There’s a lot of hype surrounding this sort of avant-garde skin treatment. It’s been called the next big thing and there are dozens of impressive clinical studies and hundreds of dramatic before and after pictures to prove it. But does micro needling work?

What Is Micro Needling AKA Collagen Induction Therapy AKA Etc...

Update fall 2016: I've updated the post with current research.

You've probably heard it called by a lot of names: collagen induction therapy, micro needling, skin needling, derma rolling, just plain needling and even vampire facial.

It all comes down to the same thing: tiny needles puncture the skin prompting a healing response that increases collagen production and skin regeneration.  It also increases product absorption 1000 times so if you follow treatment with the right product micro needling can plump up wrinkles and scars, erases dark spots, and boost hair regrowth. 

The best part is that when done right at home micro needling ​can be a cost effective alternative to more expensive but comparable treatments like laser therapy. A device and good serum cost around $50 for a 1-2 month supply so you can incorporate it as part of your regular routine with up to twice weekly treatments and it would cost you less than $10 a treatment for a one month regimen. 

I compiled all the information I've gathered into this post under relevant headings that I hope will make the process easier and more effective for beginners and experienced "needlers" alike. 

Does Micro Needling Work

To put it simply, yes. Micro needling has been clinically and anecdotally proven to a lot of pretty amazing things with a relatively low risk and low cost.

Microscopic analysis has shown that micro needling increases collagen production up to 400% and "leads to reorganization of old collagen fibres and laying down of new collagen, elastin, and capillaries." [1]

It's also ​safe for darker skin tones and it's relatively accessible and inexpensive for home treatment. It's  effective whether or not you use product following treatment, and it's also effective when used in an integrative skin care regime without the addition of potentially toxic products. 

Clinical ​interest in micro needling is really starting to ramp up. There's also more research being produced that clarifies best practices for effective treatment in both professional and at home settings, which means better treatment outcomes.

Two years ago when I first started writing about micro needling there was 73% worth it rating on the website real self based on 57 reviews. Today, there's an 89% worth it rating based on 92 reviews over the past 24 months.  

Even with an unclear FDA position there's still a big upward trend in interest surrounding micro needling because science and results can't be ignored. 

Micro Needling Benefits, Results & Studies By Topic

Face

Increasing Product Absorption

The Dermatology Review reported that micro needling is "proven to increase chemical absorption up to 1000 times."

Anti-Aging, Fine Lines, Wrinkles & Sun Damage

In one study in micro needling was shown to increase new collagen fibers by 206% 6 weeks after treatment. In another, "4 microneedling sessions 1 month apart shows up to 400% increase in collagen and elastin deposition at 6 months."

Computer imaging analysis was used to show that micro needling is a safe and effective treatment to improve upper lip wrinkles

Unlike laser treatments, "the epidermis remains intact and is not damaged."

micro needling results for wrinkles source


Dark Spots / Post-Inflammatory Hyperpigmentation (PIH)

micro needling results for hyper pigmentation and scarring

results of micro needling treatment source


Acne Scars, Atrophic Scars, & Burns

Micro needling is "...proven to be very effective in minimizing acne scars and burn scars..."

Microscopic analysis has shown that micro needling increases collagen production up to 400% and "leads to reorganization of old collagen fibres and laying down of new collagen, elastin, and capillaries." [1]

The appearance of scars is diminished by the production of collagen fibres. The collagen produced by micro needling is in the form of  "collagen fibre bundles [that] appear to have a normal lattice pattern rather than parallel bundles as in scar tissue."

micro needling results for scarring

After multiple microneedling treatments with a 1.5mm derma roller over 90% of patients saw reduction in severity of atrophic (deep and recessed) facial scars. 80% assessed their treatment as "excellent" on a 10-point scale. No significant adverse effects were noted in any patient. 

Scalp

Hair Loss / Hair Regrowth

Hundreds of cases of androgenic alopecia (most common cause of hair loss in men and women) were divided into 2 groups: one received only: twice daily 5% Minoxidil (like Rogaine) while the other group received twice daily 5% Minoxidil along with weekly micro needling (using a 1.5mm derma roller).

Over 80% of patients treated with micro needling in combination with minoxidil reported more than 50% improvement compared to 4.5% in minoxidil only group.

micro needling accelerated hair regrowth results source

After 12 weeks the mean hair count was significantly higher for the micro needling group as compared to the Minoxidil only group.

