Skin Needling Lesson 6: Procedure and Recovery

The needling procedure is more or less straightforward. Follow the directions of your needling tool. Make sure to sterilize your skin and work area by wiping it down with alcohol. Pull the skin taut as you needle to ensure penetration. Do your best to distribute the needle pricks evenly across the surface of the skin. Lifting the tool slightly after each pass will help prevent the needles from going back into the same channels. Rolling in a “star” pattern (5 passes vertically, 5 horizontally, and 5 diagonally) is helpful for distribution. Use moderate pressure while needling. You don’t want to push too hard, but there should be some pinpoint bleeding if you are reaching the dermis.

The needling process is often uncomfortable. People report varying degrees of pain depending on the area needled and individual pain tolerance. Not all people will need to numb the skin. You’ll get an idea of how much it will hurt when you do your patch test.

You can use topical numbing cream on small areas of skin. Wash the numbing cream off with an oil free cleanser before wiping the skin down with antiseptic alcohol. Large areas should be numbed with ice because you don’t want to absorb too much of the numbing ingredients into your bloodstream. Ice packs are helpful because they can and should be sterilized by wiping them with alcohol. If you do use plain ice make your cubes with distilled water and wipe the tray down with alcohol before freezing. After numbing with ice, wipe the water off of the skin with gauze or a paper towel before wiping the skin down with alcohol.


These are general recommendations. Follow the instructions included with your needling tool. Proper after care following your needling treatment will reduce the risk of infection and enhance your results. Although you do not need to use topical actives, it is highly recommended. The same actives you should use to prepare your skin will help while the skin is remodeling after needling.

You should expect some pinpoint bleeding during and immediately after skin needling. If there is no bleeding whatsoever, you may not be reaching the dermis, which is necessary for the procedure to remodel the skin matrix. The bleeding stops quickly, usually in 5 to 10 minutes. This is often followed by a clear serum oozing from the skin, which also quickly subsides as the channels close. You can clear away the serum and ooze with lukewarm water, no soap or rags.

Immediately after the oozing subsides, rinse the area with lukewarm water and allow it to air dry. Do not use any cleansers. After the skin has dried, apply an occlusive ointment to the area. Ointments do not contain any water or alcohol that can soak into the skin. Their greasy base can’t be absorbed and locks in the skin’s moisture to prevent it from drying out. If possible, use an ointment that contains Vitamin A, like Infadolan. Covering the area with petroleum jelly is also sufficient. You don’t have to use a lot, just a light coating will suffice. Apply the ointment 2 or 3 times a day for the following 10 to 14 days.

A few hours after the procedure, wash the area again with lukewarm water in the shower. Do not use soap or soak in a bathtub to avoid contamination. Massage the treated area very gently to help remove any excess blood and serum. Don’t use too much pressure; there is not need to actually see anything oozing out of the skin. Reapply the occlusive ointment.

For the first three days after needling, the skin will be red or purplish from micro bruising. This color is more apparent in lighter skin tones. There is also some swelling, which may be worse on the second day than it was on the first. Avoid using cleansers until the end of the second day, but rinse the area with water frequently and keep applying the occlusive ointment. By the end of the third day, the skin will typically lighten to a pink color resembling sunburn and swelling will be reduced.

Be very careful about the skin care products you use in the first few days after your needling treatment. For the first 2 days, do not use creams or lotions because the emulsifiers and preservative can travel deep into the skin.

You can start using an ascorbic acid serum on the third day after needling to enhance collagen production. Use of Vitamin A and peptides are usually reintroduced on the third to seventh day. Sun protection in the weeks after needling is very important, but you can’t wear any sunscreen until day 3. A natural zinc and titanium dioxide based sunscreen is ideal. Sun protective clothing like a hat is also recommended. You may not need to use sunscreen on body skin as long as it is covered with clothing.

It’s important to keep using an occlusive ointment on the skin at all times. Wash it off before applying your other products, allow them to soak in for 20 to 30 minutes, and then reapply the occlusive ointment. Skin peeling during the healing process is common. Do not pick at any skin flakes or peel hanging skin. Using an occlusive ointment will help delay skin peeling and hopefully prevent scabbing. It is critical that you continually use an occlusive ointment while the skin is healing.

On the fourth or fifth day, you can start wearing make up again. Swelling and bruising should become minimal by the sixth day. By Day 7 or 8, there are very few visible signs of the procedure and the tissue remodeling process is underway. Dense needling will take a few days longer to heal, but the process is generally the same. Using skin care products with active ingredients over the following weeks will enhance collagen production and is greatly recommended.