When Angelina Jolie attended the Cannes Film Festival this year, she caused a stir -- and not just on the red carpet. Beauty boards buzzed about her radiant skin, speculating on the recent transformation. Was it plastic surgery? A chemical peel?
British magazine Grazia claimed to have the inside scoop -- derma rolling. Also known as needling or Percutaneous Collagen Induction (PCI), derma rolling has been around for at least the last five years, but a recent interest in DIY med-spa treatments has propelled it back onto the beauty scene, and into the realm of celebrity conjecture.
The technique seems oddly primitive, especially in these days of lasers and cosmeceuticals. Its primary tool is a hand-held derma roller, a small, narrow device (rather like a tiny paint roller) studded with almost 200 fine surgical steel micro-needles -- common lengths are 0.5 millimeter, 1 millimeter and 1.5 millimeters. (Smaller lengths are designed for the face; longer lengths are used for the body.) The device is rolled over the skin and produces multiple mild pin pricks.
The object of the process, which can be quite painful, is to stimulate collagen production by injuring the skin through those hundreds of punctures.
"Theoretically, any injury to the skin should instigate a process of wound healing by stimulating the production of more fibroblasts and collagen," says Denver-based plastic surgeon Dr. Christine Rodgers.
And more collagen theoretically means smoother skin, as collagen is the protein responsible for skin elasticity; its breakdown leads to wrinkles and scarring.
South African plastic surgeon Dr. Des Fernandes pioneered derma rolling, and a study conducted in South Africa and Germany and published in 2008 evaluated its effects on 480 people. Each participant first applied topical vitamin A and C creams, then each was treated with a derma roller up to four times weekly for four weeks. Scientists evaluated tissue samples from 20 participants and found a "considerable increase in collagen and elastin," according to the report.
Plastic surgeon Leonard B. Miller, clinical instructor of surgery at Harvard Medical School, offers Percutaneous Collagen Induction treatments at his practice and says the procedure is particularly effective in improving skin texture and reducing wrinkles on the forehead. But he emphasizes that not all skin reacts the same way -- some will have excellent results while others may see little change.
Manufacturers such as Roll-Cit ( www.environ.co.za) and Dr Roller ( www.dr-roller.com) make a couple of claims for their hand-held rollers. First, they say, the rollers stimulate collagen production to help reduce acne scarring, stretch marks and fine lines. Second, they say, the rollers help the skin absorb treatment creams more effectively -- they liken it to aerating your lawn when fertilizing.
If such images put you in mind of some sort of medieval torture, you're not alone. "Several of my patients have tried them," says Beverly Hills dermatologist Dr. Jessica Wu. "None of them would do it more than once because of the pain."
And pain aside, some experts question whether the treatment can really produce significant results. "What are the visible changes in the skin?" Wu asks. "Just because a biopsy shows more collagen doesn't necessarily mean their skin looks or feels any better. Maybe the improvement was due to the vitamin creams, not the roller."
Adds Dr. Ronald May, former chief of dermatology surgery at UCLA: "A lot of pins in the skin will do much less than fractional laser treatments."
Rodgers speculates that the rolling process could produce additional scar tissue that could possibly fill in acne scars, "but I doubt that this would feel like new youthful, soft skin. I think the skin would feel more fibrous and firm, rather than softer and glowing."
But some consumers who have used the rollers vouch for the results. San Diego-based website designer Loren Ellis first heard of the treatment on a beauty forum where she read rave reviews. She tried the device in conjunction with Retin-A Micro. "My skin turned bright red after the first use, but the redness went away overnight," she says. It took another two weeks for her to notice any results: "My forehead lines had practically vanished." However, she admits the device wasn't as effective on other areas of the face such as the cheeks, and she says she's a "bit paranoid about sanitation," replacing the roller monthly.
Most experts agree that sanitizing the roller is one of the biggest concerns. Manufacturers recommend using the device only once, but as it comes with an $80 price tag, many consumers are trying to sterilize it at home. "Since the rollers penetrate the skin, the problem of infection is always a possibility. You must be cautious that everything is sterilized clean," says L.A.-based dermatologist Dr. Ava Shamban.
Roll-Cit offers a $154 kit that includes the roller and a cleaning solution. Using the roller with moderate pressure that does not cause bleeding also reduces the risk of infection.