Question 1

What is microneedling?

Accepted Answer

Microneedling (aka collagen-induction therapy) is a skin rejuvenation treatment that penetrates the skin’s surface with tiny needles to create microinjuries, which spurs new collagen growth. Controlled injuries are a hallmark of most skin rejuvenation treatments, including lasers and chemical peels, because they trigger a wound-healing response that kick-starts natural cellular regeneration.

This popular procedure has a host of benefits, from improving sun damage to scars. More specifically, it can help:

smooth lines and wrinkles
even skin tone (including dark spots and stubborn melasma)
minimize large pores
subtly firm the skin
fade stretch marks and scars, including acne scars
allow topically applied ingredients to absorb better
bolster hair loss treatments

“I love microneedling, because it can be used on any skin type, the downtime is minimal, and the results can be so dramatic,” says Dr. Nima Shemirani, a board-certified facial plastic surgeon in Beverly Hills, California. “Skin is tighter, brighter, and more healthy. And although there’s no magic bullet for treating acne scars, microneedling can be more effective than more expensive lasers.”

Since microneedling doesn’t involve heat, it’s also generally safer for patients with melasma or skin of color.

Microneedling can also be combined with topical platelet-rich plasma (PRP) derived from your own blood, for a more potent treatment called a Vampire Facial.

This combo is more expensive, but it delivers more of an anti-aging punch, according to Dr. Lara Devgan, a board-certified plastic surgeon in NYC. “The PRP adds to the efficacy of the treatment, making it about 15–20% better.” PRP is packed with growth factors that encourage your cells to regenerate, so you’ll also get a bigger boost of collagen from each microneedling session.

RealSelf Tip: RF microneedling treatments like Vivace, Morpheus8, and the newer Sylfirm X deliver radiofrequency energy into the tissue via fine needles, ramping up the results of the traditional energy-free treatment. Learn how the benefits compare to the risks.

Question 2

What are the pros and cons of microneedling?

Accepted Answer

Pros

The treatment is relatively quick, comfortable (when paired with a topical numbing cream), and cost-effective, compared to other skin rejuvenation treatment options.
Microneedling provides both short- and long-term benefits. “There is an immediate result that people describe as a ‘glow’ to their skin, which is actually mostly related to temporary swelling,” says Dr. Cameron Chesnut, a board-certified dermatologic surgeon in Spokane, Washington. “But it serves as a nice interim benefit while the longer-term result of collagen production takes effect.”
The treatment can be customized to treat localized problem areas, such as acne scars, dark under-eye circles, crow’s feet, and neck or chest lines.
Recovery time is usually just a few days, depending on your treatment intensity. “If you do more passes and go deeper, there will be more downtime,” says Dr. Jason Emer, a board-certified dermatologist in West Hollywood, California.
Microneedling doesn’t involve the delivery of heat, so it’s safe to use on all skin tones without the risk of pigmentation issues that can accompany laser resurfacing and light procedures.
Though it’s mostly used on the face, neck, chest, and hands, microneedling can be done all over the body.
A majority of RealSelf reviewers say microneedling is “Worth It.” Many liked that it didn’t hurt much and led to firmer, more evenly toned skin.

Cons

Microneedling results are extremely technique-dependent. Inexperienced providers or DIY at-home devices can damage your skin and even leave scars, so find a well-reviewed doctor or clinic.
Other potential complications include infection and hyperpigmentation.
You’ll need a series of multiple treatments (at least three) to get the full benefits, and follow-up sessions are required to maintain them.
While the treatment can help with mild skin laxity, particularly around the eyes and jawline, it can’t significantly lift and tighten sagging skin.
RealSelf members who said it’s “Not Worth It” say it left lingering marks or changed their skin’s texture for the worse. Again, it’s important to find an experienced, skilled provider who knows how to avoid this kind of damage.

Question 3

How much does microneedling cost?

Accepted Answer

Individual microneedling treatment sessions typically cost $100–$200, but a series of at least three is recommended for optimal results. Your total cost will depend on how many treatments you have, as well as your provider’s level of experience and where they practice.

You’ll pay up to $600 more to add platelet-rich plasma (PRP), for a combination treatment called a Vampire Facial.

See our complete guide to microneedling costs

Question 4

Microneedling before and after pictures

Accepted Answer

The microneedling photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

Who makes a good candidate?

Accepted Answer

Adults who are in good health (free from any infections, fever, or rash) and looking to help smooth fine lines and wrinkles, boost collagen production, reduce hyperpigmentation, or combat scars from acne or injuries are good candidates for microneedling.

