Skin Needling Lesson 1: Introduction to Skin Needling

Skin needling, also called micro needling, dermarolling, or needle abrasion, is a powerful skin remodeling technique. Needling uses a handheld device that has rows of very, very fine needles that pierce the skin in a grid like pattern. The most common needling tool is a roller, similar to a mini paint roller, but other products resemble a stamp or are simply a single needle. Skin needling is one of several popular techniques that use controlled damage to stimulate the dermis to regenerate the matrix. The process is intimidating for many people, but it is actually less risky than a strong chemical peel and has a shorter recovery period involving minimum discomfort. A lot of DIY skin care enthusiasts are using the technique to drastically improve the appearance of scars, stretch marks, and wrinkles. Ideally, the process should be done in a medical setting to minimize the risk of infection, but it is usually quite expensive. It is possible to purchase needle rollers and perform the treatment at home, provided you use the right technique for the skin damage you are treating, take the proper precautions to prevent infection, and properly sterilize the roller.

Types of Skin Needling

Medical Needling – The most effective form of skin needling is often called medical needling. This type of needling is done with fine needles that are at least .5 millimeters (mm) long. That is considered the minimum length needed to reach the dermis, where the controlled damage stimulates the wound healing response and initiates a cascade of growth factors that results in tissue proliferation. Fibroblasts located in the dermis produce more collagen and elastin, along with other components of the skin matrix. The epidermis begins producing more keratinocytes and gets thicker. The process creates more blood vessels and normalizes skin cell function and signaling. Medical needling can be done on the face or body. Body skin is often treated with 1.0mm to 1.5 mm to ensure penetration to the dermis. Medical needling is ideally performed in a professional because of the risk of infection, but many skin care enthusiasts do it at home with no complications.

Cosmetic Needling– Using tools with needles that are less than .5mm long is often called light or cosmetic needling. It isn’t considered true needling but is a great way to enhance the results of a “topical only” skin care regimen. These tools use extremely short needles, usually .2mm or .3mm. Many products use needles that are even finer than typical needling tools. This type of needling won’t remove skin damage, but creates micro channels though the stratum corneum and upper epidermis that enable your active ingredients to directly reach live skin. They are safe for use at home because there is a lower risk of infection. Until recently, it was thought that cosmetic needling simply enhanced product penetration, but new research has show that it can thicken the epidermis and may even slightly stimulate matrix synthesis. Cosmetic needling can be done much more often than medical needling, generally 2-4 times a week. There is virtually no discomfort and a very low risk of infection.

In this course, the word “needling” means medical needling. The benefits and risks discussed will not usually apply to cosmetic needling.


Needling with needles longer than .5mm is one of the best skin remodeling techniques, especially for stretch marks. It is one of the very few ways to stimulate elastin growth, which is an essential component of the skin matrix and gives skin its “spring back” and tightness. In addition to treating scars, stretch marks, discoloration and wrinkles, it is also effective for improving overall skin texture, lax or mildly sagging skin, broken capillaries and even cellulite to some degree because it increases skin thickness. The results for stretch marks and certain types of scars is particularly impressive, with most users reporting at least a 70% reduction after several home treatments. Some people will experience complete or near complete removal, including restoring skin color and at least some tanning ability to stretch marks.

One advantage to skin needling is that there is actually very little damage to the skin. The process doesn’t rely on tissue death (necrosis) to stimulate the regeneration process, unlike other remodeling techniques like lasers and chemical peels. The numerous needle pricks create controlled damage in the dermis to stimulate the synthesis of skin matrix components, but the epidermis remains more or less intact. The pricks are miniscule and will often separate the skin cells instead of tearing through them. The skin heals quickly, with some research indicating that the channels begin to close in as little as 10 minutes. Other techniques like peels and dermabrasion need to destroy most of the epidermis in order to reach the dermis, often resulting in a permanent thinning of the epidermis after multiple treatments. With needling, the epidermis actually gets thicker over time.

Skin needling also contains virtually no risk of hyperpigmentation and can be used by people with dark skin tones. In fact, needling is a good treatment for many types of hyperpigmentation, including melasma.

It can also be used on thin, dry, or sensitive skin that cannot tolerate exposure to acidic ingredients such as peels even with proper strength building. The healing time is short and there is minimal discomfort, though the process itself can be slightly to moderately painful. The treatment can be repeated many times with cumulative results provided the frequency is appropriate.

Using collagen and/or elastin building actives in your routine before and between treatments will enhance greatly enhance results for most people. Topical actives are not strictly necessary, but some researchers do consider it essential to use topical Vitamin A and C for proper matrix synthesis. If you don’t want to commit to an elaborate skin care regimen, you can achieve significant improvement from performing a needling treatment once every 4-12 weeks without using powerful skin care products daily.

Next Lesson: Risks and Sterilization