When a woman in my inbox said microneedling with exosomes was “a big trend right now, with discussions that it could even be more effective than Botox,” I hastily booked an appointment. As a CeraVe girl who didn’t discover serums until the pandemic, the realm of aesthetic medicine has been a footnote of LA cocktail hour gossip with flippant declarations of “fuck it, I’m getting Botox next year.” With my appointment a week away, I coincidentally found myself introduced to an esthetician while on a press trip in Palm Springs. My friend initiated the conversation with, “Andie, I want you to meet my friend. He knows everything about facials.” I acquiesced, figuring I could start putting a little of the “investigative” in my so-called “journalism.”
The man I was introduced to looked like a cross between Dan Levy and Handsome Squidward–taught and glossy like all the other circuit gays in town from West Hollywood. He prompted, “Guess how old I am?” I was in no mood to flatter him, so I answered honestly, “Thirty-seven?” He smiled and said, “I just turned fifty.” He had my attention. I asked him, “I’m getting microneedling with exosomes, what are your thoughts on that?” Without hesitation, he said, “Oh, definitely get it, that’s the best one right now. It’s a formula of cultured cells, and with the microneedling, it stimulates collagen and plumps all the fine lines.” I asked him if there was anything else I should consider getting, and he said, “Let me get a good look at your face.” He floated his face close to mine, squinting in the dark of the outdoor patio. “Oh, you have great skin…” he started, and as his eyes drifted down, he added, “Well, maybe ask them if there’s anything they can do for your neck.” With that, I felt like I’d done enough investigating for one night.
My microneedling appointment was set for 10 a.m. the next Friday morning at Routine in Studio City. I was told to come in at 9 a.m. so they could “put the numbing cream on my face.” I was given the option to pick up the numbing cream ahead of time and arrive pre-creamed, but the thought of sitting in LA traffic looking like Mrs. Doubtfire after face-planting on a cake didn’t appeal to me. It took about an hour for the cream to numb my face, so I had ample opportunity to do some photographic documentation (in layman’s terms, selfies) and jam out to the orchestral Lana Del Rey covers softly playing in the lobby. After an hour, an assistant kindly wiped the goo off my face, leaving me a bit blotchy and with the odd sensation that my entire face had fallen asleep.
One hour of numbing cream.
Courtesy of Andie Eisen
Now fully numbed and prepped for the microneedling, it was time for me to meet my Cosmetic Nurse Practitioner, Anush Movsesian. Unlike the man in Palm Springs, her disposition and countenance assured me I was in good hands. As she leaned me back in the dentist's chair and adjusted the setting on her microneedling device, I asked her to walk me through the science and technique behind microdermabrasion. She explained, “Anytime you want to rejuvenate the skin, you need to injure it because that’s when the wound-healing process is going to start. The rejuvenation begins when that process stimulates collagen, elastin, and hyaluronic acid.” Elaborating on the various methods of injuring the skin, she continues, “In aesthetics, you're either going to cause thermal damage with heat, microneedling, or radio frequency lasers, such as CO2.”
She walked me through the pros and cons of each treatment she listed. Lasers work to burn the top layer of the skin. While very effective, the process is quite painful, and since lasers operate via light frequencies, skin tones on the Fitzpatrick scale that are level 4 and up will not work. Microneedling is more universal in that it works on all skin types. The popular Morpheus8 treatment is a combination of both lasers and microneedling. Movsesian explains, “The needles go down, but heat is given at the tip of the needles. With the needles and the burning, it’s essentially shrink-wrapping the skin. That one hurts like a bitch. No matter how much you numb, it hurts.”
When asked how exosomes compare to Vampire Facials, she informed me that the viral Kim K trend is, in fact, a copy-written term, and the procedure is called “PRP.” In this microneedling treatment, blood is drawn from the patient and put in a centrifuge to separate the platelet-rich plasma (PRP), which is then administered during the microneedling. “In the photo of Kim, she looks super bloody, and that was really just for Instagram. All we want to see is pinpoint bleeding. You don't need to be all gushing and bloody.” Due to its ability to turn over old skin and stimulate collagen, microneedling is a great procedure for anyone who wants to minimize hyperpigmentation or acne scarring. She added, “The only thing we can’t do is microneedling on active acne since it will start to spread it around.”
Two hours after microneedling.
Courtesy of Andie Eisen
Four hours after microneedling.
