Microneedling – Why Do We Injure the Skin to Make It Renew Itself?

In recent years, microneedling treatments have become one of the most sought-after treatments in the field of aesthetics.

We are promised improvement in wrinkles, in acne scars, in pores, and in skin texture, all through tiny needles that penetrate the skin and create thousands of tiny punctures in it.

The idea sounds almost contrary to what we are used to thinking about skincare.

Usually we try to protect the skin from injuries, but here we actually create a controlled injury to encourage a process of repair and renewal.

So how does it really work? Is the treatment effective? And what happens to the skin when we repeat it over years?

What is microneedling?

Microneedling, or Microneedling, is a treatment in which a device equipped with very thin needles is used, penetrating the skin to different depths.

Common devices include electric pens and other professional systems that allow control of the penetration depth.

The goal is to create controlled microscopic injuries, which trigger the body's natural healing mechanisms.

During recovery, processes are activated that are related to the production and reorganization of collagen and other components in the skin's extracellular matrix.

Why can injury improve the skin's appearance?

When the skin is injured, the body begins a complex repair process.

Different cells arrive at the area, growth factors are released, and processes begin that are meant to restore the tissue.

Among other things, cells called fibroblasts take part in collagen production and in processes of rebuilding the tissue.

When the treatment is performed in a controlled manner, these processes may gradually improve skin texture and the appearance of certain scars.

But it is important to understand that the goal is not to create as many injuries as possible.

Too deep an injury or treatment repeated at too high a frequency can cause irritation and complications instead of improvement.

What are the advantages of microneedling?

1. Improvement of acne scars

One of the uses studied relatively well is the treatment of sunken acne scars.

Microneedling may improve the appearance of some of the scars through processes of repair and reorganization of the collagen.

The result depends on the type of scar, its depth, and the number of treatments.

Not every scar responds in the same way, and it is not always possible to eliminate it completely.

2. Improvement of skin texture

The treatment may help in gradual improvement of uneven skin texture and of certain fine lines.

But it does not return the skin to its state at a young age and does not stop the aging process.

3. Certain improvement in the appearance of pores

When skin texture improves, the pores may also look less prominent.

However, the treatment does not eliminate pores and does not completely change their genetic structure.

4. A treatment option for some darker skin tones

Compared to some laser treatments, microneedling may be a suitable option also for people with darker skin tones.

But here too there are risks of pigmentation and scarring, and therefore professional adjustment is required.

How soon are results seen?

Immediately after the treatment the skin may look red and sometimes slightly swollen.

Some people feel the skin looks tighter after the redness goes down, but the changes related to rebuilding collagen develop gradually.

Usually it is a process of weeks to months.

In many cases a series of treatments is required, especially when treating scars.

What are the disadvantages and risks?

Although microneedling is considered a treatment with a reasonable safety profile when performed professionally and suitably, it is still an action that penetrates the skin barrier.

1. Infections

The needles create tiny openings in the skin.

If the device is not sterile, if unsuitable needles are used, or if the treatment is performed under unhygienic conditions, an infection may develop.

2. Post-inflammatory pigmentation

In some people, especially those with a tendency to pigmentation, the inflammatory response can lead to dark spots.

The risk rises when the treatment is too aggressive or when the skin is exposed to the sun without suitable protection during recovery.

3. Irritation, redness, and swelling

Temporary redness and sensitivity are relatively expected responses.

But if significant pain, ongoing worsening, discharge, or unusual swelling appears, it is important to go for an examination.

4. Scars

Although the treatment is sometimes intended to improve scars, incorrect use of needles can actually cause new scarring.

5. Worsening of existing skin problems

Microneedling should not be performed on skin with an active infection, active herpes sores, or significant inflammation without a medical assessment.

People with a tendency to keloid scars or with certain skin diseases also need a special assessment before the treatment.

Is microneedling suited to skin with acne?

One must distinguish between acne scars and active inflammatory acne.

Microneedling may help improve scars that remained after the acne has calmed.

But when there are active inflammatory pimples or an infection, inserting needles into these areas may worsen the condition.

Therefore it is important to first treat the active problem and only afterwards consider treating the scars.

And what about microneedling with radio waves?

In recent years, a treatment called RF Microneedling has also become common.

In this treatment, the needles penetrate the skin and release radio-wave energy that creates controlled heating in the tissue.

The combination is meant to encourage processes of change in the collagen and improve texture and skin laxity in suitable cases.

But it is important to know that this is not the same treatment as regular microneedling.

Adding heat energy changes the nature of the action and the risks.

Serious complications have also been reported in RF Microneedling treatments, including burns, scars, loss of subcutaneous fat, and nerve damage.

Therefore it is especially important to choose a skilled medical professional who knows the device and the anatomy of the treated area well.

Should microneedling be done at home?

Many home devices can be found today that promise results similar to professional treatments.

But there is a significant difference between a superficial device and a medical treatment in which needles penetrate to the depth of the tissue.

Incorrect home use can cause infections, injuries, and pigmentation.

In addition, applying regular cosmetic products immediately after creating openings in the skin may increase penetration of ingredients not meant to reach deeper layers.

Not every serum suited to application on intact skin is suited for use together with microneedling.

Therefore I do not recommend performing penetrating treatments at home or using non-sterile preparations on injured skin.

Do more treatments mean more collagen?

Not necessarily.

The body needs time to complete the processes of healing and rebuilding the tissue.

If treatments are performed at too high a frequency, before the skin has recovered, the irritation may be prolonged and the healing process harmed.

The number of treatments and the intervals between them should be determined according to the treatment depth, the skin's condition, and the therapeutic goal.

And what happens to the skin when microneedling is performed for years?

This, in my view, is one of the most important questions.

We know that a controlled treatment can encourage changes in collagen and improve certain skin problems.

But there are not enough quality studies that follow people who perform penetrating treatments at a fixed frequency for decades.

Therefore it is not correct to promise that unlimited repeated treatments will keep the skin young.

On the other hand, there is also no proof that a professional treatment done at suitable intervals necessarily causes cumulative damage.

What is important is not to treat controlled injury of the skin as a routine maintenance treatment that every woman must perform.

How should one prepare for the treatment?

Before the treatment it is important to receive a diagnosis of the skin's condition and make sure the goal suits the technology.

The practitioner should be updated about medications, a tendency to scarring, recurring infections, herpes, and skin diseases.

It is also worth clarifying which device is used, what the planned penetration depth is, how sterility is ensured, and what the expected recovery period is.

After the treatment, one must follow the skin-care instructions, avoid unprotected sun exposure, and not use active or irritating substances until the skin has recovered and in accordance with the instructions.

My daily recommendation

I think microneedling is an interesting example of our body's ability to repair itself.

We create a small, controlled injury, and the body responds through its healing mechanisms.

But I also think there is a point here worth remembering.

The fact that the skin can recover from injury does not mean we need to injure it again and again to keep it healthy.

I believe first of all in preserving the skin barrier, in protection from the sun, in good nutrition, in sleep, and in a skincare routine suited to the skin's condition.

Penetrating treatments can be an effective tool when they have a clear goal, especially in cases of scars or certain texture problems.

But not every treatment suited to one woman suits another, and not every aesthetic improvement justifies every level of risk.

In my view, the goal is not to make the skin work harder at any cost.

The goal is to understand how it functions, when it is worth helping it and when it is actually better to let it continue doing what it knows how to do naturally.

Nurit Rozenblat

With love,
Nurit Rozenblat
OrOrgani

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