Table of Contents
1. Introduction
In my previous post, I explained how various microneedling devices work. In this post, I will explain the potential benefits of microneedling for various skin conditions.
There’s a lot more research on skin needling than I thought and it’s compelling. In-office microneedling has proven benefits for the skin, especially acne scars. Whether you’ll see these benefits by doing it at home, it’s a different story.
Note: Skin needling and microneedling are the same thing.
2. Microneedling for acne scars
Many trials have shown that microneedling improves atrophic acne scars. Researchers believe that the needles break collagen fibres that create scars and they trigger the production of new collagen right under the epidermis.
In most studies, the needle depth was 1.5 mm and the number of sessions between 4-6. It seems that a minimum of 4-6 sessions are required for a significant improvement. But results may be seen after only two sessions.
Microneedling is possibly more effective for rolling and boxcar scars than ice-pick scars. (To view a picture of each of these scars, click here). It won’t eliminate very deep acne scars on its own, but it’s very likely that it will reduce their size.
2.1 Microneedling vs laser for acne scars
Laser treatments can significantly improve acne scarring, but the side-effects can be off-putting. That’s especially the case with ablative lasers, which basically remove the epidermal layer. Non-ablative lasers are gentler but they may not be equally effective.
Skin needling is an alternative to lasers for reduction of acne scars with a shorter recovery time. Some research has shown that it is just as effective as non-ablative lasers but less so than ablative lasers.
Clinical trials
In a clinical trial, microneedling and a non-ablative fractional laser gave comparable results. However, skin redness lasted less in the patients who had microneedling. Also, some volunteers who had laser experienced PIH (post-inflammatory hyperpigmentation). None of those who had microneedling experienced PIH.
On the other side, in another trial, microneedling was less effective than an ablative fractional laser. Microneedling improved scars by 30% and the laser by 70%! However, downtime was significantly shorter in the microneedling group.
2.2 Microneedling with chemical peels
Results are usually more dramatic when skin needling is combined with other treatments.
In a clinical trial, treatment with a dermaroller and 35% Glycolic acid was clearly more effective than dermaroller alone. The combination significantly reduced not only scarring, but also post-inflammatory hyperpigmentation. A trial with 70% Glycolic acid had similar results.
In another study, a combination of subcision (a type of treatment for acne scars), dermarolling and a 15% TCA peel reduced scarring in all volunteers. Some were left with no scars at all. However, some volunteers experienced PIH (post-inflammatory hyperpigmentation).
3. Microneedling for acne
Standard microneedling isn’t typically used to treat active acne. However, Fractional microneedling radiofrequency does improve acne. Simply put, it reduces sebum production. It improves acne scars too, so it could be ideal if you have both acne and acne scars at the same time.
In all studies, improvement was seen after 1-3 sessions, done once every 4-6 weeks. Some typical adverse effects are redness, pain and bleeding, but they are not very severe. And it seems that this technique doesn’t aggravate existing acne.
However, results may not be permanent: in one trial, acne returned in most patients 8 weeks post-treatment.
Check my post on microneedling devices to learn more about this procedure.
4. Microneedling for aging skin
Microneedling may reduce fine lines and wrinkles, tighten skin and increase elasticity. The recommended needle length for skin rejuvenation is 0.5 to 1 mm. There is continued improvement for at least three months after the first session.
You may need roughly six sessions for a noticeable improvement, especially for stubborn signs of aging. Results may be more dramatic if your physician uses longer needles (i.e. 3 mm), but downtime will be longer.
Some clinical trials
In a well-conducted trial, most volunteers experienced a visible difference in their skin after skin needling with a dermaroller.
Another trial examined the benefits of microneedling with Dermapen on volunteers with wrinkles. Some were smokers and some weren’t. Most volunteers experienced a visible improvement.
In both trials, the volunteers had six sessions and the needle length was 1 mm.
In two other trials, microneedling reduced upper lip wrinkles and signs of aging on the neck after only two sessions.
Preparation of the skin
It is recommended to use skincare products with vitamin A for at least a month before microneedling. Retinol is a well-known form of vitamin A and so is Tretinoin, which is prescription-only in many countries. Simply put, Vitamin A will maximize the benefits of microneedling and it will help skin heal faster.
Skincare products with Vitamin C and other antioxidants are also recommended for at least a month before the procedure.
Fractional Radiofrequency Microneedling
Treatment with Fractional radiofrequency Microneedling has also shown promising results for aging skin. Typically 1-4 sessions are required to see benefits from this type of microneedling. Just like with plain microneedling, there is continued improvement for at least 3 months after the first session.
