Collagen induction therapy or microneedling for skin quality

They say that the dose makes the poison, and as a society, we seem to be getting more and more comfortable with that idea. Building muscle, which requires you to create tiny tears in your muscles to build new tissue, has never been more popular. We’re even injecting botulism into our faces—just in carefully measured amounts—for placid foreheads that look like they’ve never seen a care in the world. It’s all about a small amount of a stressor to achieve your goal.

But what about thousands of needle pricks? That’s what some people are signing up for in the name of smoother, tighter skin. The treatment, called microneedling, is just what it sounds like: tiny needles stuck into the skin. And the reasoning is similar to that of muscle building, that the healing process kicked off by the tiny wounds stimulates the production of collagen, which is why you might also hear it referred to as collagen induction therapy.

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Microneedling is a medical procedure in which a medical device with needles ranging from 0.25mm to 2mm is used to create small punctures in the skin in order to stimulate collagen formation. Some devices are rollers, while others are pens. They are dragged over the surface of the area that is getting the treatment, which is typically the face or scars.

The procedure typically takes 10 to 20 minutes, though there’s a lot of prep involved. In some cases, patients may be required to have a counseling session to show they understand the potential effects of the treatment, as well as how long it can take to see results. They also need to prep their skin for a month with vitamin A and vitamin C treatments in order to improve collagen production stimulated by the procedure (Singh, 2016).

“Microneedling works by creating tiny wounds in the skin surface,” says Boca Raton board-certified dermatologist Jeffrey Fromowitz, MD, FAAD. “The purpose is to activate fibroblasts in the skin and create new collagen.” But treatments differ, and microneedling is often used in addition to other skincare products in order to boost their absorption and efficacy. “The microneedling opens a channel into the deeper layers of skin, and now the usual epidermal barrier is disrupted, which allows products applied to the skin surface to absorb rapidly and more completely than through intact skin,” he explains.

That’s why skin needling is used in the trendy Vampire Facial: to boost the absorption of your blood serum that’s rich in growth factors. “The idea is that the platelet-rich plasma (PRP) used in this treatment is absorbed through the channels created by the needling,” he explains. It’s far from the only treatment that uses the pinpricks with the goal of delivering better results, though.

Your dermatologist may also recommend that radio-frequency (RF) is added to your treatment as well. “The best results occur when you combine microneedling with radio-frequency,” Fromowitz advises, explaining that “the RF energy improves the results and also minimizes the bleeding associated with the procedure.” You may see this offered at your dermatologist’s office as microneedling with fractional radiofrequency, or MFR.

Fromowitz underscores that blind trials, in which participants don’t know if they’re getting an actual treatment or placebo, aren’t possible with microneedling since the treatment is invasive, but researchers strive to judge the effects fairly. If participants are stuck with these microneedles, they’ll know, and it will also be clear if they’re there for a microneedling study and never poked with anything. “There have been tissue studies done comparing control skin with skin after microneedling,” he says, “and the results show an upregulation in new collagen and elastic fibers in the skin.” This is the basis for those claims that microneedling makes your skin look more youthful. “These are the fibers that improve tone, texture, elasticity, and appearance of the skin,” Fromowitz explains.

Improved appearance of the skin is hard to measure, except if you’re looking to correct a specific issue. Past research, for example, shows that needling does hold promise for lessening the appearance of acne scarring, one meta-analysis found (Harris, 2015). 

Another study found that this benefit held true in patients with darker skin, lessening acne scars, and the pigmentation that comes along with them, though researchers noted that some people might need multiple treatments to see the same results (Qarqaz, 2018). One study noted a minimum of 4 to 6 treatments in order to see significant improvement (Singh, 2016). It has also been shown to improve the appearance of scars caused by burn injuries (Suca, 2017).

Microneedling, though most often seen offered as a cosmetic treatment for skin concerns on the face, may also help your scalp. Studies show it may help stimulate hair follicle growth to counter hair loss from conditions such as alopecia. Researchers are quick to note, however, that it isn’t more effective than other treatments and shows the most promise when combined with other hair growth strategies (Fertig, 2018).

Dermatologists use micro-needling devices such as the Dermapen to create these micro-injuries in the skin’s surface. But while at-home devices featuring microneedles are available, Fromowitz explains that the needles differ in a pretty significant way. Optimal results, he explains, come from needles of a certain length. The devices you can get for at-home use (called dermarollers or facial rollers) don’t penetrate as deeply into the treatment area, which may not activate wound healing—and the improvement in skin conditions that come from it—to the same extent.

And if you’re using these devices instead of getting microneedling therapy from a dermatologist or aesthetician in order to boost the absorption of skincare products, it may not work as well. The shorter needles open shorter channels in the epidermal barrier. Professional treatments puncture between 0.25 mm and 2 mm, while many at-home devices have needles with lengths from 0.25–0.3 mm. For that reason, home devices are mainly intended for reducing pore size, diminishing the look of fine lines, and addressing sebum production (Singh, 2016).

The biggest risks with these procedures come with unsterilized equipment, which is why it’s always important to go to a qualified and certified dermatologist. Aestheticians can perform microneedling, but only with needles up to 0.3mm, which means you may not get the same results as you would with professional treatments from a dermatologist. Anything longer than this is considered a Class A medical device, and aestheticians are not allowed to perform medical procedures (Esthetician Edu., n.d.). Fromowitz notes that it’s “critical that the device used for microneedling prevents back splatter and cross-contamination” in order to prevent infection. 

The other big risks Fromowitz underscores are scarring and pigment abnormalities. Since you’re creating small wounds in the skin, there’s a chance that scarring happens as they heal. And the treatment process does create temporary inflammation, which may be an issue with the skin of some patients. “Pigment abnormalities are most likely when treating patients with darker skin types,” Fromowitz explains. “In the skin of patients who are people of color, when there is inflammation in the skin, there is always a risk of hyperpigmentation.” This was seen in one study that looked at microneedling on Asian patients. Of the 30 participants, five experienced pigmentation associated with inflammation after the treatment (Dogra, 2014).

You may also want to avoid the treatment if you have any conditions that may make your skin more sensitive. It’s not recommended for people with active cold sores, acne, or conditions of the skin such as eczema. People with blood disorders, such as those that affect clotting, should speak with their healthcare providers before getting the treatment.

You should expect your skin to look flushed redder than normal for 2 to 3 days following the treatment. This is normal. Edema, or swelling, can also happen in the treatment area for this same amount of time and is also normal. But since these side effects are superficial, the patient is free to return to their normal routine right after treatment. Treatments are given at 3 to 8-week intervals, but the most common timeline is having treatments spaced one month apart (Singh, 2016).

Fromowitz explains that pricing depends on the equipment being used. A series of three treatments that only include microneedling, for example, will cost you between $500 and $1,000. But once you start combining microneedling with other procedures requiring other tools, the price can increase drastically. Again, it will take 4 to 6 treatments in order to see significant results, especially in the case of scarring (Singh, 2016).

The same series of three treatments will set you back between $1,000 and $2,000 if platelet-rich plasma (PRP) is involved. Go with the works, which uses radiofrequency in order to boost results in addition to the microneedling and PRP, and you’re looking at $2,000 to $3,000 for three sessions.

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Current version

March 01, 2020

Written by

Linnea Zielinski

Fact checked by

Mike Bohl, MD, MPH, ALM

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About the medical reviewer

Mike Bohl, MD, MPH, ALM

Dr. Mike is a licensed physician and a former Director, Medical Content & Education at Ro.