily to skin.

  4. Jae Z says:

    Hi Drs. John and George,

    Patrick’s and Scott’s questions have raised my own:
    I have been reading a lot about microneedling and am considering it for myself for mild to moderate rolling acne scars and post-acne enlarged pores. I am considering both ProCell and anteAGE MD which as far as I can tell are very similar – cytokines and GF derived from adult (not sure in ProCell’s case but I emailed Dr. Schwartz to ask) human bone marrow mesenchymal stem cells. (Actually, I would really love if you guys could tell me what the differences are – or may be – between ProCell and AnteAGE MD, as I think I have gotten pretty much to the limit of my ability to suss it out for myself).
    Based on the points Scott was bringing up, would you recommend AnteAGE MD for immediate post-needling treatment for acne scars, or only for anti-aging?
    And based on Patrick’s question, if someone had a BRCA1/2 gene predisposing them to breast cancer, would shallow (i.e. “home device” depth) microneedling of the chest area followed by application of AnteAGE MD or similar potentially make them less likely to develop breast cancer? Would applying AnteAGE MD topically (without needling) potentially have a similar effect?
    Thank you so much for your response, I would so appreciate answers. And thank you for your wonderful blog.

    • drjohn says:

      ProCell MD and AnteAge MD microneedling solutions are identical. Use either one for microneedling (during and for the first 4 hours or so thereafter, until the micro-channels are plugged and sealed). Then in the period between microneedling treatments use the stem | growth factor serum & accelerator system applied twice daily. Both AnteAge and ProCell sell those as well.

      Stem cell derived growth factors to reduce susceptibility to cancers is a theoretical possibility, but not enough data yet to make any scientific conclusions. But as long as the cytokine profile is anti-inflammatory, and does not contain excess adipokines (growth factors abundant in adipose stem cells) we believe them to be safe.

  5. Curious says:

    This was shocking to read:
    “As mentioned above, PRP presents a conundrum of sorts. While true that platelets contain beneficial growth factors and cytokines, they also are sources of some of the most powerful pro-inflammatory cytokines, specifically TNF-α, Il-1, and Il-6.”

    A PRP/vampire face lift was on my wish list for the future.

    Also this:
    “Fibroblasts from fetal skin and parthenogenic embryonic stem cells (unfertilized human ova chemically induced to proliferate), are used to make lysed cellular ingredients for skincare.”

    In light of the Ohui evaluation, this means that the stem cells that Ohui uses are suboptimal in relation to marrow stem cells. Since those types of stem cells take their order from marrow stem cells?

    Finally:
    “On intact skin, BFT is of the opinion that improvements may be as much related to the “spackle” effect (like patching plaster cracks in a wall) as opposed to cellular responses to growth factors and cytokines.”

    So using a marrow stem cell product will deeply rejuvenate the skin whereas a fibroblast one won’t?

    • drjohn says:

      Stem cell growth factor procedure serums are replacing PRP for skin. For orthopedics, PRP is still the thing. Skin doesn’t want inflammation.
      See Dr. George’s table Stem cells make 10-50 times as much of the good stuff as fibroblasts. Which cell is the healing cell of the body? makes perfect sense.
      Yes, fibroblasts are the worker bees. Stem cells are the queen bees.
      Fibroblasts do make rejuvenating GF’s and cytokines. Just 1/10 to 1/50 as much. Compare efficacy and cost.

  6. Curious says:

    With the PRP technique is it ok to use with other procedures like fat transfer to the face or other parts of the body?

  7. Curious says:

    Thank you so much Dr. John!

    I reread the article and keep referring back and forth between the two trying to get everything clear in my head. I really appreciate your clarification – it made it simple.

  8. Risa says:

    hey there! I just found your site and have already ordered a trial size of your anteage and can’t wait to try it! This is probably a stupid question but I read so many things on the internet about butylene glycol. most sites say it’s safe and others don’t and I know it’s in the accelerator cream and wondering why you chose this ingredient instead of another. I also find glycerin to be drying, not sure why I don’t have dry skin. on another note I have decided to dump all other skin sites and read yours 🙂

    • drjohn says:

      Risa, thanks for the vote of confidence. Butylene glycol is safe, and glycerine is drying but there are such tiny quantities in our product (a tag along from another ingredient that uses it as a carrier) that it should not be a worry. There any a number of superb moisturizing and moisture retaining ingredients in it as well.

  9. Anne says:

    Hi, I haven’t been able to find much information about how to use the Home Needling Solution. Is one entire 1.7 ml bottle intended to be used after medical needling? Cosmetic needling can be done up to every day, so unless the 1.7 ml is to be spread over multiple uses, the set would not last long. For medical needling, would you recommend using the Home Needling Solution immediately afterward, then waiting several hours before using other products? When can AnteAge Serum and Accelerator be used?
    How long the channels remain open is unclear to me; in Dr. Setterfield’s book, he says “the tiny holes caused by the [cosmetic] roller in the epidermal layer seal naturally within one hour” (p. 93), and under Medical Needling Protocol, “there is only a short window of time to apply any actives or serums as the needling channels generally close within about 10-15 minutes” (p. 102). So actives should be applied within 10-15 minutes, and any other products at least an hour later?
    Thanks, and I’m looking forward to trying these products!

