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Microneedling — Does It Still Have a Place?

One of the oldest in modern aesthetic medicine is also one of the most . Here is an honest account of what microneedling actually does, what the science says about penetration, and where the sits in a contemporary landscape.

A technique with a longer history than its current marketing suggests

Microneedling is presented as though it were a recent innovation; a of the injectable and energy-based era. In fact, the of using skin injury to stimulate collagen production predates most of the that now share its space.

The modern dermaroller, the device that the into widespread aesthetic was in the mid-1990s by Dr. Fernandes, a South plastic surgeon, who observed that repeated of the skin produced progressive improvements in texture, firmness, and scar . His observations were clinically astute, and the he was has since been in detail.

What microneedling actually does

Microneedling, termed induction therapy, works by creating of controlled in the epidermis and upper dermis using fine needles. These micro-injuries trigger the skin's intrinsic wound healing cascade, a precisely orchestrated biological sequence that unfolds in three phases: an initial inflammatory in the first 24 to 72 hours, a proliferative phase days three to during which new and fibres begin forming, and a remodelling phase that continues for weeks to months as the new matures and

The main physiological mechanisms associated with are collagen and elastin production, increases in skin permeability, and improved skin post-treatment. As the wound repair process is initiated, to the wounded area to initiate collagen and elastin production, contributing to improved and of the healed epidermis.

Improved enhances the of nutrients and growth factors to the tissue, to the overall in skin quality that goes beyond what alone would .

Is Needle depth important and what it determines

The depth to which needles penetrate which tissue layer is targeted and, consequently, what effect is produced

0.5mm, needles the epidermis and superficial dermis, primarily topical penetration and improving surface skin .

At 0.5 to 1.5mm, reach the dermis and initiate collagen induction.

At 1.5 to 2.5mm, the dermis is targeted, the most significant collagen stimulation, but with the most post-procedure .

This depth-effect relationship has important clinical implications. A 0.3mm dermaroller used at home bears little resemblance to a 1.5mm professional treatment in its biological effects, however the devices may look.

The marketing that conflates the two or that home produces the same clinical result as a treatment is not patients honestly.

From manual to motorised — and why it matters

The original dermaroller relies on manual pressure and a rolling technique to drive needles to the correct depth . The shift to motorised microneedling pens in which oscillate at high speed and rather than at an angle represented a advance.

Vertical needle penetration reduces the that can occur with rolling motion, more depth control across different areas and Medicated Skin Care thicknesses, and allows depth and speed to be within a single .

The motorised pen is now the professional for good clinical reasons, and those go beyond marketing preference. It is for these sound reasons that at the Cosmetic in Esher, Surrey we use the

The topical penetration question — and its surprising answer

One of the most clinically discussed of microneedling is its capacity to enhance the of actives.

The logic is intuitive: create temporary microchannels through the stratum corneum, apply ingredients, and those ingredients will more deeply than they could through intact skin.

This logic is in principle. The clinical is more and in one important respect, genuinely .

skin sites recover within approximately two hours. Hence the effective penetration window for topically is considerably than most post-procedure protocols acknowledge

More significantly, agent immediately before microneedling penetrated deeper compared to agent applied afterward at one and three hours, with microneedling extension beyond with penetration over time. This finding, that pre-application may deeper penetration than post-application, challenges the standard assumption that topicals should be applied after needling and raises important questions about the optimal sequencing of topical in a

What topical serums are worth using and when

Given the penetration kinetics described above, the post-microneedling topical strategy deserves more thought than it typically .

The ingredients with the strongest rationale for application are those with a effect on wound and recovery: acid for and tissue support, growth and PDRN for wound healing acceleration, and formulations to barrier as the reseal.

The trendy topicals examined in namely exosome complexes, cocktails, and NAD precursors may have a more window via post-microneedling than via standard use. The questions about their activity after formulation, and about whether they are optimally sized for microchannel penetration, remain.

The clinical indications where microneedling genuinely excels

The base for is strongest in several .

Acne scarring — particularly and boxcar scars has a well-evidenced to microneedling sessions, with histological evidence of dermal remodelling and clinical improvement in scar depth and texture.

Skin quality improvement in texture, tone, pore appearance, and the overall quality of the dermal matrix is consistently demonstrated across a broad range of studies. has been widely employed in cosmetic applications for acne scar treatment, skin rejuvenation, hair loss, melasma, and skin cancer, with the formed delivery of cosmetic agents while stimulating and production through the wound-healing cascade.

The for marks and for certain of hyperpigmentation is more variable but clinically credible. The for hair loss, particularly androgenetic in with minoxidil, is growing and interesting.

Where microneedling sits in a contemporary treatment landscape

produces genuine and collagen without the component that devices introduce.

For with darker skin types, where the risk of hyperpigmentation with treatments is a clinical consideration, offers a safer path to collagen stimulation. Its cost profile, both for the clinic and the patient, makes a series of more than energy-based . And its to enhance topical penetration, properly understood and properly managed, adds a useful dimension that energy-based cannot in the same way.

Summary

Microneedling has a well-established, well-evidenced role that has not been displaced by newer technologies. It works through a that is characterised and .

The clinical results in appropriate i.e. acne scarring, skin quality and collagen stimulation are real, meaningful, and durable when a proper series of is .

The dimension is clinically important but more nuanced than acknowledge. The that Dr. in the 1990s remains, in 2025, a useful and credible tool in the aesthetic medicine repertoire. Not everything that has come since has earned the right to displace it.

The views in Clinical Perspectives are the Dr Forrester’s own and reflect his and professional experience in aesthetic .

References

Tehrani L et al. Physiological Mechanisms and of Microneedling: A Narrative Review. Cureus. 2025. 

Recent in Microneedling-Assisted Applications. . 2024;11(2):51. 

Ogunjimi AT et al. Micropore closure time is longer following application to skin of color.  Reports. 2020. 

Factors Affecting Depth of in and Drug Delivery: The Importance of Timing of Topical Application. PubMed. 2020. 

of Skin Resealing After of Microneedles in Human . PMC. 2011. 

Carver S et al. Microneedling versus microcoring: A review of percutaneous induction for the face and neck. Journal of Dermatology. 2024;23:1541–1550. 

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