The History of Needling – A Cape Town Innovation Since 1997 | Environ Skin Care

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Press Release

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In 1997, in Cape Town, South Africa, Dr Des Fernandes initiated a revolutionary approach to skin regeneration: percutaneous collagen induction therapy, now widely known as skin needling. Inspired by Dr Camirand’s use of a tattoo device to repigment post-surgical white scars, Dr Fernandes began experimenting with needling to treat not only scars but also wrinkles, acne scarring, and burn scars. From the outset, his protocol was unique, always combining needling with topical vitamin A, a decision that would later prove critical to the long-term success of the technique.

Dr Fernandes quickly observed that the results were not transient. Unlike many aesthetic interventions, the improvements were durable and regenerative, suggesting a deeper biological mechanism at play. Transitioning from tattoo devices to skin rollers, he found that the spaced needle configuration allowed for more effective dermal penetration and minimised trauma.

At the time, Dr Fernandes was studying the work of Ferguson on regenerative growth factors, particularly Transforming Growth Factor Beta 3 (TGF-β3). He hypothesised that the regenerative effects of needling were driven by the upregulation of TGF-β3, a theory later validated by Dr Aust in 2005, who demonstrated that needling elevates TGF-β3 levels for up to 14 days post-treatment, a stark contrast to the response seen with surgical incisions.

One of the earliest and most striking observations was the lifting of the eyebrows following forehead needling, an effect that could not be explained by superficial skin changes alone. Dr Fernandes also noted that 3mm needle lengths, used in the early stages, produced profound dermal remodelling.

Collaborations with international colleagues, such as Dr Cynthia Weinstein from Australia, helped disseminate the technique globally. Importantly, Dr Fernandes emphasised that all skin types can be safely treated with rollers, with no post-inflammatory pigmentation observed, unlike stamping devices, which carry a higher risk of overtreatment and pigmentation.

In a landmark observation, skin grafts treated with needling not only improved in texture but also regained sensation, suggesting stimulation of nerve growth factors, a finding with profound implications for regenerative medicine.

By 2005, Dr Fernandes refined his protocol to use 1mm rollers with topical anaesthetic, allowing for weekly treatments over six weeks to maintain elevated TGF-β3 levels and maximise regenerative outcomes. 

Dr Matthias Aust demonstrated that vitamin A and C alone could induce a 20% increase in skin thickness, underscoring the power of topical nutrition in skin health.

In 2014, his theories were further validated when Zeiter’s research showed that Environ’s Vitamin A, C & E Body Oil quadrupled skin thickness when combined with needling. Histological slides presented during the lecture confirmed these findings, showing tissue regeneration and collagen synthesis.

Dr Fernandes emphasised two critical rules for successful needling:

1. Vitamin A and C are essential: Vitamin A stimulates TGF-β3, while vitamin C enhances collagen synthesis.
2. Weekly treatments with 1mm rollers are optimal to sustain regenerative signalling.

He also highlighted the synergistic role of peptides, particularly when used with Environ’s Electro-Sonic DF Technology, which enhances transdermal delivery and cellular response.

The lecture concluded with compelling clinical imagery showing skin tightening, pigmentation correction, and visible rejuvenation across various anatomical areas, including the abdomen, arms, and stretch marks on the body. Even cosmetic 0.2mm rollers, when used correctly, yielded impressive results.

Dr Fernandes closed by reaffirming the safety and efficacy of combining vitamins and peptides with needling, backed by over 25 years of clinical experience and zero incidence of granulomas. His work continues to shape the future of regenerative dermatology, with Cape Town remaining the birthplace of this global innovation.

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About ICOPLAST 2025

The 3rd ICOPLAST World Congress took place from 17–19 September 2025 at the Cape Town International Convention Centre, hosted by the Association of Plastic, Reconstructive, and Aesthetic Surgeons of Southern Africa (APRASSA). This prestigious event brought together medical professionals from around the globe to share advances, showcase research, and engage in discussions on the latest developments in plastic, reconstructive, and aesthetic surgery. ICOPLAST is a non-profit organisation with a mission to improve patient outcomes worldwide through education, collaboration, and the advancement of high professional and ethical standards in plastic surgery.

About Dr Des Fernandes

Dr Des Fernandes is a Cape Town-based Plastic and Reconstructive Surgeon, internationally acclaimed for his pioneering work in medical and cosmetic Skin Needling as well as his scientific innovations in skin health. He founded Environ Skin Care in 1990, becoming one of the first medical professionals to harness the benefits of topical vitamin A and antioxidants in cosmetic formulations. Dr Fernandes has published extensively in medical and aesthetic journals, lectured globally, and remains at the forefront of research into skin regeneration, health and longevity. His lifelong commitment to innovation has influenced both surgical and non-surgical skincare worldwide.

About Environ Skin Care

Environ Skin Care is a globally recognised and loved professional skincare brand that is built on science, beauty and care. Since 1990, Environ has used the science of beauty to change the way the world sees skincare. The introduction of vitamin A to skincare formulations was a ground-breaking development, first successfully included in cosmetic products by world renowned Plastic Surgeon and Environ founder Dr Des Fernandes. His sister, Val Carstens, Environ’s Chairman, has built the brand from a dream to a global success. Today, Environ has over 140 products in more than 70 countries. Environ has received over 100 international awards, which have recognised the brand for its outstanding products, most recently being voted Top Medical Skincare Line in the highly revered Aesthetic Everything® Aesthetic and Cosmetic Medicine Awards for the eighth consecutive year.