Microneedling Resurgence as Alternative to Laser


“The Next Big Thing.” “2016’s Trending Skincare Treatment.” “Our New Favorite Skincare Procedure.” Even if you didn’t see these headlines, you have likely experienced an increase in patients asking about microneedling. Although the procedure has been around for decades, it has recently become a media darling.

There’s no single significant event that explains the surge in interest. But physicians have seen growing evidence that inducing channels of dermal injury whether by laser or needles stimulates collagen regeneration. Improved microneedling devices as well as better treatment protocols, including adjuncts such as platelet-rich plasma (PRP), and the availability of more professional training may also be playing a role.

Perhaps the best explanation for the increased popularity of medical microneedling is the growing number of patients seeking affordable skincare treatments that offer visible results—a micro-needling session typically costs about a quarter of what patients pay per laser treatment.

“One of the disadvantages of medical microneedling is that patients often confuse it with roller-type microneedling employed by estheticians,” says Tina S. Alster, MD, director of the Washington Institute of Dermatologic Laser Surgery and clinical professor of dermatology at Georgetown University Hospital in Washington, D.C., who uses medical microneedling in patients of every skin phototype for a variety of indications.

Medical microneedling devices do not employ rollers; instead they feature a motor that rapidly applies a needle configuration in a stamping fashion to the skin. Practitioners can vary the speed and depth of penetration.

According to the U.S. Food and Drug Administration (FDA), any procedure using a needle more than 0.2mm in length is a medical procedure, but in a few states nurses and other ancillary providers can still perform microneedling treatments using devices with needles up to 1.5mm in length.

It is considered safer than many other aesthetic procedures, as the majority of adverse events—including prolonged redness, dermatitis and infection—have been traced to two causes: the application of inappropriate topical products and improper patient selection. There are some basic contraindications for microneedling such as active skin infection, open wounds and wound healing/collagen disorders. Some physicians also screen patients for recent sun exposure (or planned sun exposure within a week of treatment) or recent ablative skin resurfacing procedures.