Microneedling At A Glance
- Best Results3-10 sessions
- Treatment Recovery1-5 days
- Procedure Time20 min
- Skin SpecialistNurse, Dermal Therapist, Davin Lim
- Duration of Results2 months +
- Back to Work1-5 days
Microneedling is an entry-level procedure. It is a form of non-laser fractional skin therapy. Needling can help boost collagen, treat textural changes including fine wrinkles, enlarged pores & very mild acne scarring. We use a number of microneedling devices including Dermapen, Skinpen, Dermaroller, Dermastamp & energy-based devices including nanoneedle & RF microneedling. The correct device will depend on your skin concerns.
FactsFacts on Microneedling
- Microneedling is a form of fractional non-laser resurfacing
- Needling can either be a roller, stamper, digital Dermapen, or energy -based radiofrequency system
- The depth of needles can be controlled by the device- ranging from 0.1 to 4.5 mm needles
- Depth, passes & energy levels are adjusted, according to concerns
- Needling can also help improve skin texture
- Microneedling can reduce mild forms of acne scars
- Newer treatments such as RF microneedling, nano-microneedles, & thermo-mechanical nano needling are more effective than non-energy based needling
- Microneedling PRP can give better outcomes in some conditions
How can Microneedling improve skin concerns?
Skin needling or microneedling, including Dermapen, can treat conditions that occur under the skin’s surface, including
- Acne scars & textural changes
- Wrinkles & fine lines
- Stretch marks- especially old ones (white in color)
- Open pores / enlarged pores
- Sun damage
Multiple treatments can also help with skin texture by decreasing fine lines, and skin pigmentation. Microneedling should not be used to treat melasma pigmentation as it can worsen pigmentation. I do not use microneedling to treat dark circles as the undereye area has very thin skin. This can lead to worsening of dark circles.
My most frequent indication of microneedling is dermal delivery of medications including intralesional corticosteroids & tranexamic acid.
How does microneedling work?
Microneedling works on the basis of controlled micro-trauma. Once the skin’s upper epidermal layer is broken, skin cell release growth factors & cytokines. These molecules can stimulate cells to produce collagen, elastin & hyaluronic acid. Over a period of months, skin is rejuvenated. The result is an improvement in skin quality.
The downside with microneedling is that it does not provide controlled heating, unlike RF microneedling, Tixel & fractional lasers. Sustained heating results in much more collagen remodelling.
How many sessions of needling will I require?
3-5 sessions spaced 2-6 weeks apart. The number of sessions will depend on your skin condition, concerns, ethnicity as well as downtime.
When will I see the difference?
In some cases, after one session. Most patients will notice improvements over the following months as collagen is generated. As a guide you will notice bigger & faster gains with fractional lasers over microneedling. Laser resurfacing provides controlled heating. Microneedling does not.
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Is microneedling – skin needling painful?
No, just as long as local anaesthetic is used. My nurses use a specialist grade anaesthetic called 23/7- this is over 5 times stronger than anaesthetic creams from beauty clinics and cosmetic doctors.
What is the difference between a roller, stamper & digital Dermapen microneedling?
Skinpen & Dermapen is a controlled digital and electronic form of skin needling that delivers holes vertically. Skin rollers such as the Dermaroller puncture the surface at an angle and are manually controlled. Dermastamps provide manual & vertical delivery of needling with a stamping footprint. I use all three delivery systems, depending on the job.
Dermapen provides a much better, safer, and cleaner fractional wound compared to skin needling rollers for novices. Cleaner wounding decreases infection, scarring as well as increases healing times. Dermastamping provides safe vertical needles, whilst rollers are useful if depths are kept shallow (around 0.2-0.3 mm).
To add to the classification, heat can be added to microneedling. This is called RFM or radiofrequency microneedling. This can be divided into insulated RF or non-insulated RFM. The addition of controlled heating gives better outcomes in the context of dermal remodelling.
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How long will it take me to heal from skin needling?
Following a proper skin needling session your skin will take up to one week to heal. Healing time is proportional to the amount of passes, depth of needle, area treated as well as clinical aftercare.
Home kits that contain 0.2 to 0.3 mm needles provide virtually no downtime, whilst clinical skin needling kits provide needle depths up to 4+ mm.
The latest microneedling treatments utilise controlled heat (Radiofrequency). RF microneedling is associated with an additional 24 to 48 hours recovery time. If high energy levels are used, you may have skin pigment changes such as darkening for a few weeks after RF microneedling.
How effective is microneedling for the treatment of stretch marks?
Microneedling has been shown to improve old stretch marks- ie. Stretch marks that are white, silvery or papery in texture and colour. New stretch marks respond much better to Vascular laser treatments.
Dermapen microneedling can improve the appearance of old stretch marks by up to 30-40% after 5-6 treatments. We tend to combine Vitamin A therapy with Dermapen for the best results.
As with other conditions, newer treatments such as Fraxel laser can deliver better results compared to microneedling.
How effective is microneedling for the treatment of acne scars?
Skin needling – microneedling can be partially effective for early & mild acne scars.
Acne scars that respond best include mild rolling, tethered, anchored, or atrophic scars. The best methods to treat acne scars are directed at the scar type, and not just a procedure, or brand- this includes even the most advanced laser systems. Sometimes a simple procedure such as TCA CROSS or punch elevation will produce superior results than a machine.
