Sterility is always an issue with these devices, especially after the first time you use it. There are two reasons you will not get the best results from micro-needling if you are using the Dermaroller. First, rollers such as the Dermaroller create a more erratic pattern of "tears" through the skin due to the angle at which the needles enter and leave the skin. This contrasts with the clean, more evenly distributed vertical punctures seen with motorized micro-needling machines. This has been nicely shown in studies done using clay models. Second, to get the best results micro-needling should be combined with the application of human growth factor serum which helps to further stimulate the skin to trigger the release of growth factors to create more collagen and elastic fibers, resulting in thicker, healthier looking skin. Since these serums are being introduced into the skin by the micro-needling process, they have to be sterile and designed for safe injection under the skin. Therefore, these treatments should only be done in a professional office.