Seeing an aesthetic procedure all over social media can breed a strange sort of FOMO. (Hey, we’re not immune.) Yet it may be difficult to distinguish for-the-’Gram fads from truly “Worth It” tweaks. Which is why we’re launching a new series on RealSelf: Everybody’s Doing It. Each month, we’ll explore all sides of an of-the-moment cosmetic procedure, to bring you the uncensored truth about its efficacy and safety so you can decide if it’s right for you. Here, in our latest installment, we’re discussing microinfusion facials.
The potions are bespoke. The needles, 24k gold-plated. And the intention, clear: “glass skin”—dewy, poreless, incandescent perfection. Such is the pretty language of microinfusion facials—the utterly uploadable skin-stamping treatment sweeping social media. If the name doesn’t ring a bell, perhaps that’s because this elevated facial boasts several aliases, including Aquagold Fine Touch, which is the specific brand of microinjector device that popularized the procedure—the Kleenex of the category, if you will. Providers who are partial to other stampers will often christen the treatment with their own trademarked terms.
There may be subtle differences between microinjection tools, but they all share a striking resemblance—lilliputian glass vials crowned with circular beds of stainless-steel needles, each slicked with gold (to minimize irritation), finer than a strand of hair (to lessen discomfort), and hollowed out to allow for the passage of liquid actives from the vial into the skin upon stamping.
While “there isn’t a standard protocol” for such treatments, says Dr. Morgan Rabach, a board-certified dermatologist in New York City, and the formulary process is somewhat “shrouded in secrecy,” she notes, the cocktailed contents within the tiny chambers of these devices usually include varying measures of neurotoxin; dilute hyaluronic acid (HA); antioxidants (vitamin C, glutathione, niacinamide); skin brighteners (tranexamic acid is a big one); and platelet-rich plasma, or PRP, derived from one’s own blood.
“I think Aquagold got a big boost of popularity and visibility from social media, [becoming known] as a painless, subtle, quick treatment for those who do not want true injectables but still like the idea of getting more bang out of a topical by ‘pushing’ it into the skin,” explains Dr. Annie Chiu, a board-certified dermatologist in Redondo Beach, California. “The concept is very intuitive—we’re microneedling active [ingredients] deeper into your skin so it glows.”
The reputed benefits of the microinfusion facial
While no doubt famous for ramping up radiance, the treatment’s perks don’t end there. “I love having this procedure in my aesthetics toolbox, because patients of all skin types and ethnicities can really benefit, with very little downtime, anytime of year,” says Dr. Elizabeth Bahar Houshmand, a board-certified dermatologist in Dallas. The unique mixture of ingredients chosen for a given patient will influence the exact effects rendered as well as the total cost of treatment, which can range from $600 to $2,500.
Neurotoxin, like Botox or Dysport, is a standard constituent of microinfusion formulas. Since it’s entering skin, not muscle, it doesn’t work to minimize motion but rather “relaxes the tiny arrector pili muscles [connecting hair follicles to dermis], thereby reducing the appearance of pores and improving the skin’s overall texture,” explains Dr. Jessica Weiser, a board-certified dermatologist in New York City. Injecting small droplets of toxin into the skin has also been shown to diminish sebum production. In fact, “the patients who seem to see the most benefit from toxin microinfusion are those who have concerns of oily skin and large pores,” says Dr. Sarmela Sunder, a board-certified facial plastic surgeon in Beverly Hills, California. They commonly tell her how much more smoothly their makeup applies post-facial.
Separately, she adds, “there have been reports of improvement in rosacea from botulinum treatments,” as superficial doses of the drug may quell the inflammation underlying the condition.
Infusions are commonly spiked with HAs, which, upon injection, are thought to act as internal moisturizers, drawing water into the skin to plump up cells and enhance light reflection. “I use the thinnest HAs on the market, such as Juvéderm Volbella or Belotero Balance, and I still try to thin them out even more [before injecting],” says Dr. Chiu, noting that thicker fillers “can clog the microchannels and not get delivered or can be deposited unevenly.”
