Microneedling: Indications, Contraindications, Procedure Technique and Clinical Effect

Shubenok P. Dermatologist

December 11, 2025 · 9 min read

Microneedling — also known as percutaneous collagen induction therapy — is a minimally invasive dermatological procedure that uses a device equipped with fine, sterile needles to create controlled microinjuries in the skin, thereby stimulating targeted regeneration.

3D-animation — microneedling

Applications and Limitations for Microneedling

Because of its versatility, microneedling can be performed on nearly any area of the body; however, the most common treatment sites include the face, neck, and décolletage.

The procedure has gained wide popularity due to its effectiveness, safety, and adaptability in treating both cosmetic and dermatological conditions. It can help reduce the appearance of acne scars, striae, and wrinkles.

Although many individuals pursue microneedling for cosmetic purposes, it can also be clinically beneficial for certain skin diseases.

Indications for Microneedling

Comparison of skin before and after microneedling treatment series

Post-acne scars;
Hyperpigmentation;
Wrinkles and ptosis;
Striae;
Alopecia.

Contraindications to Microneedling

Active skin diseases;
Pregnancy and breastfeeding;
Herpes infection;
Use of certain medications;
History of keloids.

How Microinjuries Stimulate Skin Renewal?

Microneedling Action Mechanism

Penetration of microneedles into the skin layers

The therapeutic effect of microneedling is driven primarily by collagen induction, one of the skin’s key biological responses to controlled injury.

By creating multiple controlled microinjuries, microneedling triggers the skin’s natural inflammatory reaction, leading to dermal repair.

Microneedling outcomes can be enhanced through transdermal delivery of vitamins, antioxidants, peptides, hyaluronic acid, and platelet-rich blood plasma.

Process of collagen and elastin fiber restoration

Phases of Microneedling’s Effect on the Skin

Inflammatory phase (up to 3 days): platelets release growth factors; neutrophils migrate to the site of injury; macrophages are recruited; and interleukins are secreted;
Fibroblast proliferation phase (days 3–21): fibroblasts reorganize elastin fibers and synthesize new collagen necessary for restoring tissue elasticity and firmness;
Remodeling phase (3 weeks to 6 months): mature type I collagen forms, and cross-linking of collagen fibers completes dermal reconstruction.

Long-lasting results are achieved through the full dermal matrix remodeling cycle.

Microneedling Technique

The procedure requires no special pre-treatment preparation.

Stages of Microneedling Procedure

Thorough antiseptic treatment of the skin;
Application of topical anesthetic for 15–30 minutes;
Microneedling using the device with depth and speed adjusted to each treatment area;
Repeated antiseptic treatment of the skin;
Application of regeneration-enhancing agents.

The entire session typically takes 30–40 minutes.

The recommended number of sessions depends on baseline skin condition and desired outcomes; the optimal treatment interval is once per month.

Key Post-Procedure Recommendations:

Skin cleansing with gentle, non-irritating products;
Use of sunscreens;
Application of regenerative creams containing panthenol, hyaluronic acid, growth factors, or ceramides;
Products containing retinol and acids should be avoided.

FAQ

1. What is microneedling?

Microneedling — also known as percutaneous collagen induction therapy — is a minimally invasive procedure that uses a device (dermapen) equipped with fine, sterile needles to create controlled microinjuries in the skin. These microinjuries activate a cascade of dermal repair processes aimed at regeneration and remodeling.

2. What is the mechanism of action and the expected effect?

The primary effect is neocollagenesis. Controlled microtrauma triggers a physiological response: an inflammatory phase with growth factor release, a proliferative phase characterized by fibroblast activation and synthesis of new collagen and elastin, and a prolonged remodeling phase (up to 6 months) during which mature type I collagen forms and the dermal matrix is restructured.

3. What are the main indications for microneedling?

Microneedling is indicated for a wide range of dermatological and aesthetic conditions. Key indications include treatment of atrophic acne scars, reduction of wrinkles and skin laxity, correction of striae and hyperpigmentation, and stimulation of hair growth in selected types of alopecia.

4. Is microneedling painful?

The procedure is performed after the application of topical anesthetic for 15–30 minutes. This makes it relatively or completely painless.

5. How long does it take for skin to heal after microneedling?

Immediately after treatment, patients typically experience erythema and mild swelling — a normal inflammatory response. It usually resolves in 1–3 days. Rehabilitation period is generally short but requires adherence to post-procedure care: gentle cleansing, strict photoprotection (SPF), and use of regenerative creams. Retinol and acids should be avoided during rehabilitation phase (5–7 days).

6. How often microneedling should be done and how many sessions are required?

The number of sessions is individualized based on the specific condition and baseline skin status. To optimally stimulate collagen, treatments are recommended once per month, which corresponds to the physiological time of proliferation phase and the onset of dermal remodeling.

7. Are there any side effects?

When performed incorrectly or without proper aseptic technique, microneedling can lead to secondary infection, post-inflammatory hyperpigmentation (especially with inadequate photoprotection), or herpes virus reactivation.

8. What is the difference between microneedling, mesotherapy, and biorevitalization?

These procedures differ in mechanism of action. Microneedling is primarily a mechanical stimulation (collagen induction) with optional transdermal delivery of certain agents. Mesotherapy and biorevitalization are injection techniques where the primary effect is driven by the pharmacological action of injected substances (e.g., hyaluronic acid, vitamins, peptides), and needle trauma is secondary.

References

VOKA Catalogue. [Electronic resource].

https://catalog.voka.io/

Chilicka K, Rusztowicz M, Szyguła R, Nowicka D. Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review. J Clin Med. 2022 May 12;11(10):2744. doi: 10.3390/jcm11102744. PMID: 35628870; PMCID: PMC9147527.

Jaiswal S, Jawade S. Microneedling in Dermatology: A Comprehensive Review of Applications, Techniques, and Outcomes. Cureus. 2024 Sep 23;16(9):e70033. doi: 10.7759/cureus.70033. PMID: 39449889; PMCID: PMC11499218.

Mujahid N, Shareef F, Maymone MBC, Vashi NA. Microneedling as a Treatment for Acne Scarring: A Systematic Review. Dermatol Surg. 2020 Jan;46(1):86-92. doi: 10.1097/DSS.0000000000002020. PMID: 31356435.

Faghihi G, Nabavinejad S, Mokhtari F, Fatemi Naeini F, Iraji F. Microneedling in androgenetic alopecia; comparing two different depths of microneedles. J Cosmet Dermatol. 2021 Apr;20(4):1241-1247. doi: 10.1111/jocd.13714. Epub 2020 Sep 29. PMID: 32897622.