An Introduction to Microneedling

Microneedling is a cosmetic procedure that aims to improve the appearance and texture of the skin. It is a minimally invasive treatment that can be used all over the body to treat a variety of cosmetic skin conditions. There are a range of benefits to the procedure, including the improved appearance of scars, collagen generation, hair growth, and the treatment of fine lines, wrinkles, sun damage, and stretch marks. Microneedling has grown significantly in popularity over the last decade, in part due to recommendations from celebrities and beauty influencers.

Microneedling is appropriate for candidates who are in good health and have certain skin concerns that are not responding to treatment at home or other simple dermatologic procedures. Some individuals consider it to be a final step before considering cosmetic surgery to address anti-aging and similar concerns.

How Microneedling Works

Microneedling involves the insertion of a very fine and short sterilized needle into the skin, creating microscopic punctures. The small wounds cause the body to produce more collagen and elastin, which heal the skin and create new healthy cells that translate to a soft, firm, and even-toned complexion.

In terms of what to expect before, during, and after a microneedling procedure, a provider may suggest a list of medications to stop using in the days leading up to the treatment. These may include retinol, glycolic acids, and some topical medications. In addition to stopping certain medications, the skin should be clean and hair should be kept out of the face, perhaps by using a headband. A topical anesthetic is typically put on the skin to reduce the chance of pain from the needle pricks. Once that takes effect, which typically takes 10 to 20 minutes, the person doing the microneedling will then move a pen-like tool with tiny needles around the face (or other treatment areas). The needles make tiny, surface-level cuts in the skin, causing a small amount of bruising or bleeding. It is typical for the provider to spread a cream or serum over the affected area following the procedure. Professional microneedling treatments often include the application of a topical treatment or nutrient-rich serum such as kojic acid, hyaluronic acid, and other growth factors to ensure the new cells are in optimal shape. The microscopic channels created by microneedling enhance the ability for topical treatments to absorb into the skin and thus increase its efficacy. The procedure typically takes about 30 minutes to complete, depending on the areas being treated. Following treatment, the skin is typically red and flushed similar to a moderate sunburn. The redness dissipates within a 24-48 hour window and should heal fully within a week.

The best results are often seen over a series of sessions, and as such candidates for microneedling should be willing to commit to a series of treatments. Depending on the severity of the skin issue being treated, patients can get microneedling done every three to six months or so. It is suggested that people with more severe acne scarring come in for treatment more often for a period of time, such as once a month for four to six months.  

Microneedling should be done as a series with ongoing maintenance. Aftercare is important; there is often a missed opportunity in terms of the delivery of certain cosmeceuticals like PRF while the skin barrier is impaired in order to achieve a bigger impact.

Dr. Patrick Blake, MD

Microneedling with PRF (platelet-rich fibrins)

Platelet-rich fibrin is an FDA-approved comprehensive therapy. When it is employed in microneedling it can enhance the natural healing process and naturally increase the treatment outcomes. PRF is a 100% natural concentrate that is made from the plasma, platelets, white blood cells, and mesenchymal stem cells from the patient's own blood. Once a sample of blood is drawn it is spun down in a centrifuge to separate the blood components and extract the stem cells and platelets for use in the microneedling procedure. Microneedling with PRF has been shown to reduce dark circles, minimize lines and wrinkles, reduce scarring and discoloration, tighten and firm the skin, and more benefits.

Who Can Perform Microneedling

Microneedling is often performed by a licensed aesthetic medical professional, such as an RN, NP, or PA, or a dermatologist who uses a specialized microneedling pen for the procedure. There are often questions about whether estheticians are legally permitted to carry out microneedling procedures since their license does not allow them to perform medical procedures. This can vary depending on which state the practice is in, and is typically determined by state regulatory boards.

Safety

Microneedling is a minimally invasive procedure and requires no downtime. A number of studies have been conducted on the safety and efficacy of microneedling. Reported adverse events are mostly minimal and resolve quickly and spontaneously. Depending on how deep the needles pierce the skin, it may take days or longer to fully heal. While microneedling is considered safe, it is possible to experience an allergic reaction to the cream or serum that is applied to the skin following the procedure. It is also possible for the wounds to get infected if the skin is not kept clean or if the equipment that was used was not properly cleaned. Most people can return to wearing makeup within a day of their treatment. The skin becomes more sun-sensitive following treatment, so sunscreen is typically advised.

Cost and Insurance Coverage

Microneedling may cost anywhere from $100 to $700 per session on average. The cost will depend on a number of factors, including the provider, extent of treatment, and number of follow-up treatments needed. Most people require between three and six sessions to achieve their optimal results. Given that it is a cosmetic procedure, payments are typically made out of pocket and the procedure is not covered by insurance.

Where to Learn More

• Microneedling, Radiance by WebMD
• What I Wish I’d Known Before I Tried Microneedling, Byrdie
• Everything You’ve Ever Wanted to Know About Microneedling, Elle
• Review of Applications of Microneedling in Dermatology, Clinical, Cosmetic, and Investigational Dermatology

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