Micro needling found to be "a safe and promising tool in hair stimulation." 

Body

Hands & Décolletage Anti-Aging, Fine Lines, Wrinkles & Sun Damage

The same principles apply to the body as to the face. Micro needling can improve the appearance of skin tone, tightness, dark spots and scars either on it's own or in combination with appropriate products. 

The Dermatology Review reported that micro needling is "proven to increase chemical absorption up to 1000 times."

In one study in micro needling was shown to increase new collagen fibers by 206% 6 weeks after treatment. In another, "4 microneedling sessions 1 month apart shows up to 400% increase in collagen and elastin deposition at 6 months."

Unlike laser treatments, "the epidermis remains intact and is not damaged."

Stretch Marks

Stretch marks respond really well to micro needling treatment. Stretch marks are a scar and they respond to micro needling the same way that all other scars do. 

micro needling stretch marks results

After multiple microneedling treatments with a 1.5mm derma roller over 90% of patients saw reduction in severity of atrophic (deep and recessed) facial scars. 80% assessed their treatment as "excellent" on a 10-point scale. No significant adverse effects were noted in any patient. 

Cellulite

As far as I know from current research cellulite does not respond to micro needling. I'm also not sure that cellulite creams work but if you use them you could definitely try adding micro needling to your regimen to increase the absorption of your cellulite cream by 1000x

Atrophic Scars & Burns

Micro needling is "...proven to be very effective in minimizing acne scars and burn scars...

The appearance of scars is diminished by the production of collagen fibres. The collagen produced by micro needling is in the form of  "collagen fibre bundles [that] appear to have a normal lattice pattern rather than parallel bundles as in scar tissue."

After multiple microneedling treatments with a 1.5mm derma roller over 90% of patients saw reduction in severity of atrophic (deep and recessed) facial scars. 80% assessed their treatment as "excellent" on a 10-point scale. No significant adverse effects were noted in any patient. 

At Home Micro Needling vs Professional

Micro needling can be done in a dermatologists office, a med spa, or at home. Given that it's still a fairly new treatment with an unclear FDA ruling professional treatment may not be available where you live.

At home treatment is a great alternative. At home treatment can also be more cost effective and provide a more consistent addition to your skincare regime if you're treating minor issues. 

Risks & Safety Guidelines

A 2012 study found that "infections after microneedling are very unlikely due to the rapid closure of the SC within a maximum of 15 minutes." 

In a 2009 study on micro needling for atrophic scars "no significant adverse effects were noted in any patient."

"Microneedling of the skin facilitates skin repair without scarring after the treatment of superficial burns, acne, hyper pigmentation."

It's generally recognized as safe to use a micro needling device at home provided you follow normal precautions and use a needle less than 1.0mm in length.

However, everyone's skin is different and your mileage may vary. You are responsible for your own choices and if you have any doubt at all you should consult a professional. If you still aren't sure please see to our T&C.

Criticism

When I first wrote this post about two years ago the famous beauty site Paula's Choice had this to say about micro needling "...there is no research proving that at home derma roller devices produce results better than laser therapy can, or even equal what’s possible from using a well-formulated skin care routine." - Paula's Choice

Actually there is here, and here - both peer review studies in which hand held derma-rollers were used with results that couldn't be achieved with a well-formulated skin care routine.

In fact, this study showed that unlike laser treatments, "the epidermis remains intact and is not damaged."

At present the Paula's Choice site doesn't have anymore posts on micro needling. 

My Micro Needling Results 

I credit micro needling with significantly improving the appearance of dark spots that I've been battling for years. Part of it is that the research I've done on micro needling has also taught me a lot more about good skin care principles.

My overall skin care regime is better than before and I'm wearing sunscreen every day for the first time. Both of these could be factors in my improved dark spots. However, I also had poor tone and light scarring that's also really improved since I started micro needling. 

Before & After Pictures

​This may not be the most representative comparison but the before picture is the only one I have that shows how my skin really looked because I always had make up on to hide my spots and avoided close up pictures. 

The after picture is concealer/foundation free and is pretty representative of how my bare skin looks now. 

