Are There Bad Side Effects to Micro-needling?

I want to reduce the appearance of my acne scars. I would like to try Micro-needling.

Doctor Answers 28

Treat Acne Scarring with Microneedling

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Microneedling has been around for a long time but is finally starting to gain traction in the US. I like to describe this in terms of roller needles, pen needles and big-box needles. There are pros and cons of each one. And any procedure can have side effects, so please make sure you learn as much as you can and that the provider is skilled — hopefully at a board-certified dermatologist or plastic surgeon’s office.

Rolling needles are the oldest form of needles, and there are many kinds. This procedure was popularized by a plastic surgeon in Cape Town, South Africa: Dr. Des Fernandez, who has taught the procedure and shown its effectiveness for many years. His company, known as Environ, is one of the market leaders with rolling needles. They can be done at home with small needles or in an office with larger needles. The procedure is very technique dependent and, if done correctly, can rejuvenate the skin and treat some mild acne scarring. It can be a fairly bloody office procedure, but it can work with several sessions.

Microneedle pens use a group of motorized needles to deliver into the skin. Names such as DermaPen, MicroPen and others are popping up in offices for the same indications as the rollers. There is still some blood after the treatment, but with a series of treatments the skin can do well. Another pen, although not the same, is called AquaGold, where needles are inserted into the skin with a canister apparatus so products can be applied during the needling — a great concept.

Then there are the big-box needles. These are typically radiofrequency-tipped needles that can penetrate the skin at various depths to have an effect on the deep layers of the skin. Bleeding is minimized as the RF current not only helps with rejuvenation or scars, but also helps coagulate the vessels in the area, so bleeding is not a major concern. RF needles are colorblind, so all skin colors can be successfully treated. Devices such as the EndyMed Intensif and the Lutronic Infini are the leaders in the US with big-box needles, and these treatments are very popular in Asia. Fewer treatment sessions are usually needed.

So what else can go wrong? These things are putting little holes in the skin and sometimes applying product to the skin. The products themselves should be sterile or at least free from allergens that can cause rashes and contact dermatitis — something we are seeing more and more when these are being performed in offices that have no clue as to what they are doing.

And with any procedure, the risk of pigment changes, although not big with needling, still can occur. Scarring has been reported, so once again, make sure that the provider is skilled and knows what they are doing.


Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Microneedling Great For Acne Scars

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Microneedling is one of the best ways to minimize acne scars. We have many patients in my office that have had tremendous success with the Dermaroller treatment. As with anything, there may always be risks associated but those risks are drastically minimized if you go to the right place. We have performed hundreds of Dermaroller treatments without any negative side effects. Experience is key and a professional medical clinic will ensure that any negative side effects such as infections will not happen.

Microneedling can be painful

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I really like microneedling. Today there are many devices that do microneedling but to be honest, I like the feel of my own hand applying the necessary pressure of a dermroller on the skin. No machine can beat the feedback of the human hand. It is a great treatment to help improve acne scars, tighten skin, build collagen. It can't take the place of a C02 laser in my experience but it is a great tool. It can be painful, and you should have pinpoint bleeding from the procedure. 


Where can things go wrong:

- starting with too much depth of the needles

- applying unsterile products after the treatment

- bad post-procedure care

- pain during the procedure

Sameer Bashey, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 9 reviews

Vivace Microneedling may be your answer

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At my practice, we use both the microneedling pen (Skin Stylus) and the Vivace Laser System that combines microneedling with thermal energy (heat) to bring out even better results for acne scarring.  I have seen phenomenal results.  Side effects are probably slight sunburn feel if any.  Also be careful...not all microneedling pens can be autoclaved.  Our Skin Stylus is autoclavable (the only one out there that can be) so this sterilizes it in between patients to elimination infection and cross-contamination.  With the Vivace you have your own disposable microneedling piece so it is always safe.  I think you will love microneedling for your acne scars.  You can also combine it with your own plasma (platelet-rich plasma) and microneedle your own growth factors from your own blood to even heal the scars faster.  

Samer Muala, MD
Phoenix Family Physician
5.0 out of 5 stars 3 reviews

What side effects can occur after microneedling?

