Skin Deep - Clinical & Cosmetic Dermatology Blog

Skin Deep is a blog for dermatologists and skin care professionals with focus on theoretical, cosmetic and aesthetic dermatology. This blog is associated with ‘Dermatologists Sans Borders’ one of the largest curated groups of skin care professionals on facebook. If you are looking for non-technical information, please visit

Damn Cheap Technology

Cardiff Castle
(Photo credit: beapen)
Couple of years back, when I started doing DermaRoller (needles on a roller, made as expensive as possible by the manufacturer by making the handle gold plated with couple of needles per square inch more than the competitor), I had the notion that this damn cheap technology is going to be more effective than the expensive laser systems. I hoped to find a dermaroller next to the shaving razor as the anti-ageing low-tech equipment. Dr. Murad Alam of Northwestern University in Chicago, who led the study that demonstrated a 41% improvement in acne scars with micro-needling echoed the same feeling: "Needling is so easy to undergo, and potentially so inexpensive, that even a modest benefit may be sufficient to make this a worthwhile treatment for some patients with limited budgets." he said in an interview.[1]

Do you know where your fillers go? (I never did!) If you don’t, read this latest article in Dovepress on the ultrastructural investigation of the lips. Whether you use Juvederm Ultra 3, Juvederm Ultra Smile, Restylane Lipp or Restylane Refresh, you should know where your filler is going, or you may be dangerously close to disaster!  (BTW one of these fillers gives terrible erythema and swelling if injected superficially)This article gives a nice overview of the surgical anatomy of the perioral region too. Carruthers lip fullness grading scale may also be useful.[2]

However the article used ultrasonographic control to “know where the fillers go” which is neither reliable nor practical. I personally feel that impedance measurement may be a better technology to pursue for filler companies to design the next generation needles that cry out when dangerously close to disaster (large blood vessel or a nerve trunk). This 2009 article titled “Impedance-based tissue discrimination for needle guidance” shows that we are/were close.[3]

1.  "Needle rollers shown to improve acne scars | Consultant for ..." 2014. 24 Jun. 2014 <>
2.  "Do you know where your fillers go? An ultrastructural ..." 2014. 24 Jun. 2014 <>
3. Kalvøy, Håvard et al. "Impedance-based tissue discrimination for needle guidance." Physiological measurement 30.2 (2009): 129.

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About Me

As a Dermatologist and Informatician my research mainly involves application of bioinformatics techniques and tools in dermatological conditions. However my research interests are varied and I have publications in areas ranging from artificial intelligence, sequence analysis, systems biology, ontology development, microarray analysis, immunology, computational biology and clinical dermatology. I am also interested in eHealth, Health Informatics and Health Policy.


Bell Raj Eapen
Hamilton, ON