If you want to know more about my experience see my write up here. ​

Home Micro Needling Device Q & A

Number of Needles

As far as I can tell it doesn't matter beyond ease of use. Derma pen and derma stamp devices have far fewer needles, they're still effective just more challenging to use especially on larger areas.

The number of needles might be important as far as needle density is concerned. More recent research is beginning to suggest that needle density is an important factor.

lower and higher needle density shown on different devices

lower and higher needle density shown on different devices

​There isn't enough information yet to tell but I'm planning a trial for winter/spring 2016-2017 comparing lower and higher needle densities. 

Length of Needles

Needle Length Chart

Length of needles0.3mm-0.5mm0.5mm – 1.0mm1.0mm-1.5mm1.5mm-3.0mm
PurposeIncrease penetration of skin care or hair growth productsDark spots, fine wrinkles, mild sun damage or aging skin.Acne/burn scars, stretch marks, loose skin, sun damage, fine lines & individual deep wrinkles.Deep scars and stretch marks.
Ideal Frequency of UseLess than 0.5mm: every other day. More than 0.5mm: once or twice a week on the same area.1.0mm: once every 2 weeks on the same area.1.5mm: once every three – four weeks on the same area.Once every 5 weeks or more under supervision of a professional.

Material: Steel vs Titanium vs Other

Clinical studies recommend stainless steel

Derma Roller, Derma Stamp or Derma Pen

It's been suggested that a stamp is better because a roller can cause tearing of the skin as it rolls whereas a stamp leaves clean micro incisions, as illustrated in this picture.

proposed comparison of derma rolling verses derma stamping

There are a lot of images like this online, however, most seem to be produced by the manufacturers of derma pens/stamps.

Most of the studies I've cited in this post used derma rollers. They are generally easier to use, especially for at home treatment, unless you're using an electric derma pen. I haven't seen anything in any study that suggests that pens/stamps are better than rollers. 

Electric Derma Stamps

How To: DIY Micro Needling Q & A

Best Way to Sterilize a Micro Needler

My personal preference is a bleach solution 1:1 ratio mixed with water.  Isopropyl alcohol is also recommended but I suspect it might be harsher on the device. You can also use a steam sterilizer or UV sterilizer if you have one.

How to Prepare the Treatment Area

Thoroughly wash the area to be treated. Pat dry with a fresh towel. If you are using pain relief cream apply all over treatment area about 15 minutes before treatment. Wipe or wash off before beginning treatment. 

Pain Relief

The question of whether you need pain relief in the form of numbing cream (like Numb Master) depends on your pain tolerance. At home needling is not very painful except when you get to the last few rolls when the blood has already rushed to the surface and your skin is much more sensitive. Even at that point it isn't totally intolerable.  I can manage fine without numbing cream but there have been times when I've taken an oral pain reliever. 

Micro Needling Technique

To put it simply the roller should be run across the skin with firm even pressure 5 times each in every direction (up and down, side to side, diagonally each way.) For detailed information about how to micro needle see this post:

At Home Micro Needling Step by Step Instructions

After Care Guidelines

Choosing a Good Vitamin C Serum 

There are a lot of vitamin c serums out there. I try to avoid the really hyped up and expensive ones on beauty sites like Sephora and generally buy from Amazon after doing research.

Be aware that Amazon is full of a lot of really poor quality vitamin c serums that are barely more than water. You don't have to spend $50+ for a serum but there are also certain fundamental things you should keep an eye out for including: 

  • Opaque or dark bottle - a clear bottle will cause the vitamin c to oxidize and become ineffective much faster.
  • Expect to pay around $30 for a quality product.
  • Percentages of active ingredients should be indicated. A product may have ferulic acid but there might be so little that it makes no difference at all. ​Get your money's worth.

Vitamin C Serum Chart

1st Place
2nd Place
Avoid

Name

Serumtologie C serum

Skin Solutions C + E

Art Naturals Enhanced Vitamin C Serum with Hyaluronic Acid

Percentages

22% sodium ascorbyl phosphate

5% hyaluronic acid

1% ferulic acid

1% vitamin E

20% L ascorbic acid

1% vitamin E

0.5% ferulic acid

not indicated

Cost

$$

$$

$

Redness

Micro needling feels like a sunburn and also happens to look like one, especially on lighter skin tones. Studies have shown that redness can last up to 48 hours and decreases by up to 50% on caucasian skin within 4-6 hours.

