It seems everyone has a strong opinion on microneedling these days - and those opinions are wildly divergent. Some doctors on the internet (I’m looking at you RealSelf!) advocate for microneedling only in a board-certified plastic surgeon’s office. On the other side, there are numerous DIYers on YouTube bloodying their faces every few weeks and tattooing foundation and other harmful ingredients into their skin. There’s a middle ground between these two sides. I’m going to provide you with a conservative, common-sense approach supported by scientific research on why you should be microneedling at home with the right tools and skincare products.
What is microneedling?
You may know microneedling by its somewhat friendlier name - collagen induction therapy. The process involves creating tiny channels in the surface of the skin which stimulate the release of growth factors, creating new collagen and elastin. These are the key proteins that give our skin its shape and structure. As we age, our body produces fewer of these proteins causing the tell-tale signs of aging - wrinkles and loose skin. By creating a controlled injury through microneedling, our body’s natural wound-healing mechanisms are triggered. Microneedling can encourage our body to produce more of these essential proteins, naturally rebuilding firm, smooth and healthy skin from the inside out.
The channels are created by one of three devices: a dermapen (motorized device with a disposable tip containing about 16 fine-gauge needles), a dermaroller (manual device with rolling drum covered in fine-gauge needles) or a dermastamp (manual device with a flat surface covered in fine-gauge needles). Most at-home users are using a dermaroller or dermastamp, although there are a number of dermapens available to consumers.
The benefits of incorporating microneedling into your at-home skin care routine cannot be understated. There is ample research[1] showing increased skin thickness with regular microneedling, resulting in fewer lines and wrinkles. In my opinion, microneedling is the most effective way to maintain healthy, natural skin without injectable or ablative treatments.
Medical vs. cosmetic microneedling
The issue for doctors and DIYers alike is how to create these channels in the skin’s surface with minimal risk and discomfort. This is where it is important to draw a distinction between medical and cosmetic microneedling. Certain doctors will recommend a deeper microneedling treatment to correct scarring or other skin conditions. In most cases, clinicians will use a dermapen to penetrate the skin at a depth between 1.0 and 2.5 mm, or sometimes deeper. This is considered medical microneedling. Microneedling at this depth will result in bleeding and is often paired with a topical numbing cream for the patient’s comfort. Skin treated at this depth will take several days to recover, will feel tight and hot, with the appearance of a sunburn.
On the other hand, cosmetic microneedling is much more shallow, around 0.25 to 0.5 mm, does not involve any bleeding and can be described as mildly uncomfortable. There is no need for topical numbing cream at this depth. A properly sterilized dermastamp or dermaroller is an effective and low-cost option for individuals interested in cosmetic microneedling. The end result is a mild redness that usually goes away within a few hours. Other than avoiding sun exposure for 24 to 48 hours, there are no contraindicated activities following cosmetic microneedling. Out of an abundance of caution, I usually avoid swimming and strenuous exercise for 24 hours to give my skin a break from any possible irritants.
The risks of medical microneedling are infection, scarring and hyperpigmentation. These risks are significantly minimized in a cosmetic microneedling treatment. Sterilizing the skin and microneedling device with alcohol is a must for any microneedling treatment, whether medical or cosmetic. However, because cosmetic microneedling only pierces the upper layer of skin (the stratum corneum), the risk of infection is much lower. Since the micro channels are not as deep, they heal in a shorter period of time, also reducing infection risk.
Is it true that medical microneedling is more effective than cosmetic microneedling because the needles go deeper, resulting in more trauma to the skin? Not necessarily! Research conducted by Dr. Lance Setterfield has shown that “less is best.” As noted in his authoritative text, The Concise Guide to Derman Needling, Dr. Setterfield found cosmetic microneedling at 0.3 mm to be as effective in reducing wrinkles as medical microneedling when used regularly with appropriate active ingredients. Others noted that targeting the dermal/epidermal junction seems to be the “sweet spot” for stimulating elastin production. The dermal/epidermal junction lies around 0.6mm deep, making it well disposed to a cosmetic needling treatment at 0.5 mm depth.[2]
While medical microneedling is likely to be more effective at reducing deep scars and lines in less time, consistent cosmetic microneedling can also improve these issues. This means you can achieve excellent results with regular microneedling at home with the right topical treatments. Cosmetic microneedling at 0.3 mm can also be carried out more frequently than medical microneedling, which should only be done after the skin has had a chance to heal, which takes about a month.
Selecting the right tools
The next big question is “what products do I need in order to safely microneedle at home?” This is probably the most important and misunderstood aspect of a safe at home microneedling routine.
Selecting the appropriate microneedling tool is crucial. I have purchased a dermaroller without knowing what to look for and ended up with something that could potentially harm my skin. Most people are familiar with a dermaroller - a handheld plastic device with a rolling drum covered in tiny needles. The key here is “needles” - not blades. The difference is subtle, a needle is the same diameter whereas a blade is tapered. A tapered blade will make a tear in the skin, as compared to a needle which makes a tiny puncture. A tear is much more damaging and traumatic to the skin. A true dermaroller will have needles which extend outwards from inside the drum.