Interestingly, Dr. Sunder no longer uses HA in her microinfusion procedures, because she hasn’t “noticed a significant result with this—most likely because the lumens of the needles aren’t wide enough to accommodate the gel,” she surmises. Dr. Weiser typically leans on the fairly fluid Restylane Silk for her Aquagold treatments but will sometimes reach for a high-molecular-weight hyaluronic acid serum instead, as an even lighter option.
Other topical skin-care serums are often added, with the goal of brightening skin, preventing free-radical damage, alleviating redness, and halting inflammation and pigment production.
When swirled into the mix, PRP aims to “enhance collagen stimulation and tissue repair, to reduce signs of aging and improve skin texture,” notes Dr. Weiser. Not everyone offers it though, because it hikes the overall cost by several hundred dollars—and the payoff isn’t always commensurate with the price.
The needled stampers essentially act as “a drug-delivery system that drives these ingredients deeper into the skin, for theoretically better benefit due to absorption,” Dr. Chiu says. While the aforementioned chemicals can all spark some degree of change in the skin, so too can the sheer mechanical stimulation of the tissue from repeated pinpricks. “I think the damage to the epidermis—and I’m saying that in a positive way—coupled with the HA that’s going in and doing the superficial plumping right at the moment, is mostly responsible for the glow that can be seen after one of these treatments,” Dr. Rabach says.
Related: The 8 Best Foundations That Cover Up Redness After Microneedling
Who sees results, how quickly, and for how long?
We interviewed several dermatologists and facial plastic surgeons about microinfusion treatments—some ardent supporters, others less enthusiastic—and all agree that the effects are quite subtle and will vary based on how much pressure is applied to the stamper during treatment, the precise ingredients in a custom infusion, and one’s individual skin type. For example, says Dr. Chiu, “I find those with thicker skin do not see the glowy effect as much but may see some shrinking of pore size.”
Your baseline, or starting point, matters too: “If you already have great skin-care and hydration, the improvement may not be as dramatic on you,” she adds. Similarly, notes Dr. Weiser, “patients with even skin tone will see more impact than those with acne, rosacea, eczema, significant pigmentation, or various types of scarring”—all of which can interfere with light reflection and distract from discreet refinements.
Enhanced hydration and a slight swell to the skin may be seen within minutes to hours of treatment, but other effects won’t register right away. A toxin’s good deeds, for instance—stemming oil, tightening pores, quieting redness—can take a week or two to show. And then, of course, there may be compounds in the mix that provide invisible skin protection or offer rewards that take time (and multiple treatments) to accrue.
“Results can last for several weeks to three months,” says Dr. Sunder, who generally likes to focus the treatment on the delicate skin of the eye area, where its effects really shine. Her most committed patients sign up for monthly or quarterly sessions.
Why some physicians have reservations about microinfusion facials
Where to begin? We’ve already mentioned that the tinctures are not standardized—not just the ingredients themselves but their quality and quantity—and this gives some doctors pause.
“We don’t have much evidence showing that these microinjections of whatever cocktail actually do result in benefit to skin health and appearance,” says Dr. Omar Ibrahimi, a board-certified dermatologist in Stamford, Connecticut. Each element of a potion may have proven efficacy when used in a specific fashion, “but that doesn’t mean we can jumble them all together and inject them into the skin and expect there to be a benefit, when these products are being used in a way that’s different from that which they’ve been tested for.” Dr. Ibrahimi also worries about the “unintended consequences” that could arise from forcing into the skin ingredients made to be used on top of it—namely irritant and allergic contact dermatitis.
Beyond the safety issues surrounding the injection of serums, there’s the question of necessity. Some of the more popular ingredients, like vitamin Cs and HAs, have been shown to “affect changes in the collagen with topical use alone,” says Dr. Rabach. And so she wonders: “Do we really need to be puncturing the skin with this procedure? What’s the true difference between putting a topical on the skin and stamping it in?”
Like Dr. Ibrahimi, Dr. Rabach doesn’t offer microinfusion facials in her office. “I don’t see the truth in them—and I think there’s a potential downside,” she says: “I worry that using little aliquots [or portions] of Botox in this way, every month or every few months, could cause long-term resistance [to botulinum toxins].” There are studies showing that repeated injections of neurotoxin over time can cause the body to develop antibodies to the drug, which dampen or nullify its effect. “We know antibody formation happens gradually and regardless of dose, and I think there’s a caution there that we have to think about as providers, especially when working with younger people. It would really suck hard if doing this quick-fix type of treatment in your 20s and 30s caused you to build up a tolerance to neurotoxin in your 40s or 50s.”