“In particular, it is a very safe technique for dark skin types, where risk of postinflammatory pigmentation is very high with other techniques that damage the epidermis,” notes a 2016 study.

Microneedling isn’t recommended for those who:

are pregnant or nursing
have active skin conditions, like eczema, rosacea, or acne
are treating acne with isotretinoin
have psoriasis due to the Koebner phenomenon, which triggers skin disease by stimulating the skin
have lupus or vitiligo

This treatment can trigger cold sores. Tell your doctor if you’re prone to cold sores, so you can start taking an antiviral medication a few days prior to your appointment.

Question 6

What does microneedling do for your skin?

Accepted Answer

Microneedling creates thousands of microinjuries, triggering a healing response that releases a cascade of growth factors and boosts production of the body’s own collagen, the protein fibers that keep skin smooth and supple.

The goal, says Dr. Emer, “is to damage the skin just enough to where it’s improving itself so you reverse the aging process, not damaging the skin so the collagen grows back irregularly.”

In one study, researchers saw up to a 400% increase in collagen and elastin deposition in the skin, six months following four monthly microneedling sessions.

The mechanical action of the needles also breaks down fibrotic scar tissue and allows it to revascularize, to smoother, healthier effect.

Because only a fraction of the skin’s surface is treated, recovery time is relatively short.

Microneedling also allows active ingredients to penetrate better and work more effectively, by creating channels for topical products to be absorbed.

RealSelf Tip: In addition to skin rejuvenation benefits, there's evidence that microneedling can also help those with a type of hair loss called alopecia areata. It's often paired with platelet rich plasma (PRP) or minoxidil in order to regenerate the health of the hair follicles and create new or thicker hair.

Question 7

What happens during a microneedling treatment?

Accepted Answer

Microneedling can hurt if you go without anesthetic, so it’s best to arrive an hour before your appointment so a topical anesthetic cream can be applied.

Once your skin is numb, the treatment itself will take between 15 and 30 minutes, depending on the size and number of treatment areas. Here’s what to expect:

Your skin is cleansed and dried.
Then, based on what issue you’re trying to treat, an active serum is applied—for instance, salicylic acid for acne or vitamin C for pigmentation. “That makes the skin very moist and slick, so the microneedling device can glide over it,” Dr. Emer explains.
The original microneedling device, a dermal roller that would be rolled over the skin, has mostly been replaced in doctor’s offices by automated stamping devices that contain single-use, sterile needle cartridges with a varying number of needles—anywhere from a dozen to more than 160, depending on the device. The spring-loaded devices—sometimes a Dermapen, though a number of variations exist—are employed, using a stamp-like motion across the skin.
Most devices have an adjustable needle head that allows your provider to customize the depth of the needles for different areas. “When microneedling, we use different depths, depending on the skin type and the part of the face we’re treating. For example, the skin on your forehead is much thinner than the skin on your cheeks, so we’d start at about 0.5 mm and maybe go as deep as 2.5 mm over the cheeks or deep scars,” says Dr. W. John Bull, a board-certified plastic surgeon in Naperville, Illinois. “There’s no therapeutic benefit to going deeper than needed.”
The depth of treatment is also influenced by the issue being addressed. As the aforementioned study explains, “For treating acne and other scars as a routine, a needle length of 1.5–2 mm is usually used. When microneedling is used … to treat aging skin and wrinkles, the needle length of 0.5 mm or 1.0 mm is usually recommended.”
Sometimes, instead of altering the depth based on the area they’re treating, doctors apply different levels of pressure.
They may also do more or fewer passes in different areas—anywhere from two to six passes per area. “Once the areas are even in bleeding and redness, the treatment is done,” adds Dr. Emer.
Post-treatment, a customized serum and cooling mask are applied to help calm down the skin.
Some doctors expose patients to red LED lights, to speed healing.

“You’ll leave looking a little bit red and have some pinpoint scabs,” says Dr. Emer. “Skin will calm down and look prettier within a week.”

RealSelf Tip: Consult with your provider prior to your microneedling procedure about how to pretreat your skin. “I find that many undervalue the importance skincare plays in both pre- and post-procedure regimens,” says Dr. Eugene Nowak, a board-certified dermatologic surgeon in Chula Vista, California. “By using medical-grade and prescription-strength skincare to prepare skin prior to the procedure, supplying it with core nutrients during recovery, and protecting it from further damage, you’ll achieve maximum results.”

Question 8

How often should you do microneedling?

Accepted Answer

An initial treatment series of three to five monthly sessions is typically recommended.

