Beauty


Carina Jahn/Blaublut Edition/August

In movies about a woman trying to get pregnant, there’s always that scene in which the protagonist looks around and sees nothing but infants in strollers, swollen bellies, signs advertising DJ school for toddlers. I have a similar obsessive streak, but in my movie, I’d be faced with a sea of Rihannas, Cate Blanchetts, Pharrells—flawless visage after flawless visage. I’d stroke my own imperfect cheek and weep.

My skin problems began in puberty with a case of cystic acne that haunted me right up until last year, at age 25. (Aczone, my friends: Ask your doctor about it.) Even though I’ve now got my blemishes more or less under control, I’ve been left with enlarged pores and scars around my cheeks and mouth. For this, I’ve tried all manner of over-the-counter peels, exfoliants, and “miracle” witchy cures (apple cider vinegar shots, anyone?) to no avail.

Then, via the wonderful world of Instagram, I caught wind of the microneedling craze. Microneedling is a process that’s exactly what it sounds like—tiny needles penetrating the skin hundreds of times—usually at the hands of a wand-wielding dermatologist or licensed aesthetician. Popularized in the 1990s by a Canadian plastic surgeon after he found he could fade surgical scars with an inkless tattoo gun, it’s used to treat all kinds of textural woes, from acne scars to enlarged pores. According to Mary L. Stevenson, MD, an assistant professor of dermatology at NYU Langone Health, the counterintuitive process, also known as collagen induction therapy, is thus: The needles create wounds that trigger an “inflammation cascade,” the same natural healing process that occurs when scar tissue is formed after, say, a scraped knee—rendering skin, to crib from Ernest Hemingway, “strong at the broken places.” But because the needles are so short (0.5 to 4 mm, tinier than a garden ant), the process is very controlled. While clinical assessments of microneedling are in their relative infancy, the results are promising: A 2015 study in the Journal of Clinical and Aesthetic Dermatology showed “a noticeable enhancement in skin appearance, post-acne scars, and patient satisfaction” in all 10 patients after six bimonthly sessions. And while lasers are more prone to causing accidental hyperpigmentation in darker skin tones, microneedling does not.

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While microneedling isn’t exactly new, it’s only in the last couple of years that at-home devices have flooded the market. Most DIY treatments involve running a small manual device (think a spiky paint roller) over the skin. Experts agree that at-home rolling should never be done with needles exceeding 0.5 mm—the risk of infection is too high—yet those same experts will tell you that at that particular length, little damage is being done to the skin, and therefore little actual collagen-building is being triggered. Which isn’t to say that at-home rolling is useless. According to Stevenson, DIY devices might increase the effects of certain topical treatments, while Manhattan-based dermatologist Joshua Zeichner, MD, notes that if you’re looking to reduce post-acne hyperpigmentation, the exfoliation “likely may give some effect. You’ll notice I put in three qualifiers.”

After a few weeks experimenting with a 0.3 mm at-home roller, I notice that my skin feels softer but not markedly changed. I want my pores teeny and my acne scars gone—now. And so, on the recommendation of superstar dermatologist Dendy Engelman, MD, I make my way downtown to Jeannel Astarita, the founder of Just Ageless NYC Medical Spa.

A single microneedling treatment runs between $500 and $750, and it’s rarely sold as a one-off (patients with deep scars often opt for a series of three to six treatments). But for my rosacea and acne-prone skin, traditional microneedling could spell disaster (inflammation! Exacerbated breakouts!). It turns out I’m in luck: Astarita can offer the EndyMed Intensif, a relatively new device that couples microneedling with radio frequency to treat both active acne and acne scars. Delivered via 12 highly conductive gold-plated needles, the heat kills acne-causing bacteria and lessens inflammation. (Because it’s basically two treatments in one, it’s more expensive; my treatment, which Astarita provides gratis, would normally cost $1,200.) After cleansing, exfoliating, numbing, and disinfecting my skin, Astarita starts stamping the thicker skin on my cheeks, nose, and chin, programming the needles to go to a depth of 2.5 mm, followed by my delicate undereyes and forehead at 1.5 mm. It’s no more uncomfortable than a light pinch—for the first few pulses. Then the discomfort gradually increases until tears stream down my cheeks. (Astarita explains that because the Intensif uses a slower in-out motion for its needles than straight microneedling, it’s considered marginally more painful.)

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But almost as soon as it begins, it’s over, and Astarita is applying postprocedure topicals—an antioxidant and a skin-strengthener. When she finally hands me a mirror, my face is a shocking shade of burgundy. It subsides to that of a particularly bad sunburn by the time I get home, and the pores on my chin—this isn’t for the squeamish—look like they’re purging sebum. In actuality, “it’s a result of the inflammation,” Astarita texts me the next day during a check-in. “The pores weep.” Per her advice, I slip two damp muslin cloths into the freezer and apply them periodically, feeling not unlike Norma Desmond in Sunset Boulevard’s gruesome makeover scene.

Everyone’s skin reacts differently to these procedures, but it’s typical to be red, dry, and flaky for a few days. I’d planned to work from home on the Friday following my treatment, and at the early-morning sight of my swollen, pink visage, I’m glad I did. I commence a weekend of extreme moisturizing, and by Monday, one colleague remarks upon my smooth skin (hallelujah!).

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By the one-month mark, my pores look definitively smaller, and the scars that have bothered me for years are far less noticeable. Time will tell as to how much collagen- induced filling and tightening I’ll experience—the effects continue to develop for up to six weeks postprocedure—but for now, I’m basking in my own glow.

Smooth Operator

Not ready to commit to an in-office treatment? Here are the tools you’ll need to baby-step your way at home.

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Skimping isn’t an option when it comes to needles in your face—at-home dermarollers like the Rodan + Fields Amp MD Micro-Exfoliating Roller System (1) may help with product penetration. And while in-office post-treatment topicals include injection-grade hyaluronic acid and platelet-rich plasma (via your own blood—as in the vampire facial), there are ultraeffective over-the-counter alternatives. Astarita swears by antioxidants, like SkinBetterScience Alto Defense Serum and SkinCeuticals C E Ferulic, and peptide promoters, like DefenAge 8-in-1 BioSerum (2); Zeichner recommends simple wound-healing balms, like La Roche-Posay Cicaplast Baume B5 (3). “You may have a fantastic micro- needling procedure,” he says, “but if you use the wrong products afterward, you may run into problems.”

1. Rodan + Fields Amp MD Micro-Exfoliating Roller System, $220; rodanandfields.com SHOP

2. DefenAge 8-in-1 BioSerum, $220; defenage.com SHOP

3. La Roche-Posay Cicaplast Baume B5, $11; amazon.com SHOP

This article originally appears in the February 2018 issue of ELLE.

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