Microneedling is a minimally invasive procedure that aims to treat scar tissue, lax skin, wrinkles, and large pores by increasing collagen production. It sounds scary—and it does involve needles piercing the skin—but the needles are very fine and short, and only mildly uncomfortable. And the advantages of the procedure greatly outweigh the disadvantages.
To help allay your fears and find out exactly how microneedling benefits problematic skin, we spoke to two microneedling experts: certified physician's assistant Whitney Conen, from Chicago Cosmetic Surgery and Dermatology, and medical aesthetician Kate, from LaBella Skin Bar in Germantown, Tennesee.
"Microneedling works by making controlled microinjuries in your skin, which your body will then heal while producing collagen," Whitney explains. More collagen means smoother, younger looking skin.
"The biggest transformation I see is on acne scarring, which speaks very highly of the process because that’s deep scarring/pitting," Kate says. "It does wonders on overall anti-aging and hyperpigmented skin [skin with dark spots], but I’m always shocked at how effective it is on deep scarring."
Whitney also frequently works on clients with acne scars. In fact, "our most requested skin issue we use microneedling on is diminishing acne scars," Whitney says. "It's also a great procedure to improve the appearance of fine lines, skin tone, and texture, and can even improve the appearance of stretch marks!"
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Aesthetician Kate of LaBella Skin Bar in Germantown, TN, performs microneedling. "The biggest transformation I see is on acne scarring, which speaks very highly of the process because that’s deep scarring/pitting," Kate says. Photo: @skincare_by_kate.
Typically, a microneedling treatment begins with the practitioner taking before pictures of the treatment area, then applying a numbing cream.
Once the area is numb, the practitioner performs the microneedling treatment with a special microneedling pen. Vibrating microneedling pens use an automated stamping motion to create controlled injuries with tiny needles. The treatment takes about 20–30 minutes.
After the needling, most practitioners apply a skin-soothing product, which is said to penetrate more deeply into the skin because of the needles. Kate uses a 100% pure hyaluronic acid serum. Whitney applies a hyaluronic acid mask that clients leave on their skin for about six hours. (Read more about the benefits of hyaluronic acid).
"The treatment is fairly comfortable due to the topical numbing cream we apply prior to treatment," Whitney assures us. "You might feel some tiny pin pricks, as some areas of the face are more sensitive than others. Overall, it's a very tolerable procedure!"
Kate agrees. "I topically numb the skin for 15–20 minutes prior to microneedling so that there is no discomfort," she says.
The downtime is about 3–5 days. According to Whitney, on days 1–3, it may look like you have a sunburn, and your skin may feel tight, dry, swollen, or sensitive to the touch. On days 3–5, your skin should start to return to its normal tone and any swelling should subside, though there is still the possibility of some minor peeling or flaking.
It all depends on what you're trying to treat. "Acne scars typically require as many as six treatments, with treatments spaced four weeks apart," Whitney says. Those who just want to improve the overall tone and texture of their skin can usually get what Whitney calls "great results" in about three treatments.
Kate recommends something similar. "I highly encourage my clients to commit to four treatments separated by 3–4 weeks," Kate says. And she has even followed her own advice.
"I personally did the original four [treatments] separated by once a month. Now I maintain and do it once every 2 or 3 months just because I can and I love the results so much!"
Laser skin-resurfacing treatments, for instance, also increase collagen. But according to Whitney, microneedling is safer for all skin types and colors.
"Some treatments like CO2 or Fraxel laser have the risk of causing hyperpigmentation (dark spots) because they utilize heat to produce results," she says, adding that microneedling actually has a shorter downtime than most laser treatments, too.
Less invasive microdermabrasion treatments and chemical peels stimulate collagen production, as well, but results are typically more subtle.
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Aesthetician Shelly at Artistry SpaSalon in Franklin, TN, performs a client's second microneedling treatment. Scroll through to see microneedling before and after pics. Photo: @youresthybestie.
At some practices, including Chicago Cosmetic Surgery and Dermatology, patients have the option of combining microneedling with platelet-rich-plasma (PRP) taken from their own blood (see: Vampire Facial).
"Your platelets have growth factors, which will help stimulate more collagen production," Whitney says. While patients wait for their numbing cream to kick in, Whitney can draw their blood and spin it in a centrifuge to separate out the platelets from the blood cells.
Once the patient is numb, she applies the PRP to their skin and then uses the microneedling pen. After 20–30 minutes of needling, she applies the rest of the PRP as a mask, instead of the hyaluronic acid she typically uses.
It depends on where you live and the size of the treatment area. For instance, Kate charges $875 for a package of four treatments at her Germantown, Tennesee, med spa. We've seen it as high as $700 per treatment in Chicago and New York.
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"Anyone with active acne breakouts, open wounds, cold sores, psoriasis, or eczema on the treatment area should not have microneedling," Whitney cautions. "Additionally, if you are on a blood thinner or have a history of keloid scars, you should consult with a medical provider prior to treatment."
Otherwise, she says, "there are very few people who can't get microneedling! It's perfect for anyone that's wanting an overall improvement to their skin."
Microneedling is the overall name for the treatment, whereas dermarolling refers to microneedling performed with a dermaroller, Whitney explains.
"Dermaroller was the first device used for microneedling. It has specific needle lengths covering a wheel, which a provider will roll over the skin," she explains. Dermapens, like the one she uses and the ones used in the Instagram posts above, are the latest technology.
"Microneedling pens are best because they can be set to very specific depths, taking away the chance of human error that comes with dermarollers. They also offer more consistent treatments, meaning you're getting the same procedure each time."
At this point, you've probably seen dermarollers meant to be used during at-home microneedling treatments. Here's the thing about those devices: medical professionals tend to disagree on whether or not they're a good idea.
Some say that although at-home microneedling is less effective than professional treatments, it can help maintain your results from an in-office treatment. But that's only if you really take care of the device, including sterilizing it.
Whitney personally doesn't like the shallow needle depths of the at-home rollers and the fact that they can spread an infection, which could lead to even worse skin issues and scarring.
"I recommend only getting microneedling treatments from licensed medical professionals, like me," she says.
This article was written by Colleen Loggins Loster and Kate Raftery.