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Microneedling works by injuring the skin in such a way that it responds by producing new collagen, which in turn plumps the skin and restores volume. It works well for texture, lines, volume loss and acne scarring

At my Vancouver cosmetic surgery practice we use rolling needles by Environ and have seen phenomenal results in staff and patients alike. The best part: microneedling is a fairly low-risk procedure with side effects tending to be few and far between.

The rolling equipment should be sterile and personal (each patient should have his or her own roller, and these should be autoclaved before each session) and the face should be cleaned and prepped before treatment to avoid cross-contamination or spread of bacteria. Patients with active acne should consider alternative options before treatment as dermal rolling can easily spread bacteria over the skin, potentially causing breakouts. Patients prone to cold sores should let their treatment provider know so that a preventive prescription can be given prior to the session.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Microneedling Safety

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When done with proper technique , there are few reasons that Microneedling would elicit unfortunate side effects. Even pinpoint bleeding that can occur with a deeper treatment , usually only leaves redness and mild inflammation for 2-4 days max!    This treatment can offer fantastic outcomes for  texture, fine lines and acne scars!!

Professional micro-needling vs. Derma Rollers at home

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Micro-needling is an interesting treatment that dates back to ancient Chinese medicine. When done in a professional practice, stamping type micro-needling is a safe and effective treatment. Much like fractional laser resurfacing, Micro-needling is a fractional treatment which means that it treats a fraction of the skin at a time. Instead of laser energy, an automated stamping device with a series of sterile one time use needles stamps micro-treatment zones into the skin. As with other fractional treatments, the surrounding untreated islands of skin heal the micro-treatment zones rapidly and initiate the production of collagen and new skin cells.

This is completely different from devices sold for home use which are ineffective and unsafe. Unlike Micro-needling tips that are used once and then discarded, derma-rollers are used over and over again. Contrary to every person who thinks they cleaned their device well enough, these devices cannot be properly cleaned. Therefore home use derma-rollers  harbor viruses, fungi and bacteria which are then introduced into the skin with the next use. Derma-roller needles also get dull and therefore instead of resulting in superficial micro-treatment zones, may cause deep injury and even scaring. I urge anyone with home derma-rollers to throw them out. 

Monica Bonakdar, MD
Corona Del Mar Physician
5.0 out of 5 stars 11 reviews

Advancement in Micro-needling for Acne Scars!

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The INtracel RF Microneedling device is the latest, most technologically advanced iteration of microneedling.

INtracel RF Microneedling takes microneedling a step further by introducing radiofrequency, or RF, technology. The INtracel uses gold-tipped microneedles that conduct radiofrequency energy into the dermis (the deep layer of skin) in order to more effectively kick-start collagen production for more dramatic results than can be achieved through microneedling alone. Radiofrequency technology has long been understood to help stimulate collagen production through heating and tightening deep skin tissue, and is used in a variety of effective skin tightening and even fat reduction technologies, such as Vanquish ME, Exilis, and Accent RF. Together, microneedling and RF technology can work wonders on the skin, and best of all, it requires no downtime at all! 

Susan Wolf, MD
San Mateo Dermatologist

Are there bad side effects to microneedling?

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There are many types of microneedling devices. In essence all the devices do the same thing,  create multiple small holes  on the surface of the skin through which skin care products/ medications are delivered below the skin surface. They can also help stimulate collagen production to a much lesser extent.

For the most part microneedling are devoid of any bad side effects. However, after a micro needling session one can experience swelling, micro bleeding spots. Unusual side effects like allergic reactions to the products can occur as well as scarring in rare cases. If sterile conditions are not maintained during the procedure infections can occur.

Side Effects of Micro-needling

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One of the beauties of micro-needling is that there are essentially no side effects. It is perhaps one of the most effective treatments for acne scarring. It is important to not perform the procedure if there is active acne as this could result in infection. You can expect your face to look mildly sunburned for a day or two after the procedure. Deeper needling, which we term medical needling involves topical anesthetic and will create a longer-lasting sunburn look. It also is more affected for deeper scars.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.