I have rosacea. Will microneedling be OK for my skin?

Thank you for your question. You didn’t submit a photo, and state you have rosacea, and ask if microneedling is okay for your skin.
I can give you some ideas of how I approach patients like yourself in my practice, and where microneedling may fit in the treatment plan. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. We have the full complement of lasers, microneedling, and other devices for cosmetic dermatologic procedures. Certainly this question arises when someone has rosacea, and the things they can do to treat it.
Rosacea is actually much more common than people realize. Rosacea has a spectrum of appearance as well as degree of inflammation. One particularly important thing about rosacea is the redness or the flush of the skin. In addition, there are a lot of little vessels called telangiectasia, which are often referred to as broken blood vessels or broken capillaries. The skin also tends to have an appearance of large pores that are a little thickened.
Rosacea is a condition that needs maximum medical management, but unfortunately there are limits of what can be done. A combination of oral antibiotics such as doxycycline and topical creams such as metronidazole gel or metronidazole cream do help. Keeping the rosacea calm is one thing, and understanding what are the triggers of rosacea is another. Often, people are advised to make a diary of triggers to see if any food, alcohol, stress, or chocolate aggravates it as certain triggers make rosacea worse.
For solutions, once the patient is stable, I lean towards treatments that help reduce the flushing through the treatment of the vessels. I typically employ lasers and pulsed light treatments, depending on the optimal choice for the patient, but I start very conservatively to make sure the patient doesn’t have too much of an inflammatory response. Although microneedling can be safe when you have rosacea, you also want to discuss with your doctor the outcome you are looking for, and ask why they think microneedling is a better option compared to something else. If someone were to say you were going to have a resurfacing procedure, that’s a different story. There’s a different issue of skin healing where rosacea falls into the spectrum of an oil gland dysfunction syndrome. You have to be careful because microneedling can have a negative impact in healing after resurfacing.
You need to discuss with your doctor where microneedling fits, and what level microneedling will be done. You can do microneedling as low of a depth as half a millimeter, and as high two and a half millimeters. In addition, it may be of value to do a combination with platelet-rich plasma (PRP). We routinely use PRP with microneedling since we’re inducing an injury, and want the body to generate collagen, improve the skin quality, and contour which we refer to as dermal remodeling. When you add platelet-rich plasma, you are assisting and enhancing the skin’s ability to heal and improve through a trauma inducing or injury model. Whether you’re using a needle, various types of lasers, radiofrequency, or microneedling, you’re trying to induce the type of injury so the body generates collagen, and these are all very effective treatments. However, when combined with PRP, we take it to another level, but that’s a separate discussion. What’s more important is establishing your level of sensitivity, what to do preemptively and proactively to minimize inflammation, which can occur with any kind of intervention. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Hi @heidi70707! Microneedling is safe in patients with rosacea. You can enhance the treatment by adding PRP. Best of luck to you, Dr. Nima!

Microneedling is safe on patients with rosacea, combine with vascular lasers to get a better outcome. Dr. Emer.