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Everyday Health
How Does Microneedling Work?
By By Moira Lawler. Medically Reviewed by Susan Bard, MD,
2024-08-05
You can use the microneedling technique at home or undergo the treatment in a dermatologist's office. Alexandra Turkina/iStock; Alamy
If you start your microneedling research with a TikTok or Instagram search, you'll probably be scared off. The photos and videos are alarming - the procedure involves puncturing the skin with tiny needles that draw blood. Nevertheless, videos like this one from @edgarsmakeup have garnered millions of views.
Sticking a bunch of needles into your face may not sound like a good idea, but the process sets off a rejuvenation reaction that leaves many people raving about the results.
Here's everything you need to know about the popular procedure.
How Does Microneedling Work Exactly?
Microneedling - also known as collagen induction therapy, skin needling, or percutaneous collagen induction - is a cosmetic practice in which the skin is punctured with small needles. "The goal is for the damage caused by the needles to stimulate your body to send healing agents in the form of elastin and collagen to the area of treatment to repair the skin," says Manish Shah, MD , a board-certified plastic surgeon in Denver.
The idea is to improve the way the skin looks (by reducing fine lines, wrinkles, and enlarged pores) and feels (more on this below).
If you're having the procedure done in a dermatologist's office, the skin will likely be numbed before treatment to eliminate or at least decrease pain and discomfort, Dr. Shah says. "And then a pen-like tool called a derma roller is utilized in order to insert tiny stainless-steel needles into the skin to cause microinjuries or punctures," Shah says.
The treatment will take 10 to 20 minutes, though you'll need to buffer in more time if you're receiving topical anesthesia beforehand.
Shah says that most of the time you'll need more than one session, but since everyone's needs are different, you'll need to consult your doctor to determine the best treatment plan for you. Fine lines and wrinkles might call for two sessions a year, burns or stretch marks may require five, and acne scars are somewhere in the middle, Shah says.
Many dermatologists enhance microneedling procedures with either a depigmentation serum (for people looking to reduce hyperpigmentation) or platelet-rich plasma (which aids the skin healing process), says Michele Green, MD , a board-certified dermatologist in New York City.
Types of Microneedling
There are different types of microneedling, and some are more effective than others. "This is very confusing for patients, because everyone has a different idea or concept of what microneedling actually is," says Sapna Palep, MD , a board-certified dermatologist and the founder and medical director of Spring Street Dermatology in New York City.
Manual Microneedling
Manual microneedling, typically done with handheld devices like derma rollers and derma stamps, is the most common type of microneedling done at home, Dr. Palep says.
While at-home devices tend to be cheaper than in-office treatments, they don't offer the same results. The needles on the manual devices are shallower and therefore have limited ability to stimulate collagen production, says Peterson Pierre, MD , a board-certified dermatologist based in Thousand Oaks, California. The at-home version needles are typically less than 0.15 millimeters (mm) long as opposed to 0.5 to 2 mm long for medical tools.
Dr. Pierre says these at-home skin-care devices do have some benefits, though: They enhance exfoliation and help products you apply afterward (such as hyaluronic acid and vitamin C ) penetrate deeper into the skin. "You may achieve brighter skin at best, but minimal skin rejuvenation," he says.
If you decide to go this route, Pierre suggests applying even pressure while rolling the device in multiple directions around your face. Be sure to clean the tool thoroughly - not doing so can result in infection. Follow the cleaning instructions specific to your device (usually it involves rinsing the roller in soap and water and soaking it in isopropyl alcohol).
Automated Microneedling
"Automated microneedling [is] done with a motorized pen-like tool," Palep says. "It can be adjusted to different depths in the skin for different areas of the face," and the needles typically penetrate 2 to 3 mm into the skin, reaching both the epidermis and the dermis, a deeper skin layer.
Radiofrequency Microneedling
In radiofrequency microneedling, the needles that penetrate the skin also release high-intensity radio frequency energy, which can trigger the growth of new collagen fibers without doing lots of damage to the epidermal layer of skin.
"Radiofrequency microneedling has a wide range of beneficial effects when used correctly," Palep says. "But this needs to be a very tailored treatment for each individual."
The Potential Benefits of Microneedling
According to Shah, microneedling can help with these concerns:
Palep notes that at-home manual microneedling treatments (like derma roller and derma stamps) are unlikely to have much benefit, since these tools only reach the outer layer of the skin.
