Collagen Induction · Skin Texture · Scarring

Microneedling

How this page was made

This page was written with AI assistance and reviewed against the sources listed under References below. It is general information only, not medical advice. See our full disclaimer for how SHEA creates and reviews treatment information.

What it is

Microneedling uses multiple fine needles to repeatedly puncture the skin. Medical microneedling devices may use a roller, stamping mechanism, or motorized pen with adjustable needle depth. The controlled injury is intended to stimulate a healing response and remodeling of skin tissue.

Standard microneedling and RF microneedling are related but different treatments. Standard microneedling creates mechanical needle injuries without adding radiofrequency energy. RF microneedling uses needles or microneedle electrodes to deliver heat into the tissue and has a different risk profile. See the RF Microneedling page for that treatment.

Needle depth, device design, treatment area, and protocol can vary according to what is being treated. Evidence from one microneedling device or protocol should not automatically be applied to every type of needling treatment.

Why people consider it

Atrophic acne scars, including indented facial acne scarring
Facial wrinkles and other textural changes
Certain scars on other areas of the body, depending on the device and indication
They want a mechanical resurfacing approach rather than a laser or radiofrequency-based treatment

What the experience is like

Topical numbing medication is commonly used before medical microneedling. The device is then moved or stamped across the treatment area so that the needles repeatedly enter and leave the skin.

Redness, tightness, dryness, peeling, discomfort, bruising, pinpoint bleeding, or crusting can occur afterward. These reactions are usually temporary, but recovery varies with needle depth, device, treatment area, and individual skin response.

More than one treatment may be needed. In a randomized acne-scar trial, participants received three needling treatments at two-week intervals, while other studies have used different schedules. There is no single session schedule that applies to every indication or device.

Limitations & considerations

Active skin infection, an active herpes outbreak, significant inflammatory skin disease, bleeding or clotting problems, immune suppression, keloid tendency, and some medications or medical conditions can affect whether microneedling is appropriate
Inflamed or deep acne lesions are commonly avoided during routine scar-focused microneedling. However, active acne should not be described as an absolute category-wide prohibition: limited newer research has investigated microneedling itself as a treatment for acne vulgaris
Pigment changes, including hyperpigmentation and hypopigmentation, are possible. Skin phototype and recent sun exposure should be considered before treatment
Infection is an uncommon but important risk. Needle cartridges should not be reused between patients or treatment sessions
Microneedling is sometimes combined with PRP, PDRN, exosomes, growth-factor preparations, vitamins, or other topical products. These combinations should be evaluated separately rather than assumed to be part of standard microneedling
The FDA states that microneedling devices it has authorized have not been authorized for delivering cosmetics, topical medications, vitamin solutions, drugs, or blood products such as PRP into the skin. The risks of these combinations may therefore differ from microneedling alone
Pregnancy and breastfeeding appear among the situations in which the FDA says microneedling may not be suitable, but this should not be presented as evidence that microneedling has been shown to harm pregnancy; the relevant safety evidence is limited
No specific degree of scar, wrinkle, or texture improvement can be guaranteed

Evidence note

A 2022 systematic review and meta-analysis included 12 randomized controlled trials with a total of 414 participants with acne scarring. The studies compared microneedling with other treatments and found evidence of objective scar improvement with non-radiofrequency microneedling. The included trials differed in their comparators and treatment methods, so the pooled evidence should not be interpreted as establishing one standard microneedling protocol.

A 2014 single-center, rater-blinded, split-face randomized trial enrolled 20 adults with bilateral acne scars, of whom 15 completed the study. One side of the face received three needling treatments at two-week intervals while the other side served as the control. At six months, scar scores on the treated side were significantly lower than at baseline, while the control side did not show significant change. Participants perceived a mean 41% improvement in scar appearance on the treated side, and no adverse events were reported. The study was supported by departmental research funds at Northwestern University.

An earlier 2009 uncontrolled study included 32 participants with rolling acne scars who received two needling sessions. The authors reported improvement in scar severity and overall appearance. Because there was no untreated comparison group, this study provides weaker evidence than the later randomized trial. The paper states that no conflicts of interest were declared.

Regulatory information is also important when microneedling is combined with other treatments. The FDA has authorized specific microneedling devices for specific indications, including improvement in the appearance of facial acne scars and facial wrinkles, but states that microneedling devices have not been authorized for delivering cosmetics, topical drugs, vitamin solutions, or blood products such as PRP into the skin. Evidence for these combinations therefore needs to be considered separately from evidence for microneedling alone.

References

Peer-reviewed literature and regulatory information.

1. Alam M, Han S, Pongprutthipan M, et al. Efficacy of a Needling Device for the Treatment of Acne Scars: A Randomized Clinical Trial. JAMA Dermatology, 2014;150(8):844–849.

Peer-reviewed · Split-face randomized trial · 20 enrolled, 15 completed · Departmental funding

2. Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesthetic Plastic Surgery, 2022.

Peer-reviewed · Systematic review and meta-analysis · 12 RCTs (n=414)

3. Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D. Acne scarring treatment using skin needling. Clinical and Experimental Dermatology, 2009;34(8):874–879.

Peer-reviewed · Uncontrolled clinical study (n=32) · Rolling acne scars · No conflicts declared

4. U.S. Food and Drug Administration. Microneedling Devices. Updated 2025.

Regulatory guidance · Authorized uses · Risks and patient considerations