Courtesy of Andie Eisen
As I was laid flat in the chair, the buzzing of the microneedling wand began. With each glide of the needling pen, she administered a pipette of exosomes–a clear, viscous liquid that felt similar to the consistency of a hyaluronic acid serum. She started with the forehead. With my face numbed, the sensation felt akin to dragging an electric razor across it. In the moments it approached the perimeter of where the numbing ended, it felt like a slight sting, but nothing that provoked even a flinch.
As she dragged the wand around my face, she explained exactly why exosomes were the hottest new treatment on the market. “Exosomes are cells, stem cells that will go into the skin and act as whatever it needs to act as. It’s basically a new skin cell growing in.” As a 90s kid, I felt a faint pang of anxiety remembering the controversy around stem cells twenty years ago. I asked Movsesian how they are sourced, and she explained, “Exosomes are either harvested from fat from a liposuction and purified, or soured from the umbilical cord of a newborn.” So stem cells in this context are far from controversial, but the liposuction comment definitely reminded me of a certain plot point in Fight Club. Movsesian continued, “With microneedling, since it’s creating tiny holes in the skin’s surface, there is about an 800% higher rate of getting good ingredients deposited into the skin. Exosomes are interesting because clinical trials are showing that they're 100 times stronger than an average person's PRP.”
After about ten minutes, my entire face had been sufficiently microneedled. She returned my chair to a seated position and held up a hand mirror. “There! You look like a baby tomato now!” She wasn’t wrong. I looked like I fell asleep with sunglasses, pink and raw except for the untouched circles around my eyes. For the aftercare, she instructed, “You are going to be red and dry after, and that’s very normal. Don’t wear any makeup or put anything on your skin other than a very gentle cleanser and moisturizer. No exfoliating or any acids for a week.” I took notes: no acid exfoliants, no retinol, nothing that could irritate the already sensitive skin. She gave me another small vial of exosomes to bring home, refrigerate, and slather on my face thoroughly before bed. For the days following she gave me some good tips: “Use a super boring moisturizer like CeraVe or Cetaphil. You can even slug at night, like with Vaseline or Aquaphor. It's great because it prevents transepidermal water loss, meaning your skin won't lose water into the environment. It locks it in. And make sure to wear SPF during the day since your skin will be very sensitive.”
Seven days after microneedling
Courtesy of Andie Eisen
I am only wearing eye makeup, lip balm, and a touch of concealer under my eyes. There is no makeup on my skin.
Courtesy of Andie Eisen
After driving home, it took another two hours before the numbing cream began to wear off and I could feel my lips again. My face continued to look sunburnt the rest of the day. It faded slightly into a fainter pink, but it didn’t fade entirely until I woke up the next morning. The healing process was nearly identical to a sunburn or retinol overuse. The skin felt dry and tight until it gave way to peeling. By the fourth or fifth day, almost all of the old skin had peeled off, and I was left with baby-soft skin. I know I’m not supposed to touch my face (sorry Mom), but I kept reflexively stroking my own cheek–it was so smooth, like feeling your teeth with your tongue after your braces come off. I noticed that, aside from my porcelain complexion, my fine lines seemed less prominent, and the texture I’d had from seasonal dryness was gone. I didn’t get a single blemish for over two weeks. And not to brag, but for the first week after the peeling subsided, I felt like Meryl Streep in Death Becomes Her right after drinking the elixir of eternal youth.
While I may personally not have the financing to make microneedling a habit, Movsesian informed me that some people return “once a month, three to four times in a row, and then come back four months later for maintenance. Clinical trials have proven you see up to 600% more elastin production in your skin when you do it multiple times.” So, if you have the financial backing, I highly recommend this procedure. It’s painless, highly effective, and the recovery is negligible compared to the results. During our session, Movsesian mentioned that, “Natural collagen production starts decreasing after 25 and past the age of 50, you don’t produce collagen at all.” I started doing some calculations in my head: “If I’m 29 and I make X amount of money as a writer, I have 21 years to figure out how to make enough money to clinically supplement the collagen I won’t be able to make naturally by the time I’m 50.” After all that girl algebra, I think my best chances are to marry (or divorce) rich–wish me luck!
Book your own appointment with Anush Movsesian at Routine in Studio City, Los Angeles, or follow at @skinsandneedles_ on Instagram.