Q & A with Dr Lance Setterfield

Posted: Feb 06 2016

Q:  Can you apply too much pressure when using a roller?

A: { Dr Lance Setterfield}: Yes and no.  It’s not as straight forward as it seems.  The aim is to apply moderate pressure, but how does one define or describe this?  These are skills developed with experience.  Too little pressure and the needle penetration will be inadequate.  Too much pressure over bone is more painful, and one obviously needs a lighter touch around the eyes or on the nose, for example.    

This question stems from pen companies attempting to create a distinctive difference and asserting that pens deliver a more accurate, consistent depth of penetration, and that rollers are not as safe because technique is user-dependant.  This is marketing spin.  For a start, with appropriate technique, the drum stops the needles from penetrating any further than their actual length.  (One could argue that applying pressure to the skin compresses it so that structures, e.g. nerves, move closer to the surface, thus increasing the chance of injury.  But the same outcome and risks would apply if the identical pressure was applied in error using a pen.)  Secondly, needle penetration has a much larger variance with pens due to insufficient power and speed of the motor, number and grouping of needles, etc.  Many pens do not deliver as deep as indicated by the settings on the dial.  Lastly, needle cartridges in most pens allow the skin to move up inside the cylinder towards the needles when pressure is applied, or when traversing curvatures of the face, thus resulting in greater depths than desired. 

One also needs to consider the length of needle in this debate.  “Precise” pressure is not as critical at 0.5 mm as it would be at 2.5 mm in the context of damaging underlying structures.  Other factors to consider include the area of the body being treated, as well as the sex and age of the patient, etc.  In other words, how thick is the skin in the area being treated?

Dr Lance Setterfield, Medical Director of Acacia Dermacare in Victoria, Canada, was one of the early adopters of this treatment modality and consequently has many years of experience to share. He has vast experience with all forms of skin rejuvenation modalities and conducted many years of research and clinical trials to evaluate the effectiveness of these modalities in specific situations. Dr Setterfield believes optimizing skin health through regulating cell function is an attainable goal. He specializes in ideal skin rejuvenation treatment programs that protect the epidermis, preserve the dermal papillae, optimize cell function, break down scar tissue and rebuild the extracellular matrix with normal collagen, as opposed to scar tissue.