Dermaroller with real needles
Here is an example of a fake dermaroller composed of blades. Note how the “needles” are actually just a blades extending from a disk held in place between plastic spacers.
In my experience, a dermastamp is a more reliable and easy to use device. It’s much easier to ensure you are puncturing the skin at a 90 degree angle (avoiding a tear) and it’s also easier to clean given its flat surface. The dermastamp I use has retractable needles, which I like for two reasons:
1) I can change the depth of needle for different areas of my skin;
2) I can extend the needles all the way, spray with alcohol, let dry, then retract completely and put on a cap. This keeps the needles clean and also protects them from becoming bent.
If you are new to microneedling, the dermastamp is a great way to start. Dermarollers are good too, but they take a little practice. Proper rolling technique is important in order to maintain a 90 degree angle between the needles and the contours of your face.
Note how the needles can fully retract after cleaning, protecting the dermastamp from being exposed to pathogens and unnecassary wear and tear. Since we are creating thousands of channels in the surface of the skin, the impact (good or bad) of topical products we use will be significantly amplified. Some research suggests that the ingredients in skincare products used following microneedling are absorbed 80% more than regular application! Also consider that most skin care products are not designed for microneedling, no matter how natural, organic or expensive they are.
My rule of thumb is: don’t microneedle anything into your skin that it doesn't produce on its own. That means, if it doesn’t occur naturally in your body, you shouldn’t be microneedling it into your skin. If you’re using a dermaroller or dermastamp, this isn’t a big issue - you can roll or stamp your freshly cleansed and sterilized skin without putting anything on it. If you’re using a dermapen, you may find the treatment easier and more comfortable with something to help the pen glide. In this case, a high molecular weight hyaluronic acid without any additives is a great option.
Other ingredients which are safe to use following microneedling include Vitamin A (retinol) and Vitamin C, although many people find these to be too harsh and irritating on freshly microneedled skin. Copper peptides and vitamin E are also excellent in helping build collagen. However, don’t be tempted to use any old serum or moisturizer which simply contains these ingredients. That is asking for trouble as many skin care formulations contain preservatives and fragrance which can be highly irritating when absorbed deeply into the skin.
If you are considering starting an at-home cosmetic microneedling routine, there will be some trial and error - you need to find what works for you. Most people are able to tolerate returning to their usual skincare within 24 hours of cosmetic microneedling. But you should familiarize yourself with the ingredients contained in your skincare. Continued use of products with fragrance and harmful preservatives may sensitize your skin over time if used in conjunction with microneedling.
The role of growth factors in healing
In my experience (and I’ve tried a lot!), the best formulations are those designed specifically for use with microneedling in order to help the skin repair itself. The gold standard ingredient in tissue repair is human growth factors and cytokines. As mentioned before, the act of microneedling tricks the body into responding to an injury. The body’s wound response system releases a number of growth factors to repair the injury by creating more collagen, elastin and fibroblasts. By adding even more growth factors in a topical treatment, we can accelerate the healing process resulting in optimal skin health.
There are two ways to add human growth factors to your microneedling treatment:
1) Applying a platelet concentrate like Platelet Rich Fibrin (“PRF”) derived from your own blood immediately after microneedling so it floods the micro channels with white blood cells, platelets and growth factors; and
2) Using cultured growth factors derived from bone marrow mesenchymal stem cells from human donors, found in AnteAGE products.
In my next blog post, I will discuss how microneedling with Platelet Rich Fibrin and using AnteAGE products can radically change your skin.
How can I help you?
When I started microneedling from home, I made ALL the mistakes - using my everyday skincare products during and after microneedling, going deeper than I ought to and not microneedling frequently enough. Thankfully I never had an adverse outcome, but I cringe to think of what could have happened! I hope by sharing my experience, you can avoid some of my mistakes.
Now that I’ve spent two years researching these issues, consulting with experts in the field like Dr. Lance Setterfield, and finding companies that produce the highest quality products specifically for microneedling, I feel much more confident sharing my at home routine with you. I completed Dr. Setterfield’s Advanced Microneedling course and have obtained certificates from the AnteAGE Academy in the science of stem cells, growth factors and cytokines. I’m also proud to say I have achieved my healthiest skin ever without fillers, lasers or any other medical aesthetic facial treatments. Full disclosure - I have a little bit of botox in my forehead to relax my 11 lines, otherwise known as the glabella. I will continue to use botox about twice a year just to give my very expressive eyebrows and forehead a break!
If you are just beginning your journey towards optimal skin health, or you’re a seasoned pro in home skincare, I hope you’ll find this blog useful, informative and thought-provoking. I would love to hear from you and welcome your comments and critical feedback.
[1]https://www.clarionmedical.com/ClarionMedical/media/AES-Skin-Health/Microneedling-in-All-Skin-Types-A-Review.pdf [2]https://journals.lww.com/plasreconsurg/Fulltext/2011/06000/A_Prospective_Controlled_Assessment_of.72.aspx