If you're in a rush hyaluronic acid sheet masks have been shown to decrease redness by up to 50% in 30 minutes

Sunscreen

Be extra careful to apply sunscreen following treatment. I use Neutrogena Ultra Sheer - it's cost effective, it isn't greasy, and it doesn't leave a white cast so it works for darker skin tones too. You can find it online or at most drug stores.

Treatment Frequency

The treatment frequency depends on the needle length. 

Length of needles0.3mm-0.5mm0.5mm – 1.0mm1.0mm-1.5mm1.5mm-3.0mm
PurposeIncrease penetration of skin care or hair growth productsDark spots, fine wrinkles, mild sun damage or aging skin.Acne/burn scars, stretch marks, loose skin, sun damage, fine lines & individual deep wrinkles.Deep scars and stretch marks.
Ideal Frequency of UseLess than 0.5mm: every other day. More than 0.5mm: once or twice a week on the same area.1.0mm: once every 2 weeks on the same area.1.5mm: once every three – four weeks on the same area.Once every 5 weeks or more under supervision of a professional.

When To Replace Your Micro Needler

One study recommends using a device 100 times before replacing. It's likely you won't get that many uses from your device because they tend to break down quickly. Watch out for these common signs of wear and replace accordingly. 

micro needling device showing rust formation

micro needling device with bent needles

derma pen with debris

Other Questions & Concerns

Micro Needling for Darker Skin Tones

"In ethnic skin, traditional skin resurfacing procedures such as dermabrasion, chemical peels, and laser therapy can be effective but can also be associated with prolonged recovery and risk of complications. These complications can include a higher risk of dyspigmentation and scarring, and unsatisfactory clinical outcomes. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. Microneedling may offer a more advantageous safety profile, particularly in the skin-of-color population."

Micro needling has been shown to have very little risk of causing pigmentation problems.

Micro Needling for Rosacea

Radio frequency micro needling has been used for the treatment of rosacea with "favourable results" but currently there isn't enough information to support a home treatment regimen. 

Micro Needling & Acne

Micro needling should never be done over active acne. The only role micro needling can play as far as acne goes is for post acne redness or hyper pigmentation. 

Micro Needling vs Microdermabrasion

Micro needling "may offer a more advantageous safety profile" compared to "traditional skin resurfacing procedures such as dermabrasion, chemical peels, and laser therapy [which] can also be associated with prolonged recovery and risk of complications."

This is especially true for skin of color or skin that is more prone to hyper pigmentation.

Micro Needling vs Laser Therapy

Micro needling "may offer a more advantageous safety profile" compared to "traditional skin resurfacing procedures such as dermabrasion, chemical peels, and laser therapy [which] can also be associated with prolonged recovery and risk of complications."

This is especially true for skin of color or skin that is more prone to hyper pigmentation.

Micro Needling vs Chemical Peels

Micro needling "may offer a more advantageous safety profile" compared to "traditional skin resurfacing procedures such as dermabrasion, chemical peels, and laser therapy [which] can also be associated with prolonged recovery and risk of complications."

This is especially true for skin of color or skin that is more prone to hyper pigmentation.

There’s good reason for the hype surrounding this avant-garde skin treatment. It’s been called the next big thing and with the impressive clinical studies and dramatic before and after pictures the reputation is warranted.


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Author

I write about wellness and ideas that make you better, whether that's a new book, a better way to travel, a skin treatment that works or an ergonomic aromatherapeutic work space. You are the biggest and most important project you'll ever work on. When you take the time to nurture and invest in yourself the returns will multiply through all facets of your life. If you want to have it all, begin with yourself.

12 Comments

  1. Hi, I have found myself reading just about every article you’ve written. I don’t often do that because many blog articles on beauty treatments are based on opinion instead of reasearch. I have been researching microneedling for some time now and I don’t have to anymore since finding your site. Your writing is easy to understand and follow, keeps my interest and provides tons of much-needed, current information on the subject! I also love your recommendations to different devices and products. To put it simply, I think you have covered just about every angle! Thank you for all of this, I’ve had my microneedling device on my dresser in it’s package for about 2 months now, not sure of how to exactly use it. Thanks to your great info, I’m ready to open it up and get started! Keep up the GREAT work!

