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Micro-needling explained: what it is and who it suits

What micro-needling (collagen induction therapy) involves, how it's thought to work, what UK sources say, downtime, aftercare and who shouldn't have it.

By Nathan Keegan Lic.Ac, MBAcC3 min read

Micro-needling is one of the most talked-about skin treatments around, and it tends to come wrapped in big promises. Leaving the sales pitch aside, here's what it actually is, how it's thought to work, what to look for in a practitioner, and what to expect afterwards.

What is micro-needling?

You may also hear it called collagen induction therapy, or percutaneous collagen induction. It's a minimally invasive, controlled process in which the skin is punctured repeatedly with tiny, sterile needles to encourage the body to start its natural wound-healing response.

Treatment is usually carried out with a small hand-held device, and the needle depth is chosen to suit the area being treated.

How is it thought to work?

The idea is that tiny, controlled punctures prompt the skin's own repair process, and that this repair involves the body producing tissue including collagen and elastin.

The quality of the evidence matters here. A 2020 literature review in Aesthetic Plastic Surgery by Atiyeh and colleagues found 25 published studies. Four were animal studies, and most of the clinical reports were "case series or small cohort non-randomized studies". The authors concluded that there were "a limited number of high-quality studies" and that results "must be carefully interpreted". So the theory is plausible, but good-quality trials are still lacking. That's why I don't promise any particular result.

Choosing who treats you

Cosmetic skin treatments like micro-needling do carry possible side effects, including burning, peeling and permanent skin discolouration. The British Association of Dermatologists recommends that cosmetic treatments are carried out by trained consultant dermatologists, while accepting that other practitioners "with the correct training" can do them too. Its bottom line is that you should never get treatment from anyone without suitable training and premises.

Whoever you go to, look for a reputable, safe and qualified practitioner who is trained in the procedure and has the right insurance. Ask about the products they use and what could go wrong, and remember that you can walk away if you're not completely comfortable. Cosmetic micro-needling isn't normally available on the NHS.

What's normal afterwards

Everyone's skin responds differently, but these after-effects are common:

  • Skin that feels warm and looks red, rather like sunburn, usually improving within 1 to 2 days.
  • Tightness or tenderness for 1 to 3 days.
  • Some peeling or flaking after a couple of days.
  • Pinpoint bleeding during treatment, which doesn't usually need a dressing.

Aftercare

Advice varies a little from one source to another, so I'll give you written aftercare suited to your treatment. In general:

  • Protect from the sun. Avoid sun exposure for 7 days, and apply sunscreen regularly.
  • Avoid heat and sweat for a couple of days. For saunas, hot water, swimming and vigorous exercise, guidance ranges from 48 to 72 hours.
  • Hold off on make-up. Ideally, wait 72 hours before wearing it again.
  • Keep it gentle. A simple moisturiser is usually all you need. Keep the area clean and don't pick at any flaking skin.
  • Watch for infection. Contact me or your GP if you notice increasing pain, swelling, heat or discharge.

Who micro-needling isn't suitable for

Micro-needling isn't recommended in several situations, including:

  • active skin infections, including cold sores
  • active skin cancer
  • a history of keloid or abnormal scarring
  • pregnancy or breastfeeding
  • bleeding disorders, or taking blood-thinning medication
  • autoimmune disease, or taking steroids
  • recent sun exposure or laser treatment

If you're prone to cold sores, mention it beforehand. I'll go through a health questionnaire with you before any treatment, and if micro-needling isn't right for you, I'll say so.

How many sessions?

Treatment plans vary. Courses are typically several sessions spaced about six weeks apart, but the right plan depends on your skin and what you're hoping for. I'd rather talk it through with you properly than sell you a package.

If you have questions about whether micro-needling is right for you, you're welcome to get in touch before booking.

This article is general information about acupuncture and traditional Chinese medicine, not medical advice. If you're worried about your health, speak to your GP or call NHS 111.

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