Microneedling: What is it used for, who is it suitable for, and what problems is it used for?

What is microneedling?

Microneedling is a minimally invasive dermatological procedure that aims to stimulate the natural wound healing response and collagen production by creating controlled microchannels in the skin with very fine needles. Therefore, it is also called "collagen induction therapy".

It can be used for acne scars, uneven skin texture, fine wrinkles, the appearance of enlarged pores, some pigmentation problems, and some types of scarring.

How does microneedling work?

The controlled microtrauma created by the needles activates repair responses such as fibroblast activity, new collagen synthesis, elastic fiber remodeling, and dermal remodeling.

The aim is not to injure the skin uncontrollably, but to create a controlled stimulus that will therapeutically guide the healing response.

In which problems can microneedling be used?

Atrophic acne scars, fine wrinkles, skin texture irregularities, enlarged pores, signs of photoaging, certain surgical or traumatic scars, and selected pigmentation problems can be assessed.

Is microneedling effective on acne scars?

Atrophic acne scars are one of the most common areas where microneedling is used. It can be particularly beneficial for rolling scars and some boxcar scars.

For deep ice-pick scars, trichloroacetic acid (TCA) CROSS, punch techniques, laser, or other surgical methods may be more suitable. Therefore, it is necessary to first determine the type of scar.

Are microneedling and radiofrequency microneedling the same thing?

No. In classic microneedling, the primary effect is the mechanical microtrauma caused by the needles.

Radiofrequency microneedling (RFMN) allows needles to deliver radiofrequency energy to specific depths. This creates a controlled thermal effect in addition to mechanical stimulation.

Is radiofrequency microneedling more powerful?

It's not always accurate to say "better." Classic microneedling may be suitable for more superficial dermal stimulation, scar treatment, and skin texture enhancement; radiofrequency microneedling, on the other hand, can be used for deeper dermal restructuring and tightening by adding thermal energy.

The appropriate method depends on the type of problem, skin thickness, scar depth, risk of pigmentation, and the anatomical layer targeted.

Does microneedling tighten the skin?

Classic microneedling can improve skin quality and reduce fine wrinkles by stimulating collagen production. However, it is not a powerful lifting treatment for advanced facial sagging.

Radiofrequency microneedling can provide more noticeable results in terms of mild laxity and skin tightening; however, it does not have the same mechanism and level of effect as high-intensity focused ultrasound (HIFU), Endolift, or surgical facelift.

Does microneedling shrink pores?

The actual anatomical number of pores remains unchanged. However, the appearance of pores may decrease as skin tissue and dermal support improve.

Does microneedling help with blemishes?

It can help with some pigmentation problems. However, melasma, post-inflammatory hyperpigmentation, and sunspots should be distinguished from each other.

In individuals prone to pigmentation, aggressive application may increase inflammation, leading to reverse darkening.

Can microneedling be used in melasma?

It can be used in selected patients. Microneedling can be used to stimulate skin regeneration as well as to increase the penetration of some topical treatments.

However, melasma is chronic and recurrent; a permanent solution should not be expected with microneedling alone.

Can microneedling be used for hair loss?

There are studies showing that microneedling is used as an adjunct treatment, particularly in androgenetic alopecia. However, it does not replace accurate diagnosis and appropriate medical treatments.

Can it be done together with platelet-rich plasma (PRP)?

Yes. Microneedling can be combined with platelet-rich plasma (PRP) in some acne scar or skin rejuvenation protocols. However, this combination is not mandatory for every patient.

Are microneedling and mesotherapy the same thing?

No. Microneedling targets collagen stimulation with controlled needle injections. Mesotherapy, on the other hand, is a broader concept referring to the injection of various substances into or under the skin.

Can products be applied to the skin after microneedling?

Microneedling temporarily disrupts the skin barrier, which can increase the penetration of applied products. While this can be an advantage, it can also pose a risk.

The passage of non-sterile, irritant, or unintended products through microchannels to the skin can lead to problems such as irritation, contact dermatitis, granulomatous reactions, or infections.

Is using a dermaroller at home safe?

In home use, sterilization, needle depth, pressure, and frequency of application can be uncontrolled. Aggressive home applications can increase the risk of complications, especially in individuals with active acne, infections, or a tendency towards pigmentation.

Medical microneedling and at-home superficial roller applications are not the same procedure.

Can microneedling be performed on active acne?

The procedure is not always suitable for areas with active inflammatory or pustular acne. Acne may need to be brought under control first.

Who should not undergo microneedling?

Treatment may be delayed or unsuitable for individuals with active bacterial, viral, or fungal infections, active herpes, uncontrolled inflammatory skin disease, active severe acne, significant wound healing problems, keloid tendency, or open wounds in the treatment area.

What happens after microneedling?

In the first few days, redness, mild swelling, burning, tenderness, and dryness may occur. These effects are usually short-lived.

How many sessions are needed?

The number of treatments varies depending on the depth of the acne scar, skin quality, needle depth used, whether a classic or radiofrequency system is used, and the patient's healing response. For acne scars, a series of sessions may often be necessary.

When will the results be seen?

Because collagen remodeling takes time, results are not immediate. Improvement in skin texture may begin within weeks and continue for months.

Frequently Asked Questions

Does microneedling completely remove acne scars? Generally, the goal is not to eliminate scars completely, but to reduce their visibility.

Are Dermapen and microneedling the same thing? Dermapen is one of the motorized devices used for microneedling.

Which is better, microneedling or fractional laser? Scar type, skin color, healing time, and risk of pigmentation should be evaluated.

Does microneedling tighten the face? It may provide slight improvement thanks to collagen stimulation; however, it is not a powerful lifting treatment on its own for significant sagging.

Dermatologist's Note

It is not accurate to view microneedling simply as "needling the skin." Needle depth, the application area, the patient's skin type, and the anatomy of the problem being treated directly affect the outcome.

Especially with acne scars, not all scars respond to the same treatment. Rolling scars, box scars, and ice-pick scars should be differentiated and combined with microneedling, subcision, laser, or other methods when necessary.

Radiofrequency microneedling is not simply a “more powerful” version of classic microneedling, but a different treatment approach that adds controlled thermal energy to mechanical microtrauma.