After that, you’ll need occasional maintenance treatments to keep up your results.

Question 9

How long does microneedling take to heal?

Accepted Answer

“Following microneedling, the skin will appear red and inflamed for about 24-48 hours,” explains Dr. Anshu Gupta, a board-certified plastic surgeon in Solana Beach, California. “This of course depends on the skin tone of the patient as well. Fair skin tones may experience prolonged redness,” which can look like a bad sunburn.

In addition to redness and swelling, you may experience crusting, pinpoint bleeding, skin flaking, tightness, and sensitivity during the healing process. While these symptoms are usually short-lived, they can last up to 12 days if skin was treated aggressively. “Textural changes in skin and sensitivity to products will linger the longest, as these are related to a repairing skin barrier,” says Dr. Chesnut.

Because everyone heals differently, it’s wise to book at least two weeks prior to an event, to allow adequate recovery time.

Question 10

What's the best protocol for microneedling aftercare?

Accepted Answer

Every provider has their own aftercare regimen, so you should head home with detailed instructions. They may include:

washing your face with a gentle cleanser after 8 hours (or earlier, if your doctor recommends it).
not wearing makeup on the day of your treatment, to help keep your skin clean and avoid infection
wearing mineral powder sunscreen and avoiding UV light as much as possible is often recommended on the day of your treatment
applying a skin care product with growth factors and peptides, to supply the building blocks necessary for the skin to repair itself

“The growth factors help decrease healing time, optimize the outcome of your treatment, and improve tone, texture, and elasticity,” says Dr. Burke Robinson, a board-certified facial plastic surgeon in Alpharetta, Georgia. That’s why you’ll heal especially quickly if you also have topical PRP.

At the very least, it’s important to keep skin moisturized during your recovery, says Dr. Nowak. “It’s a myth that skin heals best if you ‘let it air out.’” He recommends a non-occlusive moisturizer, since occlusive (film-forming) products can clog pores and cause milia, small white bumps that occur when dead skin gets trapped in the pores.

Because microneedling disrupts the skin barrier and leaves skin more sensitive, post-treatment skincare products should ideally be sterile (think single-use) or at least free from allergens that can cause rashes and contact dermatitis.

Related: The 8 Best Foundations That Cover Up Redness After Microneedling

Question 11

How long does it take to see microneedling results?

Accepted Answer

Most patients see a reduction in pore size within a day or two, often due to swelling, says Dr. Emer.

You should start to notice an improvement in your skin's texture within a week of your first treatment.

More dramatic changes, like an improvement in acne scars or deeper wrinkles, likely won’t appear until you’ve had at least three treatments.

Question 12

Is microneedling permanent? How long do results last?

Accepted Answer

Microneedling results are not permanent. How long the benefits last for you will depend on your age, the state of your skin, and how well you take care of it.

“Once you have completed your treatment series, your clinician can determine what maintenance regimen will best suit you, based on your overall skin care goals,” says Dr. Larry Leverett, a board-certified plastic surgeon in Phoenix, Arizona. “If you continue to maintain an effective home care regimen, in addition to regular skin care treatments, you should be ‘sitting pretty’ for six months to a year before you need a maintenance treatment.”

Patients over age 40 and those with heavily sun-damaged skin will need touch-ups every three to four months, says Dr. Connie Hiers, a board-certified plastic surgeon in San Antonio. “The depth of microneedling and the use of PRP also guides the frequency of treatments.”

Question 13

Can you have fillers at the same time as microneedling?

Accepted Answer

The traditional wisdom is that it’s best to either let your skin heal from microneedling or to let the fillers settle between these two treatments. “If you choose to do microneedling first, wait about 3-4 days before getting fillers (or injectables),” says Dr. Vibha Gambhir, a physician in Prussia, Pennsylvania. “If filler is injected first, wait at least one week to do your microneedling. This will give the filler a chance to settle, and swelling should be gone by then.”

However, there’s a recent and growing trend of microchanneling fillers and Botox into the skin (rather than injecting them), often using a device like Aquagold. This more superficial application has a host of skin rejuvenation benefits, from reducing oiliness and redness to treating scars and stimulating collagen.

Question 14

Is microneedling worth it?

Accepted Answer

Reviewers on RealSelf give microneedling an type: embedded-entry-inline id: Ks6V6ARYAktTMUTOEu3el Worth It Rating, and the science behind the treatment (dating back to the early 1900s) is solid.

In a 2018 study on patients ages 35 to 75, researchers reported a noticeable improvement in lines and wrinkles, skin laxity, and skin texture three months after the first of four monthly microneedling treatments—and improvements continued for two more months.