Automated microneedling and radiofrequency microneedling, on the other hand, reach the dermal layer of the skin. This type of microneedling triggers the healing process and stimulates the production of collagen and elastin, both of which are proteins that firm and smooth your skin. Collagen also combats wrinkles, and collagen levels naturally decline with age. "Any intervention that encourages increased collagen synthesis can make skin look and act younger," Shah says. In one study, participants ages 35 to 75 underwent four microneedling sessions one month apart. After the final treatment, they saw significant improvements to lines, wrinkles, skin texture, and skin laxity. Microneedling can also treat acne scarring because the needles can break down hardened scar tissue and encourage it to rebuild, per research. Another study explored the effect of four microneedling sessions on 50 people with acne scarring. After two months, everyone saw improvements, no matter how severe the scars were to begin with. Finally, a small study found that microneedling can help minimize the appearance of stretch marks , with marked to excellent improvement noted in about 44 percent of the 16 study participants following three monthly sessions. One thing to keep in mind is it typically takes up to 6 months to start seeing results, so don't be disheartened if you don't notice better skin immediately after healing. And, although there is evidence that microneedling promotes skin rejuvenation through collagen production, one article points out that there's limited evidence on its effectiveness in treating all of these skin concerns.
Green and Palep recommend microneedling as an effective, minimally invasive way to address several common skin concerns. "There are minimal risks associated with the microneedling procedure," Green says. "Individuals may experience mild redness or swelling that will resolve on its own within a day or two after treatment."
Who Should Not Try Microneedling and Why
First, Green and Palep both advise against at-home microneedling. "There is an increased risk of developing an infection if the skin is not properly cleaned or if the tools used are not sterile," Green says. Plus, using the wrong needle length or technique may cause side effects like scarring and hyperpigmentation - two skin concerns that many people try to get rid of with microneedling.
When it comes to whether you should try microneedling, Palep says it's crucial to talk to a dermatologist who can offer an individualized recommendation based on your skin, your health history, the medications you're on, and your skin goals. "There are so many gray area contraindications for the different types of microneedling," Palep says.
Certain conditions, like blood disorders that impact blood clotting, acne, frequent skin rashes or cold sores , eczema , and psoriasis could impact whether or not you're a candidate for microneedling. The same goes for medications and treatments like anticoagulants, acne medications, chemotherapy, and radiation treatment. A good dermatologist will ask you about all of these things before performing microneedling to determine whether it's the right treatment for you.
Palep also points out that automated microneedling and radiofrequency microneedling are very different, and the question of who should avoid microneedling varies depending on which type you're talking about, too.
"Individuals should not undergo a microneedling procedure if they have an active acne breakout, open wounds, rashes, or infection in the area, as microneedling may exacerbate the symptoms," Green says.
Before- and after-care will also depend on your skin and other health factors, Palep says, although she recommends that everyone avoid excessive sweating and sun exposure immediately after a microneedling procedure.
Green recommends discontinuing any exfoliants, retinoids, or hydroxy acid skin-care products for about a week before and after treatment.
How Much Does It Cost to Get Microneedling, and Who Does It?
At-home microneedling options are far cheaper than in-office treatments, with derma rollers and derma stamps costing about $35 or less, and electric derma pens costing anywhere from $50 to $250. But again, while these options are cheaper, they don't offer the same benefits as in-office treatments and can actually create new skin concerns, like hyperpigmentation and scarring.
The cost of professional microneedling isn't standardized and varies by location and who's performing the treatment. According to reviewers on Real Self, an online resource for folks interested in cosmetic procedures, microneedling can cost anywhere from $150 to $800 per treatment. The number of sessions needed will vary, but most will probably need to get treatments one to two months apart for three to six months, with annual maintenance treatments afterward.
"Microneedling is a medical procedure and really should be performed in a board-certified dermatologist's office," Pierre says. "This is your face, after all, so you want it in the best hands so you can get the best results while minimizing any side effects."
That means you'll need to steer clear of medical spas, where doctors may work but they aren't necessarily board-certified dermatologists, who complete medical school and an additional three years of a dermatology-specific residency plus an optional fellowship in a dermatologic specialty area, notes the American Academy of Dermatology. Board-certified plastic surgeons are also equipped to perform microneedling treatments.
The Takeaway
Microneedling is an effective, minimally invasive cosmetic procedure that involves piercing the skin with tiny needles to stimulate collagen production and accelerate the skin healing process. It can be helpful for folks who want to address skin concerns like wrinkles and fine lines, skin tone and texture, hyperpigmentation, acne scarring, and stretch marks. But it's important to have the treatment done by a professional for best results, as at-home microneedling isn't as effective and can lead to side effects like infection, scarring, and hyperpigmentation.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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