By Sandra Low
[Above: South African plastic and reconstructive surgeon Dr
Desmond Fernandes using a 1.5mm needling stamp on the forehead area.]
His youthful skin belies his age, and that could be because
69-year-old South African plastic and reconstructive surgeon Dr Desmond
Fernandes has done more than 50 skin needling procedures on himself.
"Skin needling is very controversial because it sounds wrong," said Dr Fernandes at an interview in Kuala Lumpur recently.
"What we've discovered is that when you prick your skin, it doesn't leave a scar," said the Cape Town-based surgeon.
Dr Fernandes started using the procedure in 1994 to treat lip lines.
It took him another four years to develop skin needling into what is
being practised today.
"If you don't bleed, you won't get the results and that is the part
that most people aren't willing to do!" pointed out Dr Fernandes, who
has written numerous papers for medical publications on various plastic
surgery procedures, methods of improved penetration and skin needling
for collagen stimulation.
This system of skin needling was first described during the 50s by
the founder of mesotheraphy, Dr Michel Pistor, who didn't employ the
method himself but came up with the concept that pricking skin would
promote collagen formation.
Skin needling helps in treating lip lines, lines on lower eyelids and
pigmentation marks, lightening, and in some cases, even removing traces
of scars from superficial to deep cuts, severe acne scars, stretch
marks and chicken pox.
Before needling, topical anaesthetic is applied to numb the skin,
which must be pricked down to the dermis layer where the nerves and
blood vessels are found.
Naturally, when the blood vessel is pricked, it causes bleeding and
this releases the platelet cells inside the blood that carry a mechanism
to clot up blood vessels. At the same time, it carries out a lot of
"When you injure skin tissue, the platelets release growth factors
for the skin to heal. It promotes more collagen and elastin. We found
that TGFB3 (Transforming growth factor beta-3) molecule helps tissue to
regenerate instead of scar," he said.
"When you needle skin, there is a surge of TGFB3. Normally, if we cut
the skin, the TGFB3 lasts 24 hours, but when you needle skin there is a
surge for two weeks."
Having seen the results of skin needling and how it can help with
scars, Dr Fernandes firmly believes that this procedure should be made
available at every Burn Unit at hospitals around the world.
He works with two devices: a roller, which he designed in 1997 and
patented in 1998, and a vertical needling stamp, used like a small
However, he stressed that needling alone will not provide the optimal
results unless it is supported with both vitamin A, which controls the
process for making collagen, and vitamin C which helps to make normal
After losing two young patients to skin cancer, Dr Fernandes came up with his own brand of skincare called Environ in 1990.
This is said to offer high effective doses of vitamin A along with
the right amount of antioxidants vitamins E and C, resveratrol and
beta-carotene that reinvigorate the genes of your skin cells, and make
the skin younger and healthier.
He said that his brand of antioxidant creams were the first cosmetics
to be shown in an international plastic surgery conference in 1994, and
since then, he's been regarded as the "skin guru".
When Dr Fernandes introduced skin needling and the need for the
procedure to be supplemented with his antioxidant creams, he was accused
of making a sales pitch for his own products.
However, he explained that skin needling alone causes skin to thicken
by 100 per cent, whereas using vitamin A and C alone causes only 22 per
cent of skin thickening.
"But if you combine both, you would get 140 per cent of skin thickening, which is the best results.
Dr Fernandes warned that when there is over aggressive needling (as
in using a tattoo gun for needling), it can leave the skin with a nasty
"With a tattoo gun you can remove skin when it is over aggressive.
However, with the roller that I designed that won't happen as it works
on a much lower pressure," he said.
Interestingly, Dr Fernandes is not overly concerned about
over-needling because the bigger problem is under-needling "whereby you
won't get the results of smoother and healthier skin. This process of
needling is the same tattooing process used hundreds of years ago."
He said that tattoos are considered extremely safe, and doctors hardly see complications or hyperpigmentation from tattoos.
"Needling is basically tattooing without ink. When we examined a
tattoo under a microscope, we couldn't find any scar tissue. Even
tattoos that are five years old reveal beautiful smooth skin," he said.
According to Dr Fernandes, when skin is needled, only a low level of
oxygen is involved. Whereas when you cut open your skin it is exposed to
20 per cent oxygen.
"Oxygen is good for us at a certain level for our lungs and tissues,
but we don't want that big amount of oxygen. You cannot survive on pure
oxygen, otherwise it will make you very ill," he said.
Skin needling is quite different from laser treatment as the results
tend to last much longer and skin actually becomes healthier (especially
when used in conjunction with vitamins A and C).
Dr Fernandes claimed that needling is "a topic of discussion at
medical conferences and it's one of the safest procedures that you can
do to your skin".
While you can't do multiple laser skin treatments to smoothen the
skin, you can do several sessions of needling and it makes the skin
"Laser basically burns your skin. When you have a flash burn on your
face, you end up looking several years younger. Later, you get fine
wrinkling of your skin so this procedure will damage skin that cannot be
replaced," he explained, adding that he was horrified that people are
so easily embracing laser skin treatments.
If someone has already undergone laser skin treatments, can needling still be done to improve the skin?
"Yes, with needling she will not only get better looking and healthier skin, she will regain her normal skin," he claimed.
Dr Fernandes said that it's ironic as people don't hesitate to sign
up for a procedure that involves aggressive burning of the skin and yet
balk at the idea of needling, which is backed by hundreds of years of
history and experience.
In Malaysia, a number of beauty salons have begun to offer the
services alongside medical centres. For those who are considering this
procedure or any other beauty treatment, it is imperative that they
consult a recognised trained medical doctor before they embark on the