    • Cristina Reply

      Thanks so much for the comment Erika! Sorry for the delay. I waited too long but then I kept thinking I should reply. better late than never as they say. I really appreciate your words. I put a lot of work into bold + blush and it’s so good to know that people find it useful 🙂

  2. Pingback: Acne Update: Treating My Acne Scars | Frivolous Girl

  3. Hi. Thank you for all your articles on needling. I am hoping you can give me some info. Your “before” photo appeared like you had pitted acne scars, not just marks/dark spots like you write about. You’re “after” shot appears like your skin has filled in all the pitted scars as well. Is this true?
    I’m looking for hope. I had great skin before a professional chemical peel @ a dr office for anti-aging prevention. It did the opposite & gave me pitted scars over my whole face. I’ve had 3 dermapen sessions so far & no improvement yet. How long before you started seeing pitted scars fill in? I have 3 more sessions to go. I’ve dealt with deep depression ever since & any hope is appreciated.

    • Cristina Reply

      Hi Lauren,

      Thank you for reaching out to me. I’m so sorry to hear you’re going through this. Your face is what you present to the world before anything else and it can be totally devastating when you don’t feel good about it.

      Yes, I did have some lightly pitted scars on my right cheek and chin and yes they’ve improved quite a bit from micro needling combined with an AHA routine (which you may or may not be sensitive to if you reacted badly to a peel.) It took about 6-8 months before I saw a difference and it’s still a work in progress.

      However, everyone’s skin is different and it’s hard for me to give you any sort of insight on your skin without more information. There are just so many factors. For example: Do you know why you reacted badly? What kind of peel was it and what strength? How long ago did this happen? Is your skin typically sensitive to products? Did they offer to help? What needle length, frequency of treatment and actives are in your treatment plan? How old are you? What does your skin look like exactly? A before and after would be ideal. If I had that information maybe I could give you some indication of how long it might take.

      In any case needling improvements come over months not weeks. You also have to be sure to wait at least 6 to 8 weeks between treatments with the longer needle lengths typically used in clinics to treat scars. All the magic of needling comes from your skin’s healing response following treatment, not in the moment it’s administered. I want to say that it’s just a matter of time before you see improvement, but again I can’t say for sure without knowing more about your skin.

      That being said, one thing you can do to (hopefully) speed up the process is help your skin help itself with good habits. Healing can be affected by so many factors like diet, digestion, dehydration, stress, inadequate sleep, medications, hormones, and even the weather. I also found out recently that posture can affect lymph drainage and make it more difficult for some areas to heal. I’m currently travelling but early next week when I’m home I’ll make it a priority to compile my research on skin healing habits into a post. Would that be helpful for you?

      I wish I could give you more than this. If you care to shed more light on your situation I’m happy to listen and give you as much information as I have. Feel free to either reply here or email me directly cristina@boldandblush.com

      Wishing you quick improvement,
      xox
      Cristina

  4. Thank you for taking the time to respond. I will try to email you a photo soon. Yes, an article on healing would be nice.
    Before the “accident” I had been on birth control pills non stop for over 10 years. I stopped taking BC about 2months before the accident. During the time of the peel, I was under severe stress at work.

    I’ve always taken good care of my skin & sunscreen & hats. Also healthy Paleo diet: lots of eggs, fresh veggies, fruit, salads, fish, meats etc. nothing processed.
    My skin has always been super sensitive. im talking very very sensitive: to any foundations, most sunscreens, most moisturizers etc.
    The peel administered was a Jessners/TCA I think 20%. The dermatologist who did it didn’t even look at my skin beforehand. (It was flawless). I went back after the damage & she denied that the peel did it. Didn’t take responsibility.
    I’ve seen 7 dermatologists since then. No one & nothing helped. They tried Retin-A for a few months. Tried fraxel laser 3 sessions. No one ever mentioned microneedling.

    I now use dermaviduals skincare (6 months) under the care of an esthitician who’s supposed to help with skin barrier repair. I use Emenence vitamin C too every night. HA after dermapen treatment for 3 nights after in addition to my normal skincare.
    I get the dermapen treatment done @ a medi-spa. First 2 times we did .75 mm needles-my request- to be more conservative at first. But my skin only got solid pink on my forehead. I know most people say sold pink or pin point bleeding is optimal end point. So the 3rd treatment we did 1mm forehead & 2mm rest of face. We do the treatment once a month (4 weeks). 4 weeks is standard time frame for most people/medi-spas. My skin responded with solid pink & some pinpoint bleeding this time.

