Title: The Dermal Roller in Aesthetic Dermatology in 2019

Desmond Fernandes

University of Cape Town, South Africa


I am a plastic, Aesthetic and reconstructive surgeon and I started needling skin in 1994 with both tattooing devices and simple needles. This developed into Medical and surgical rollers by 1998 when I realised that needling was an alternative to laser treatments. I theorised that needling caused the release of platelet derived growth factors and most likely TGF-beta-3. Vitamin A also stimulates TGF-beta-3 probably from keratinocytes and is an ideal way to prepare skin for needling. Aust did the first laboratory research in skin needling and confirmed the importance of TGF-beta-3. My continuing research focuses on the most effective frequency, depth of penetration and the topical ingredients that facilitate the most impressive results


Skin needling is emerging as one of the most important, affordable ways to treat scars, lax skin, stretch marks and to rejuvenate photoaged skin. It is safe for all colours of skin and never causes permanent colour changes. Fernandes considered it the alternative to laser resurfacing but today more and more people are saying it's the “poor/sensible” dermatologists’ laser - but with better results. Fernandes started with pen-type of devices but moved to rolling devices for better results.There is a wealth of misinformation about roller-type needling versus mechanical pen-style needling. Both are useful but rollers are easier and safer to use. Mechanical devices need good training and constant care to avoid overtreatment. It seems one cannot over-treat with the Roller.

Matthias Aust first showed that activated platelets produce growth factors such as TGF-beta-3 instigate regeneration and rejuvenation of the dermis. Very much deeper needling may recruit Mesenchymal Stem Cells that may take regeneration up a quantum leap. Furthermore Zeitter (with Aust) has shown that needling at 7 day intervals gives even greater changes. Aust also proved that topical vitamin A and C in particular almost quadruple the results.

Experience since 1994 shows that the Vitamin ACE oil is clinically safe in many thousands of cases.Selected peptides help to induce the perfect cocktail of changes for rejuvenation and smoothening out troubled skin.We will show that skin needling, and especially Dermal Rolling is the safest and most effective way to rejuvenate skin and to smoothen stretch marks, acne and burn scars of all skin colours.