Why ultra micro-needling is the latest and greatest collagen-boosting treatment.

Collagen is the most important element of youthful-looking skin, keeping our skin plump, taut and firm. When we’re young, we have plenty of it; it’s deep down in the dermis, supporting the structure of our skin. And we can make plenty more of it. As we age, however, not only does the amount of collagen in our skin decrease, our ability to produce it tapers off as well. And that’s why our skin starts to sink and sag, and give in to the pull of gravity.

Over the past few decades, dermatologists and aesthetic surgeons like myself have made it our mission to develop better treatments that can stimulate collagen production deep below the surface of the skin that can help achieve and maintain a firmer appearance.  

In the past few years, micro-needling, a technique that uses tiny little micro needles to mechanically penetrate the skin and stimulate collagen production, has become popular. When the top layer of skin is injured in this way, the body responds by producing collagen to repair it. The original form of micro-needling uses little mechanical hand-held rollers, with needles 1-2 millimeters that were rolled onto the skin to create the injury.


Micro-needling has become quite fancy now. I’ve been using Fractora, a system that uses small stamps instead of rollers to apply the micro-needles into the skin. Fractora also delivers radio frequency energy through the micro-needles, so now there is a heat component to the treatment, which amplifies collagen production and skin tightening as well. So it’s almost like doing a very mild fractional resurfacing (you may have heard of Fraxel, that’s the brand name of the fractional resurfacing machine) at the same time as the micro-needling treatment. That’s why I call this radio-frequency-boosted micro-needling "ultra" micro-needling. 

I can even introduce antioxidants through the tiny needles, for example I administer a combination antioxidant serum on the skin at the time of the procedure which also facilitates healing. (Medications, such as Minoxidil for the scalp, can also be administered with the use of microneedling.)

Fractora by InMode

I perform Fractora in our SkinLabRx on-site Medspa in a series of 3 treatments, 6-8 weeks apart, to address texture, tone and pigment. The ideal candidate has fine lines and wrinkles, brown spots and sagging and is looking for overall improvement in these specific areas. (If you have dark skin, this may not be for you, as darker skin tones are more likely to have post-inflammatory hyperpigmentation, or dark marks that show up as part of the healing process.)

The results have been pretty impressive. Texture, brown spots and fine lines all improve relatively quickly because of the fractional resurfacing. Reduced wrinkles and increased firmness take a bit longer to see as collagen production takes 3-6 months in the dermis, but the improvement is excellent. Acne scarring, which micro-needling was originally developed for, shows significant improvement but may need a few more treatments. 

There’s really no downtime to ultra micro-needling. I do the procedure on clean skin, then immediately apply a highly concentrated antioxidant, like CE-Ferulic from SkinCeuticals, to speed up the healing and then cover the skin with Hydrabalm or Aquaphor healing ointment. You may see pinkness for a few days, and even a little peeling due to the radio frequency. Fractora is not a painful treatment, which is one of the reasons I like it so much. I really don’t like to inflict pain on my patients in the name of younger-looking skin.

Before having this treatment, make sure to be evaluated by a Board Certified specialist in one of the core aesthetic specialties: plastic surgery, dermatology or facial plastics


  1. SkinLabRx