    • drjohn says:

      Great questions, Anne. In terms of Dr. Setterfield’s book, he tells me this is not what he currently teaches in seminars, and that he is working on a revised edition. I believe he speaks to this on his website as well. Cosmetic microneedling (.25-.3 mm needles) penetrate the stratum corneum (SC) only, and thus do not present the same risk as medical needling at 0.5mm+. Also the channels are smaller, and SC is actually pretty swift in secreting ceramides and other gluey molecules to close any small gap. We recommend avoiding applying any “non-native” molecules until 2 hours after. Non-native means anything not made by humans naturally. Of course, the AnteAge microneedling solution is native human growth factors, cytokines, and hyaluronic acid. The serum and accelerator contain additional plant-derived materials, so we tell users to wait two hours before applying. The AnteAge home microneedling solution can be used sparingly and will last for 2-4 sessions. If you are needling every day, it would run out quickly. Dr Setterfield says you can needle cosmetically every day, but he himself only does a few times a week. I like to give the skin 3 or more days in between, because the therapeutic effect most certainly does not fade that quickly. Our best results are seen when you use the AnteAge serum/accelerator daily which I believe (in theory) extends the benefit of 0.25mm needling so that 1-2 per week is optimal.

  10. Tracy says:

    Hi and this is absolutely the more educational article I have read in a long time. I am looking at microneedling with PRP for sporadic under eye bags, fine lines, hyperpigmentation and general anti aging but I have rocacea and very youthful skin so have concerns about inflammation. I use skin medica today but haven’t seen much of a difference so my question is what would you suggest microneedling starting at a very low gauge and adding a serum or the PRP. Thanks!!

    • drgeorge says:

      Microneedling continues to impress us with its utility and effectiveness for most aesthetic concerns. Surface texture, pigment abnormalities, fine lines, and rosacea all respond well. We are not great fans of PRP since the trauma of dermal needling itself will cause damage sufficient to activate platelets when medical (longer) needle lengths are used. PRP has beneficial bio-signals but also is heavily laden with pro-inflammatory cytokines. We know from the fetus that inflammation is NOT needed for skin healing, and in fact can be counterproductive if chronic and persistent. Remember that inflammation plays a major role in promoting abnormal pigmentation and fibrosis. Occasional PRP sessions is unlikely to create problems. We just don’t think it is needed.

      As far as SkinMedica is concerned, their topical products with growth factors contain fibroblast conditioned media. Fibroblasts are very weak producers of growth factors and cytokines which is the major reason TNS serum has such a high concentration of conditioned media, which accounts for its “smelly socks” odor. Drjohn and Drgeorge, working in consultation with Dr. Lance Setterfield (the author of The Concise Guide to Dermal Needling) have developed microneedling products formulated especially for this purpose. By all means, do not apply topical products with ingredients that are foreign to the skin as you may be setting yourself up for nasty allergic reactions. BFT has had several women send us photos with serious reactions to products containing so-called snail growth factors. It turns out their is a 60-70% cross reactivity between snails and dust mites, one of the most common allergies. BFT covers all these topics. We suggest you poke around a bit and your questions will be answered in depth.

  11. Johan says:

    Great article, thanks for sharing. I designed a simple at home microneedle serum for use during application, 1.5mm depth needling with the purpose of improving acne box scars and hyperpigmentation. Trying to only use bio identical materials.

    Allantoin 0.3%
    Epidermal Growth Factor BT 0.00005% (Skinactives – think it would be beneficial?)
    Glutathione 1%
    Glycerin 3%
    Hyaluronic Acid 0.5% (Vegetable derived, high MW for gelling fx)
    L-Asorbic Acid 5%
    Lecithin 1%
    Sodium Lactate x% (x = amount required to get pH 5)
    Tocopherol 1%

    Made fresh with sterile techniques so preservatives are not required.
    Lechithin in this case would be derived from Soy, think that could cause problems? Better options could be Esters of monoglycerides of fatty acids (E472a-f) or Mono- and diglycerides of fatty acids (E471).

    • drjohn says:

      According to the world’s leading expert in microneedling, just about any non-native (non-human) molecule can be a troublemaker right after microneedling, until the channels created have clotted and closed off to reseal the barrier That includes even Vitamin C (which was the putative suspect in two cases of granulomatous reaction published in the AMA journal). And you are talking mere picograms of EGF so I see not much risk, but as we often say around here, EGF is not the best GF to use alone for microneedling (OK in combo with others), or for collagen synthetic boosting in general. I would think that to amplify microneedling’s know effect of collagen induction you would favor the FGF’s (fibroblast growth factors 1,2,5) since they are far more stimulating to collagen production. And to reduce scarring i would add a big dose of TGF-beta 3 which is the most anti-fibrotic (anti-scarring, scar-revising) of all the GF’s.

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