Introduction: Microneedling has been performed in several areas of Dermatology, including the treatment of androgenetic alopecia. However, one of its major limitations is pain, which occurs both with the use of rollers with multiple fine needles and with motorized devices equipped with microneedles.
Objective: To describe a new technique aimed at minimizing pain during the microneedling in the scalp.
Methods: An observational, prospective and comparative study of the microneedling effects was performed with a motorized device, with and without folding the skin by using the thumb and index finger of the surgeon’s non-dominant hand. This procedure was termed “pinch technique” by the authors. The pain was assessed by the patient based on a visual analogue scale, and the data analyzed with the Student’s t-test, in order to verify the existence of statistical difference between the data sets.
Results: Fourteen patients bearers of androgenetic alopecia (13 men and 1 woman) were treated. The analysis of the data on the pain reported by the patients suggested that the arithmetic mean of the data obtained from the areas where the technique was not applied was greater than that obtained in areas where the technique was employed.
Conclusions: The described technique was proven effective in reducing pain during the microneedling procedure. That outcome resulted from the alteration of the perception of pain due to the tactile stimulus and the increase in the distance of the needles regarding the galea, which is richly innervated.

Keywords: AMBULATORY SURGICAL PROCEDURES; ALOPECIA; NEEDLES

Introduction: Managing pain during the performance of dermatological procedures is a challenge. Several topical anesthetics are available for use prior to carrying out minimally invasive treatments.
Objective: To evaluate the efficacy of topical anesthetics for reducing the pain during dermatological procedures and to compare the effectiveness of two different anesthetics using the visual numeric pain scale.
Methods: Twenty-five patients underwent facial dermatological procedures after the application of two commercial preparations: one containing 7% lidocaine and 7% tetracaine (applied in one hemiface) and the other containing 4% lidocaine. Each of the preparations was applied in one hemiface. Pain intensity was assessed using the Visual Numeric Pain Scale (VNS) at the end of the procedure.
Results: Eighty-four percent of the patients reported a lower pain score in the hemiface that received the commercial preparation containing 7% lidocaine and 7% tetracaine. The mean pain score in the hemifaces that received the 4% lidocaine preparation was 7.3, while that computed for the hemifaces that received the 7% lidocaine and 7% tetracaine preparation was 5.3.
Conclusions: Topical anesthetics are effective and safe for pain reduction in dermatological procedures, with the commercial preparation containing 7% lidocaine and 7% tetracaine was more effective than the one containing 4% lidocaine.

Keywords: Anesthesia; Anesthesia, local; Dermatologic surgical procedures; Minimally invasive surgical procedures; Pain perception; Pretreatment