Another sticking point for some is the needling tools themselves—more specifically, their supposed reach. Stampers are made by multiple manufacturers, and across brands, “there may be nuances with depth of penetration,” notes Dr. Rhonda Klein, a board-certified dermatologist in Westport, Connecticut. Aquagold is among those claiming to penetrate 0.6 millimeters into the skin, bypassing the epidermis and depositing actives into the very top of the dermis, or living layer of tissue, where blood vessels and collagen cells reside.
“I’m skeptical of this claim, because I do a lot of microneedling with radiofrequency, and even in that arena, many devices do not get their needles down to the depths they claim,” says Dr. Ibrahimi. “I personally don’t think just the needles can induce collagen production [as certain brands purport]. I have not seen any microscopic or clinical evidence of this.”
Dr. Rabach echoes his doubt. “When we think about collagen production from medical microneedling, you’re talking about going 2.5 millimeters into the skin—that is actually creating injury in the dermis.” With stamping tools, “I’m not sure we’re at the level of the dermis.”
Dr. Chiu makes the important point that microinfusion treatments—and results—are very operator-dependent. If a provider is carelessly stamping at lightning speed, “a lot of times they are not getting the full microneedle penetration nor adequate delivery of the solution,” she notes. “These tiny hairlike needles can also dull very quickly against skin, especially thick skin, which clogs them, and over a treatment, they may not get consistent depth.”
The skin actually varies in depth across the face, she says, with the eyelids being the thinnest and the nose and upper lip being thicker. “The practitioner administering these types of treatments should be familiar with these varying depths and increase or decrease pressure on the stamper accordingly.”
If the needles cause an even pinpoint bleeding throughout the face, Dr. Chiu adds, this is a very good sign that your provider has “likely hit the papillary dermis, where the blood vessels are most prominent.”
Procedures, old and new, promising similar but longer-lasting results
Doctors who are dubious about microinfusion claims and long-term gains insist that more proven and predictable alternatives do exist. With a glycolic acid peel, for instance, “you’re going to get a little bit of glow and help the health of your skin cells and collagen over time,” says Dr. Rabach. Lasers too can smooth and illuminate the skin “by inducing thermal changes, which then set off a wound-healing cascade,” explains Dr. Ibrahimi. “Depending on the type, they can build collagen or reduce pigment or redness—there’s a wealth of data on this.”
On the horizon are HAs specially designed for shallow injection into the skin. Unlike our current collection of FDA-approved HAs, which primarily impart volume and shape, these newer gels, like Juvéderm Volite and Restylane Skinboosters, are engineered to hydrate skin to supple effect and give an obvious glow when injected in tiny droplets across the face.
The Aquagold facial “was almost a shortcut to getting some of those benefits,” notes Dr. Chiu, who was an investigator on the clinical trials for Volite (which will hopefully earn approval within the next year or two). “But upcoming skin-quality fillers will offer longer-lasting and more substantial and consistent improvements, not just in skin texture but also fine lines, acne scarring, and creping—conditions that we typically wouldn’t treat with Aquagold alone.”
Related: How to Tackle Your Most Stubborn Skin Conditions at Home
Dr. Shannon Humphrey, a board-certified dermatologist in Vancouver, British Columbia (where Volite has been cleared for use for the past two years), finds that stamping tools generally deposit smaller amounts of HA more superficially, whereas Volite is placed deeper and in larger droplets—two factors that contribute to its durability. (Volite studies show a single treatment can last up to nine months.) Because Volite is injected with a traditional needle, she adds, providers can also tailor the depth and density of injections to best suit a patient’s needs.
Of course, in aesthetics, better outcomes typically translate to greater downtime. So while some doctors call microinfusion facials a fad, others see real value in them, particularly for those craving an occasional refresh before special occasions, when redness and bruising won’t do. If you want “immediate results with the least amount of downtime, this is a great procedure,” says Dr. Houshmand. “Come in about a week before your event—and expect a beautiful glow.”
