MTS Therapy

Microneedling Therapy System (MTS) is a procedure that uses a special device, such as a roller or motorized pen, to insert fine, short needles (usually made of surgical stainless steel) vertically into the skin, creating numerous microscopic wounds or punctures.

The length of these needles varies from 0.13 mm to 3.0 mm, depending on the device and depth of treatment. These controlled microscopic wounds trigger the skin’s natural wound healing process. This process involves the release of various growth factors that promote the proliferation of fibroblasts and the synthesis of new collagen and elastin fibers in the dermis. The microscopic channels created by the needles also significantly enhance the skin penetration and absorption of topically applied skin care products, allowing the active ingredients to bypass the skin barrier and reach deeper layers, where they can be more effective.Studies have shown that this absorption can be increased by up to 1000 times. The depth of penetration of the needles can be adjusted by a trained professional depending on the specific skin concern being treated and the area of the face or body being treated. Short needles (0.25-0.5 mm) are often used to promote product absorption, while long needles (1.0-2.5 mm) target deeper skin concerns such as scars and wrinkles.

Some advanced MTS devices use fractional radiofrequency micro-needling (FRM), a method that combines microneedling with radiofrequency (RF) energy delivery. This combination delivers thermal energy deeper into the dermis, further stimulating collagen remodeling and improving skin elasticity. The effectiveness of MTS is based on the principle of “controlled skin damage,” which stimulates the body’s own regenerative processes, leading to long-term improvements in skin structure and function.

Although collagen induction through wound healing is the most well-known mechanism of microneedling, additional mechanisms have been proposed, including.

Principle of percutaneous collagen induction (PCI) through microinjury

Microneedling, also known as Collagen Induction Therapy (CIT), is a procedure that uses tiny needles, often thinner than a hair, to create numerous controlled micropunctures or microchannels in the epidermis. The procedure is minimally invasive and epidermis-sparing, with the advantage of a shorter recovery period and lower risk of side effects compared to traditional ablative procedures.

Stimulates the wound healing process

The microscopic damage created by microneedling locally triggers the physiological wound healing process described above. During the initial inflammatory response, various growth factors such as PDGF, TGF-α/β, CTGF, and FGF are released from platelets and inflammatory cells. These signals promote the proliferation and migration of fibroblasts, which actively produce ECM components including new collagen and elastin, thereby remodeling the dermal layer and increasing skin thickness.

Enhanced transdermal drug delivery

Another important mechanism of action of microneedling is its ability to significantly enhance transdermal drug delivery (TDD). Microneedles physically penetrate the stratum corneum, the outermost barrier of the skin, forming numerous microchannels. Normally, the stratum corneum greatly restricts the skin penetration of large molecular weight or hydrophilic substances (some sources state less than 0.3%), but the microchannels created by MTS can bypass this barrier, allowing various effective ingredients such as vitamins, growth factors, hyaluronic acid, tranexamic acid (TXA), PDRN, and exosomes to effectively penetrate deep into the epidermis and dermis. This dual action of microneedling, its ability to maximize the delivery of active ingredients alongside its own collagen-inducing effects, makes microneedling a very versatile platform for skin improvement. Depending on the type of topical agent used in conjunction with the procedure, the treatment’s effectiveness can be tailored and augmented for specific skin concerns. For example, brightening agents such as tranexamic acid or vitamin C may be used in combination for melasma, while growth factors, PDRN, hyaluronic acid, and exosomes may be used in combination for skin regeneration or elasticity improvement.

Additional mechanism of action hypothesis

Although collagen induction through wound healing is the most well-known mechanism of microneedling, additional mechanisms have been proposed, including.

• Bioelectrical Signals

A hypothesis proposed by Liebl et al. is that when microneedles approach the cell membrane, the cell membrane potential temporarily changes significantly (from -70 mV to -100 mV), which can induce increased cell activity, release of proteins and growth factors, and migration of fibroblasts. From this perspective, microneedling can induce cell proliferation through electrical signals without actual injury. In addition, it is possible that it can help epithelial cell migration and healing by restoring damaged transepithelial potentials (TEPs).

• MMP Induction

It has been speculated that the expression of matrix metalloproteinases (MMPs) induced by microneedling stimulation may contribute to the reduction of hyperpigmentation. Since MMPs are involved in ECM degradation and remodeling, they may also play a role in improving scar tissue.

• Keratinocyte Regulation

It may contribute to restoring cellular balance by downregulating the hyperproliferation of keratinocytes observed in acne patients.

• Melanocyte Regulation

The mechanism by which growth factors (MGF, KGF, EGF, etc.) released after microneedling can improve pigmentation by normalizing signaling between keratinocytes and melanocytes and regulating melanin production has been proposed.

These additional mechanisms suggest that microneedling may have multifaceted effects beyond simple wound healing stimulation, through electrophysiological changes at the cellular level and direct regulation of cell function. However, it is also noted that these hypotheses require further research to be clearly elucidated.

It stimulates collagen and elastin production, significantly reducing fine lines and wrinkles, making skin smoother and more elastic. Collagen production is stimulated, tightening the skin surface and effectively minimizing the size of enlarged pores. It improves the overall skin tone, giving you a radiant, even skin tone and a youthful complexion. It also helps improve hyperpigmentation such as freckles and blemishes, and promotes skin cell turnover and collagen production. This treatment is less invasive and has a relatively short recovery time compared to more aggressive skin resurfacing treatments such as ablative lasers. It is generally suitable for most skin types and tones and has a lower risk of inflammatory hyperpigmentation that can occur after the treatment compared to some laser treatments. It enhances the penetration and efficacy of topically applied skin care products, increasing the delivery of active ingredients. It can be applied to various areas including the face, neck, and body.

Immediate side effects that may occur include skin irritation, erythema, swelling, and potential microbleeding or bruising. There is an increased risk of infection if the procedure is not performed under strict sterile conditions by a trained and qualified professional. Multiple treatment sessions, usually spaced a few weeks apart, are usually required to achieve significant and lasting results. Temporary peeling, flaking, or dryness may occur during the recovery period as the skin regenerates. MTS procedures are generally not recommended if you have an active acne breakout, open wounds or ulcers, skin infections, eczema, psoriasis, a blood clotting disorder, uncontrolled diabetes, or if you are pregnant. A history of keloid scars may also be a contraindication. Home MTS devices may be less expensive, but they can increase the risk of scarring, infection, and inconsistent results if not used correctly or with the proper needle length.