Check my post on microneedling devices to learn more about this procedure.
5. Stretch marks
Some research has shown that treatment with dermarollers reduces stretch marks for some people. Typically 3-6 sessions are required. However, in a trial, the volunteers saw benefits from just one microneedling session.
The most common needle length in clinical trials is 1.5 mm.
Chemical peels may boost the effectiveness of skin needling. In a trial, a combination of microneedling with a (trichloroacetic acid) TCA peel was more effective than microneedling alone. However, the combination had more side-effects.
6. Hyperpigmentation
Microneedling may have benefits for people with melasma. It is typically combined with other skin lightening agents.
In a trial, skin needling was used to improve absorption of a serum with skin lightening ingredients. It was very effective.
Microneedling has also been used to treat hyperpigmentation around the eyes. In a trial, it was combined successfully with a 10% TCA peel.
In another trial, a treatment with Dermafrac reduced dramatically dramatically reduced hyperpigmentation around the eyes of a 48-year old male. Please check my post on microneedling devices to learn about Dermafrac.
7. Safety of microneedling at home
In-office microneedling costs a pretty penny. So of course it’s tempting to channel your inner dermatologist and do it at home.
It’s easy to get carried away by Youtube videos that start like “I used a derma roller at home and it changed my life”. But the scientific evidence on the benefits of microneedling comes from clinical trials.
In those trials, it was the researchers, not the patients who handled the microneedling devices. And the skin of the patients was frequently monitored for any complications.
7.1 Anecdotal evidence
What we know about the effectiveness of DIY microneedling comes almost exclusively from personal experiences. And there are loads of threads on Reddit and other forums. Some people claim to have seen a positive difference on their skin and some others had very bad experiences.
Adverse effects from microneedling that’s not done properly can be more serious than the simple irritation we’ve all had from skincare products. Especially from devices with longer needles (1-3 mm).
The longer the needles, the higher the risk of side-effects.
I have no doubt that some people have seen benefits from at-home microneedling. But for some others, it was a negative experience. That’s why you need to be aware of the risks before some influencer convinces you that it will change your life for the better.
7.2 Recommendations
If you really want to do microneedling at home, I recommend you don’t use a device with a needle length of more than 0.5 mm. Ideally, stick to the recommended length of 0.25 mm or 0.13 mm.
0.13 mm is actually enough if you’re looking to enhance absorption of skincare products. And I believe that 0.5 mm will improve aging skin, acne scars and stretch marks to some extent.
Do a lot of research before you buy a dermaroller or a dermapen. It’s so easy to get carried away by cheap prices, before-and-after photos and fake reviews. We’ve all been there! There are hundreds of skin needling devices on the market and some have very bad quality needles. If you use one of these devices, you’ll either damage your skin or not see any difference.
8. References
Sharad J. Combination of microneedling and glycolic acid peels for the treatment of acne scars in dark skin. J Cosmet Dermatol. 2011;10(4):317-323.
Garg S, Baveja S. Combination therapy in the management of atrophic acne scars. J Cutan Aesthet Surg. 2014;7(1):18-23.
El-Domyati M, Barakat M, Awad S, Medhat W, El-Fakahany H, Farag H. Microneedling Therapy for Atrophic Acne Scars: An Objective Evaluation. J Clin Aesthet Dermatol. 2015;8(7):36-42.
Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D. Acne scarring treatment using skin needling. Clin Exp Dermatol. 2009;34(8):874-879.
Cachafeiro T, Escobar G, Maldonado G, Cestari T, Corleta O. Comparison of Nonablative Fractional Erbium Laser 1,340 nm and Microneedling for the Treatment of Atrophic Acne Scars: A Randomized Clinical Trial. Dermatol Surg. 2016;42(2):232-241.
Preissig J, Hamilton K, Markus R. Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface. Semin Plast Surg. 2012;26(3):109-116.
Osman MA, Shokeir HA, Fawzy MM. Fractional Erbium-Doped Yttrium Aluminum Garnet Laser Versus Microneedling in Treatment of Atrophic Acne Scars: A Randomized Split-Face Clinical Study. Dermatol Surg. 2017;43 Suppl 1:S47-S56.
Bonati LM, Epstein GK, Strugar TL. Microneedling in All Skin Types: A Review. J Drugs Dermatol. 2017;16(4):308-313.
