People who desire younger-looking skin, but don't want to turn to botox injections or go under the proverbial knife, are turning to a procedure called "microneedling" for results that are often just as effective. A relative newcomer to the world of aesthetic dermatology, microneedling sounds terrifying in theory, but is actually quite safe, despite the fact that it involves making thousands of tiny puncture sites in your skin.
"Microneedling uses numerous small needles to make micro injuries to the skin," says board certified dermatologist Skylar Souyoul, in an email. "These micro injuries stimulate new collagen production and can help the appearance of fine lines, wrinkles or scars."
The benefits of microneedling have long been suspected, with a German dermatologist named Ernst Kromayer experimenting with the concept as far back as 1905. More recently, dermatologists began offering the procedure in office around 1995. The concept has since spun off into various lines of home-use dermaroller products, such as the one touted by derm-giant Rodan & Fields, although big-box retailers now peddle much cheaper versions.
True microneedling, however, is done in the dermatologist's office, under care of a board-certified professional, typically a dermatologist, cosmetic surgeon or plastic surgeon.
Who Has Microneedling Done?
Microneedling is most often performed on the face to improve the appearance of fine lines, wrinkles, scars, large pores and even stretch marks. People also have it done to improve overall skin tone and texture. Really, anything that can be made better by improved collagen production can be addressed with microneedling.
Wondering how this collagen production is amplified? The central idea behind microneedling is that the needle penetration causes skin trauma, which in turn spawns a "wound healing cascade." As a result, topical skin therapies are more effectively absorbed into the skin than they would be if you just slathered them onto a solid surface. "In my practice I have found microneedling most useful for drug delivery," says Jason A. Clark, board-certified dermatologist and adjunct assistant professor of dermatology with the Emory University department of dermatology. "The tiny holes created pull topically applied medications into the skin, allowing enhanced penetration."
However, facial skin isn't the limit for microneedling. "Microneedling can also be used on the scalp to stimulate hair growth, especially when combined with platelet rich plasma," Souyoul says. In fact, one study, published in 2013 in the International Journal of Trichology, found that men who underwent microneedling in addition to using a hair loss medication experienced significantly greater hair regrowth than their counterparts who only used the medication.
Does Microneedling Hurt?
"Depending on the device used, the procedure can feel as mild as tiny pin pricks to an intense burning sensation with some energy-based devices," Clark explains. Tearful patients are not uncommon, but are hardly the rule. Souyoul applies a topical numbing medicine about 30 minutes before the procedure. "With the use of topical numbing medicine the procedure is practically painless," she says.
That doesn't mean you'll be ready to hit the clubs immediately afterward, though. The skin is typically bright red for 12 to 24 hours, followed by several days' worth of pinkness. It's also common for skin to be rough like sandpaper and peeling for approximately three to five days. Makeup cannot be worn for 24 hours because it could cause an inflammatory reaction or acne flares. "Patients should not get microneedling if they have a tan. If patients do not follow these instructions the risk is hyperpigmentation," Souyoul adds. Hyperpigmentation is a typically harmless condition in which patches of skin become darker in color than the normal surrounding skin.
Sun exposure must also be strictly avoided for two weeks before and two weeks after each treatment. When you consider that most microneedling treatments are multi-appointment affairs, (Dr. Souyoul recommends three to six treatments spaced one month apart each) you can see how it's critical to be totally on board with the sun moratorium.
Is Microneedling Safe?
True microneedling definitely falls under the category of "don't try this at home." "Given disruption of skin barrier, there is a risk of infection," Clark notes. "I am aware of at least one case of microneedling combined with PRP [platelet-rich plasma] in the medspa setting where a patient may have contracted HIV."
Fortunately, though, microneedling is typically very safe if done by a board-certified dermatologist with the proper equipment. Pre- and post-treatment care is also critical to keeping skin reactions and other complications low, as is use of sterilized equipment.