If you would like to attempt microneedling, you can use a home kit, providing the needles are less than or equal to 0.25 -o.3 mm. Visit the acne scar section on this website to understand what scar treatments are best. I have included a safe & practical section on DIY treatments.
Is microneedling a good treatment for dark circles?
No. There a far better & safer treatments out there. The reason why I do not like this treatment is due to the delicate under eye area. This area has the thinnest skin on your body, less than 0.1 mm thick. Microneedling can often cause too much tissue trauma, leading to bleeding under the skin. This can often make dark circles worse. The same applied to PRP microneeding of the undereye area. Bleeding under the skin can result in iron staining, a condition known as post procedure prupura.
Treatments such as gentle fractional lasers, Tixel, dermal fillers, pico & vascular lasers are more directed to the causes of dark circles. These treatments can potentially improve the under eye area.
Why is microneedling not a great solution for melamsa?
If you have melasma, the primary treatment is medical, namely with tyrosinase inhibitors & vascular modulation. Lasers, devices & peels are always adjunctive treatments.
Microneedling has the potential of basement membrane rupture. This means the pigment cells can drop down into the deeper dermal layers, resulting in dermal melasma. This form of melasma is much harder to treat compared to epidermal melasma. Most dermatologists will agree that there are far better & safer treatments for melasma.
Can microneedling treat enlarged pores?
Yes, however it can also enlarge smaller pores. On this basis I prefer to treat pores with small diameter lasers, like pico fractional or short pd ablative – non ablative lasers. Other safer & more effective pore-reducing treatments include laser genesis, pico facials, & laser toning.
Skin care is also important in the treatment of pores. A good formulation of retinol, ascorbic acid, niacinamide & AHA-BHA wash can really help your pore sizing, especially if you have enlarged pores due to poor support of your follicle & or skin inflammation.
So, is microneedling an outdated treatment?
No, microneedling is still a useful clinical treatment, even though we have over 25 laser & energy devices. I use microneedling on a daily basis for the treatment of –
- Focal forehead scars. (I prefer manually microneedle over using a pen-device as I have a better feeling for scar tissue).
- Hypertrophic scars. I still like to use a dermaroller in order to deliver dilute CS to scar tissue without the ablation of laser resurfacing
- Very mild and early acne scars. See section on scarring. I use a manual Dermastamp. Especially useful to give to patients as ‘homework’ in between scar revision sessions.
Can I perform microneedling at home?
Yes, if you are careful. Giving DIY advice is difficult as I must work with the lowest common denominator, hence advice has to be conservative. As a guide-
- Choose needle lengths of 0.1 to 0.2 mm maximum.
- Stamping device is far safer than a roller or a pen.
- Conservative passes means 3-5 passes overall.
- Addition of skin care actives such as retinol, hydroquinone, ascorbic acid can be beneficial.
See the section on DIY skin care on this website for a more detailed explanation.
What are side effects of microneedling?
Fortunately, side effects are, for the most part rare (except when treating melasma & under eye areas). These include-
- Iatrogenic scarring. Mostly due to poor technique or equipment. Examples including ‘drag of pens’, weak motor, skin or dermarollers without traction or too deep needles
- Further enlarged pores. If the needles are bigger than your pores, don’t do it. My saying ‘always treat the problem with a solution that is smaller than the problem itself’, applies. Pores are best treated with small diameter short pd lasers, such as thulium or diode 1927, fractional Pico or short pd CO2 over erbium lasers.
- Worsening of dark circles, esp. in combination with PRP. This can lead to iatrogenic bleeding & iron staining.
- Worsening of melasma. This treatment can make melasma much harder to treat.
- Infection- HSV or bacterial infection (rare).
- Worsening of acne, common.
How much are treatments?
For an up-to-date pricing structure on microneedling, book an appointment with my dermal therapists @cliniccutis
What treatments are better than skin needling?
For the best in collagen remodelling and scar revision, controlled heating of the dermis should be achieved. This heating is between 65-70 degrees, can only be delivered via lasers, radiofrequency or High Intensity Focused Ultrasound.
Heat is not generated with microneedling. Controlled heating of lasers will give better results in the majority of cases.
It is not to say that this treatment is outdated, as microneedling is my preferred method for entry into the dermal layers without ablation of lasers. One should approach microneedling as a method & not the only tool in the toolbox.
Davin’s viewpoint on microneedling
Skin needling was the very first method of fractional skin resurfacing. This technique was first invented decades ago by tattooist to remove unwanted ink. Dermatologist then re-invented the tattoo gun with skin needling rollers. Over the years, rollers evolved into digital or electronically controlled hand held devices that provided vertical skin wounding via needles, rather than angled wounding (skin rollers). This device is called the Dermapen.
The question is – does skin needling actually work? Yes, it does, however more advanced equipment, coupled with clinical experience can deliver far superior results. Fractional devices such as pico lasers, 1927 thulium lasers, CO2 and Hybrid lasers deliver more predictable, safer & in many cases more cost-effective results.
Having said this, I still perform microneedling on a daily basis, either manually with a handheld needle, or with rollers, stamps & pen-devices. I do think they are great at creating a controlled injury to the upper layers of the dermis without the ablation or heat of lasers.
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