Chandrashekar BS, Sriram R, Mysore R, Bhaskar S, Shetty A. Evaluation of microneedling fractional radiofrequency device for treatment of acne scars. J Cutan Aesthet Surg. 2014;7(2):93-97.
Kim ST, Lee KH, Sim HJ, Suh KS, Jang MS. Treatment of acne vulgaris with fractional radiofrequency microneedling. J Dermatol. 2014;41(7):586-591.
Min S, Park SY, Yoon JY, Suh DH. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial. Arch Dermatol Res. 2015;307(10):897-904.
Lee KR, Lee EG, Lee HJ, Yoon MS. Assessment of treatment efficacy and sebosuppressive effect of fractional radiofrequency microneedle on acne vulgaris. Lasers Surg Med. 2013;45(10):639-647.
Lee SJ, Goo JW, Shin J, et al. Use of fractionated microneedle radiofrequency for the treatment of inflammatory acne vulgaris in 18 Korean patients. Dermatol Surg. 2012;38(3):400-405.
McCrudden MT, McAlister E, Courtenay AJ, González-Vázquez P, Singh TR, Donnelly RF. Microneedle applications in improving skin appearance. Exp Dermatol. 2015;24(8):561-566.
Araújo AR, Soares VP, Silva FS, Moreira Tda S. Radiofrequency for the treatment of skin laxity: mith or truth. An Bras Dermatol. 2015;90(5):707-721.
Sahni K, Kassir M. Dermafrac™: an innovative new treatment for periorbital melanosis in a dark-skinned male patient. J Cutan Aesthet Surg. 2013;6(3):158-160. doi:10.4103/0974-2077.118420
Doddaballapur S. Microneedling with dermaroller. J Cutan Aesthet Surg. 2009;2(2):110-111.
Fernandes, Desmond. (2005). Minimally Invasive Percutaneous Collagen Induction. Oral and maxillofacial surgery clinics of North America. 17. 51-63, vi. 10.1016/j.coms.2004.09.004.
Aust, Matthias & Fernandes, Desmond & Kolokythas, Perikles & Kaplan, Hilton & Vogt, Peter. (2008). Percutaneous Collagen Induction Therapy: An Alternative Treatment for Scars, Wrinkles, and Skin Laxity. Plastic and reconstructive surgery. 121. 1421-9.
KIM, J.K., ROH, M.R., PARK, G.‐h., KIM, Y.J., JEON, I.K. and CHANG, S.E. (2013), Fractionated microneedle radiofrequency for the treatment of periorbital wrinkles. J Dermatol, 40: 172-176.
Budamakuntla L, Loganathan E, Suresh DH, et al. A Randomised, Open-label, Comparative Study of Tranexamic Acid Microinjections and Tranexamic Acid with Microneedling in Patients with Melasma. J Cutan Aesthet Surg. 2013;6(3):139-143.
Amer, Mohamed & Farag, Fawzeya & Amer, Amin & ElKot, Riham & Mahmoud, Rana. (2018). Dermapen in the treatment of wrinkles in cigarette smokers and skin aging effectively. Journal of Cosmetic Dermatology. 17. 1200-1204.
Fabbrocini, Gabriella & Vita, Valerio & Pastore, Francesco & Annunziata, Maria Carmela & Cacciapuoti, Sara & Monfrecola, Ambra & Cameli, Norma & Tosti, Antonella. (2011). Collagen induction therapy for the treatment of upper lip wrinkles. The Journal of dermatological treatment. 23. 144-52.
Sanad, Eman & Aginaa, Halaa & Sorour, Neveen. (2015). Microneedling system alone versus microneedling system with trichloroacetic acid in the management of abdominal striae rubra. Journal of the Egyptian Womenʼs Dermatologic Society. 12. 96-101.
Hagag, MagdaM & Samaka, Rehab & Mahmoud, HananA. (2019). Role of microneedling in treatment of patients with striae distensae. Menoufia Medical Journal. 32. 756.
Fabbrocini, Gabriella & Vita, Valerio & Di Costanzo, Luisa & Pastore, Francesco & Mauriello, Maria Chiara & Ambra, Monfrecola & Annunziata, Maria Carmela & Santolo, Maria & Cameli, Norma & Monfrecola, Giuseppe. (2010). Skin needling in the treatment of the aging neck. Skinmed. 9. 347-51.
Fabbrocini G, De Vita V, Fardella N, et al. Skin needling to enhance depigmenting serum penetration in the treatment of melasma. Plast Surg Int. 2011;2011:158241.
Have you ever had microneedling and did you see any benefits? Leave a comment below!
Comments and questions