Dermatologist: I Was Wrong About This Viral Microneedling Cream

Scientific Concepts / Nature & Medical Phenomena Presented

• Microneedling-style “spicule” transdermal delivery

  • Products described as “microneedling creams” (e.g., VT Reedle Shot, Medicube Exosome Shot) are said to contain tiny glass-like needle particles (“spicules”).
  • These spicules are intended to create channels and increase deeper penetration of actives.
  • The spicules are described as originating from sponge skeletons, since sponges naturally form microscopic needle-like structures.

• Micron-scale penetration and skin layer thickness

  • The dermatologist disputes a prior claim that spicules are ~15 µm long, arguing the “15 µm” figure appears to represent spicule width, not length.
  • Reported spicule lengths measured (via microscope at ~200x):
    • 184 µm
    • 191 µm
    • 232 µm
  • Skin anatomy & variability
    • The epidermis (outer layer) is reported as ~30–65 µm thick depending on facial location.
    • If spicules are ~180–230 µm, they could extend well beyond the epidermis—especially in thinner regions such as the eyelids.

• Evidence from animal studies (depth and persistence)

  • A 2019 study is cited using sponge spicules ~120 µm long:
    • Channel depth ~49 µm (reported for pig skin).
  • Additional studies are cited suggesting spicules remain embedded in pig and mouse skin for >72 hours.
  • The video emphasizes that direct human facial measurements are limited because they would require biopsies.

• Regulatory classification: cosmetics vs skin-penetrating products

  • The argument presented: once a product physically penetrates the skin and makes structure-change claims, it may be treated more like drug/device-like regulation under the US FDA framework.

• Foreign-body immune response and delayed granulomatous reactions

  • Proposed mechanism:
    • If a foreign material reaches the dermis and cannot be broken down/cleared, the immune system may wall it off, forming a granuloma.
  • Clinical appearance:
    • Granulomas can resemble pimples, cysts, rosacea, or acne, making them easy to misidentify.

• Silica spicules and long latency

  • The referenced paper frames potential “hidden risks” of silica spicules for transdermal delivery.
  • Examples described include very delayed granulomas after silica exposure (latency measured in decades), such as:
    • A stonemason exposed to rock dust with silica who developed granuloma-like lesions ~22 years later.
    • Other cases with ~20+ year delays after silica from minor wound exposure.

• “Double-edged sword” of deeper penetration

  • Deeper delivery is not only beneficial for actives:
    • It may also introduce potential contact allergens (e.g., fragrance, preservatives, plant extracts) into deeper tissue where they may sensitize the immune system.
  • Sensitization concept:
    • After sensitization, patients may develop allergic contact dermatitis on future exposures.

• Comparison to dermal fillers and irreversibility

  • Contrast mentioned:
    • Hyaluronic acid (HA) fillers can be dissolved with injection if needed.
    • Silica spicules cannot be dissolved in the same way, making reactions potentially harder to manage.
  • Potential interventions mentioned if reactions occur:
    • Steroids / immunosuppressants
    • Surgical removal / excision, with risk of scarring

Methodology / “How the Dermatologist Investigated It” (as described)

• Microscope measurement workflow

  • The dermatologist acquired the cream product and examined it under a microscope.
  • Used ~200x magnification.
  • Measured three individual spicules to estimate their length (reported values: 184, 191, 232 µm).
  • Compared measured values with the marketing number previously used (15 µm) and argued it likely reflects width, not length.

• Sanity check against marketing claims

  • Reviewed company materials (VT marketing and Medicube marketing/FAQs) for whether spicule length is disclosed.
  • Claimed the companies do not disclose length, and that numerical product names (e.g., 100/300/700) refer to spicule concentration, not needle length.

Key Sources / Researchers Mentioned (end of video)

• Dr. Andrea Suarez (also known as Dr. Dray) — credited for raising the concern earlier.
• “Hidden Risks Behind the Cosmetic Use of Silica Spicules for Transdermal Delivery”
  • A paper in the Journal of the American Academy of Dermatology (JAD).
  • The subtitle description indicates it was written by “a group of dermatologists in New York,” but individual author names besides Dr. Suarez were not listed.
• 2019 study researchers
  • Studies cited involving sponge spicules (~120 µm) and resulting channel depth (~49 µm) in pig skin (specific authors not named in the subtitles).
• Federal law / FDA (US regulatory framework)
  • Referenced as the regulatory standard (no individual authors).