The boost in skin tightening, researchers noted, was largely due to the conversion of collagen III, the type found in older skin, to collagen I, the type found in younger skin—a process that can take as long as a year to complete.

While microneedling is also an effective scar treatment, the level of improvement depends on the type of scar. In a 2015 study on pitted acne scars, biweekly treatments produced a good to very good response in rolling and boxcar scars, which are shallow, while icepick and deeper scars had a moderate to poor response.

Studies also show an improvement on both early and late stretch marks, but doctors on RealSelf stress that consistent and long-term treatment—often six or seven sessions—is required to make them less noticeable.

In the study mentioned above, side effects (mainly redness) were minor and easily managed compared to other invasive technologies, such as laser ablation and radiofrequency energy treatments.

Related: The Treatments and Ingredients Actually Proven to Reduce Wrinkles

Question 15

Can microneedling ruin your skin?

Accepted Answer

When it’s performed by an expert, “microneedling is a safe and effective treatment,” says Dr. Jennifer R. Berman, a physician in Los Angeles, California. “It is well tolerated, with limited to no side effects, and patients are generally happy with the results.”

However, microneedling has the potential to do long-term damage in the hands of an inexperienced provider, as RealSelf member k10001 experienced. “I actually find it difficult to look at my face in the mirror. I have pinholes across my entire face. When I smile, hundreds of little wrinkles form as the skin bunches up between the scar tissue caused by the needles,” she posted six months after her treatment. “It looks extremely disturbing.”

The rules surrounding who can legally perform microneedling vary by state, but generally speaking, this medical treatment—like any procedure that pierces the skin—should be performed only by a licensed medical professional, not an aesthetician.

According to the American Med Spa Association, “an aesthetician's license does not permit him or her to perform medical treatments; rather, aestheticians may only perform procedures for the purpose of beautification.” And currently, “many state regulatory boards specifically are classifying microneedling as medical treatment.”

Microneedling is very technique-dependent, so find a well-reviewed doctor, nurse, or physician assistant who’s been well-trained in the procedure and can show you their own before and after photos, with consistently good results.

Related: Everything You Need to Know About Microneedling Side Effects

Question 16

Are at-home microneedling derma rollers safe?

Accepted Answer

Doctors are divided on the safety of at-home microneedling derma rollers: some feel they're just be ineffective, while others warn that they could be dangerous.

“At-home devices don’t have the sterility to prevent infection,” says Dr. Shemirani. “This [procedure] should be done in a doctor’s office or qualified medical spa, to reduce that risk.” According to the American Academy of Dermatology (AAD), “at-home microneedling can accidentally spread warts, herpes, and other viruses across the skin.”

The needles on at-home devices can also create wounds in amateur hands. “Pressing too hard can damage your skin,” warns the AAD, causing “scarring or changes to your skin’s color or texture.”

DIY rollers are also largely ineffective, since most penetrate a fraction of a millimeter, affecting only the skin’s outer layer (pro devices reach the dermis, where collagen cells live).

“The microneedling devices sold for at-home use do not go as deep as those used in a physician's office,” explains Dr. Jean Casello, a physician in Northborough, Massachusetts. “The purpose of these devices was to penetrate skin care products deeper into the skin and treat very superficial lines/wrinkles. They would not be as effective for cellulite and stretch marks as a treatment you would get in a medical facility.”

A professional microneedling treatment offers many advantages over DIY versions. In addition to knowing the exact depth to stimulate collagen and elastin—and using a device with quality needles that penetrates predictably and uniformly–a reputable microneedling practitioner can also administer PRP (platelet rich plasma) to speed healing and bolster rejuvenation benefits.

Related: 3 Treatments You Should Never Do at Home

Question 17

Sources & studies

Accepted Answer

Ablon, Glynis. “Safety and Effectiveness of an Automated Microneedling Device in Improving the Signs of Aging Skin.” The Journal of Clinical and Aesthetic Dermatology, Matrix Medical Communications, Aug. 2018.

Singh A, Yadav S. Microneedling: Advances and widening horizons. Indian Dermatol Online J. 2016 Jul-Aug.

El-Domyati, Moetaz, et al. “Microneedling Therapy for Atrophic Acne Scars: An Objective Evaluation.” The Journal of Clinical and Aesthetic Dermatology, Matrix Medical Communications, July 2015.

MICRONEEDLING

Cameron Chesnut, MD, FAAD, FACMS

Karyn Repinski

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Cameron Chesnut, MD, FAAD, FACMS

Karyn Repinski

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