Microneedling
Microneedling is a relatively new minimally invasive procedure involving superficial and controlled puncturing of the skin by rolling with miniature fine needles. Microneedling was initially introduced for skin rejuvenation, but now it’s used for a wide range of indications, including acne scars, acne, post-traumatic/burn scar, alopecia, skin rejuvenation, drug delivery, hyperhidrosis, stretch marks, and many more. It is very safe for dark skin types, where risk of postinflammatory pigmentation is very high with other techniques that damage the epidermis. Traditionally, it’s used as a collagen induction therapy for facial scars and skin rejuvenation, but it is now widely used as a transdermal delivery system for therapeutic drugs and vaccines.
The standard medical dermaroller has a 12 cm long handle with a 2 x 2 cm wide drum-shaped cylinder at one end studded with 8 rows and 24 circular arrays of 192 fine microneedles, usually 0.5–3mm in length and 0.1–0.25 mm in diameter. The microneedles are synthesized by reactive ion etching techniques on silicon or medical-grade stainless steel and pre-sterilized by gamma irradiation. Rolling with the standard dermaroller over an area of skin for 15 times results in about 250 holes per square cm up to the papillary dermis depending on the pressure applied. Each pass produces 16 micro punctures in the stratum corneum per square cm without damaging the epidermis significantly.
Micro punctures are created using microneedles to produce a controlled skin injury without actually damaging the epidermis. The micro injuries lead to minimal superficial bleeding and set up a wound healing cascade with release of various growth factors such as platelet derived growth factor (PGF), transforming growth factor alpha and beta (TGF-𝛂 and TGF-𝜷 ), connective tissue activating protein, connective tissue growth factor, and fibroblast growth factor (FGF). The needles also break down the old hardened scar strands and allow it to revascularize. Neovascularization and neocollagenesis is initiated by the migration and proliferation of fibroblasts and laying down of intercellular matrix. Another proposed hypothesis explains that resting electrical membrane potential of cells is approximately -70 mV, and when needles come near the membrane, it increases quickly to -100mV, triggering increased cell activity and the release of various proteins, potassium, and growth factors from the cells into the exterior leading to the migration of fibroblasts to the site of injury, which causes collagen induction. The needles do not create a wound in a real sense, just fooling the cells in believing that the injury has occured.
Consumers can buy at-home microneedling rollers over the counter. But for best results, microneedling should be administered by a dermatologist using more advanced equipment. The dermatologist can adjust the device depth according to the area of the skin and deposit medication, such as topical tretinoin or vitamin C, deeper into the skin. At-home microneedling devices only superficially affect the skin, penetrating just the outer layer, the stratum corneum or epidermis and reaching 0.25 mm deep. Professional devices can go deeper (2 mm to 3 mm deep), reaching the dermis. Professional devices are also electrically powered and evenly pushes the microneedles into the skin. Home versions rely on manually rolling the barrel over the skin to create small punctures.
References:
Singh, A., & Yadav, S. (2016). Microneedling: Advances and Widening Horizons. Indian dermatology online journal. Retrieved March 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/
Yale Medicine. (2021, June 23). Microneedling. Yale Medicine. Retrieved March 21, 2022, from https://www.yalemedicine.org/conditions/microneedling
Microneedling, also known as percutaneous collagen induction therapy, is a minimally invasive dermatologic procedure used to treat various skin conditions, including acne scarring, fine lines and wrinkles, hyperpigmentation, striae (stretch marks), and alopecia. The technique involves using a derma roller or motorized pen device with fine needles to create controlled micro-injuries in the epidermis and dermis. These microchannels stimulate wound healing cascades, resulting in increased production of collagen and elastin, as well as enhanced skin remodeling.
In recent years, microneedling has gained attention not only for its standalone benefits, but also for its potential as a transdermal drug delivery system. The microchannels created during treatment can facilitate the absorption of topically applied agents—including retinoids, vitamin C, tranexamic acid, and even topical minoxidil in cases of androgenetic alopecia—by bypassing the stratum corneum barrier. This raises new considerations for pharmacists, particularly regarding the safety, stability, and formulation of topical products used adjunctively with microneedling.
Common adverse effects include transient erythema, swelling, pinpoint bleeding, and post-inflammatory hyperpigmentation, especially in patients with darker skin types. Although generally well tolerated, infection risk exists if non-sterile techniques or contaminated products are used post-procedure. Therefore, antiseptic protocols, use of sterile topicals, and sun protection are critical components of post-procedure care. Over-the-counter or compounding pharmacy products used after microneedling should be carefully evaluated for pH, preservatives, and potential irritants.
Pharmacists in dermatology, aesthetics, or compounding settings may be asked to recommend or prepare products for use before or after microneedling. As such, it is important to assess ingredient compatibility, avoid allergens or sensitizers, and counsel patients on avoiding retinoids, alpha hydroxy acids, or benzoyl peroxide for at least 24–72 hours post-procedure due to increased skin sensitivity. In certain medical contexts, microneedling may also be combined with platelet-rich plasma (PRP) or drug-loaded microneedles for enhanced therapeutic effect—areas of growing interest for pharmacists involved in innovation or research.
As microneedling becomes more widely adopted in both dermatology clinics and med spa settings, pharmacists are increasingly involved in product guidance, patient education, and risk mitigation. Understanding the procedure's mechanism, indications, and post-care requirements helps support safe and effective outcomes, particularly when paired with pharmaceutical-grade topicals.
Singh A, Yadav S. Microneedling: advances and widening horizons. Indian Dermatol Online J. 2016;7(4):244–254. doi:10.4103/2229-5178.185494
Fabbrocini G, De Vita V, Pastore F, et al. Collagen induction therapy for the treatment of wrinkles and skin laxity: a prospective study. J Cosmet Dermatol. 2014;13(4):272–279. doi:10.1111/jocd.12107
Alster TS, Graham PM. Microneedling: a review and practical guide. Dermatol Surg. 2018;44(3):397–404. doi:10.1097/DSS.0000000000001375
Lima EVA, Lima MA, Takano DMD, Silva ANR. Microneedling in facial recalcitrant melasma: report of a series of 22 cases. Dermatol Ther. 2017;30(5):e12447. doi:10.1111/dth.12447
Abdel-Motaleb AA. Transdermal drug delivery via microneedle arrays: understanding the mechanisms of skin penetration. Pharmaceutics. 2021;13(6):885. doi:10.3390/pharmaceutics13060885
Cohen BE, Elbuluk N. Microneedling in skin of color: a review of uses and efficacy. J Am Acad Dermatol. 2016;74(2):348–355. doi:10.1016/j.jaad.2015.08.033