    The oddest thing about my skin is the way the damage displays itself. It’s (thank god) very very shallow & yet nothing has improved it yet. It looks different in different lighting. A straight on view of my face indoors & you can’t see any damage. If I’m somewhere that creates shadows like in my car, you can see thousands of lines from straight on view.
    If I tilt my head you can see small shallow pits. In other lights it looks a bit like orange peel. Other lighting it looks straight up weathered looking & bad texture but when u actually feel it, my skin is soft & smooth.
    This damage happened when I was 29 years old. I’m now 33.
    My esthitican says it’s collagen degradation.
    Anymore insight is appreciated
    -Lauren

    • Cristina Reply

      Hi Lauren,

      I’m sorry for the delay. I needed some time to really think about this. It sounds like you’re doing everything you possibly can, so it might be the case that the only thing to do it wait. However, it’s also possible that your state of mind is the one unchecked variable. Understandably, this is causing you a great deal of stress. You mentioned in your first comment that you’ve dealt with deep depression ever since the accident. There are a lot of studies that point to the link between psychological stress and poor wound healing. A lot of these studies happen to deal with skin barrier recovery. These are just some of the findings:

      -A 2011 meta-analysis of a diverse range of wound healing studies found that “psychological stress can have a substantial and clinically relevant impact on wound healing.”
      One of the studies considered in the analysis concerned skin barrier function and found that participants who reported greater levels of psychological stress showed slower skin barrier recovery in standardized tests measuring the rate of transepidermal water loss (TEWL).
      Another study from 2001 found that “acute psychosocial and sleep deprivation stress disrupts skin barrier function homeostasis in women.”

      This is just a cursory overview but I find these studies compelling. Based on other studies I’ve read I think of stress as tension we hold in our bodies that turns into congestion, which limits free circulation of nutrients and removal of waste products. Psychological stress also puts the body into fight or flight mode, which shuttles resources away from bodily processes that are not essential for survival. Unfortunately, long term skin repair is not essential from an evolutionary perspective.

      I’ve often found that the thing I don’t want to do is exactly what I need.

      The stress and turmoil you’re feeling could be what’s stopping your skin from healing. Based on these studies that’s a totally possible scenario. Maybe your skin will improve if you work on reducing your stress…but maybe it won’t. What I can tell you for sure is that if you remove the stress and turmoil from the equation, you will be better off no matter what the result.

      It’s hard for me to tell you this. That’s why I deliberated so much on my reply. I’m not in your shoes and I can’t feel how difficult this is for you…but I’ve been there. I spent my teens and twenties trying to fix my skin (and my hair, and my thighs, and etc etc). Now moving into my thirties I’ve learned that nothing makes me as beautiful as happiness and confidence, which incidentally don’t come from everything about me being perfect. There are a lot of things in life that are out of our control. If we fixate on those things, we’ll crumble under their burden. But if we focus on the things we can control, the things we do have, the beauty in and around us…..happiness multiplies.

  5. This blog post is so incredibly helpful and clear. Do you have any brands you recommend for micro needlers? Thanks in advance!

    • Cristina Reply

      Ah thanks a lot Anna! Love to hear that. I wrote a post on the best micro needling devices for home treatment. A lot of the devices on the market are manufactured according to pretty similar (like almost identical) manufacturing standards, irrespective of brand. I would suggest you focus more on finding a device with the appropriate length for your needs and combining it with the right treatment protocol. You can find a good intro device for around $15 USD. Expensive doesn’t necessarily indicate higher quality…at least not with what’s currently on the market. Best of luck and feel free to reach out if you have any other questions.

  6. Just wanted to say appreciate the thorough post, been doing research on this and this is definitely one of the better blog posts I have read. Thanks!

  7. I have micro needling done by a natureapath. After 3 treatments I have seen improvement. I love it. It doesn’t hurt and I have had no bruising or side effects and I am a blonde with sensitive skin. Its cheaper than a high end facial. Try it.

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