Microneedling has been exploding in popularity. It's claimed to reduce scars, wrinkles, and more.
But it sounds a bit crazy: we're supposed to improve our skin and treat the signs of aging by sticking a ton of little needles into it.
So is there actually anything to this? In this article, I'll walk through the clinical evidence. And I'll share some crucial information you need to know if you've been considering an at-home device, so you don't get ripped off.
Table of Contents
- How Microneedling Works
- What the Clinical Evidence Shows
- What About At-Home Devices?
- The Bottom Line
- References
How Microneedling Works
Back in the mid 90s, a plastic surgeon in Canada had a novel idea to improve the appearance of scars. He used a tattoo gun to inject ink into the skin of his patients to try to hide the discoloration [1].
This led to a surprising discovery. Though he'd been trying to hide the scar, he began to notice his patients' scars were improving in texture and appearance. And it didn't seem to be because of the ink. Instead, the tattoo needles themselves were causing the improvements.
He published an influential article in 1997 describing a method of treating scars by using a tattoo gun — without the ink [2].
Since then, various forms of what came to be called microneedling have developed. An early product was the Dermaroller, which consisted of a head embedded with tiny needles, which is rolled over the skin [3]. Later developments have included stamps and pens. But they all rely upon the same basic approach of piercing the skin with a ton of tiny needles.
So why is that supposed to help?
At first, the idea sounds counterintuitive. The aim is to bring healing by causing damage. But the key is that it's carefully controlled damage. The microinjuries caused by the needles stimulate a powerful healing response. The body releases growth factors that generate new collagen and elastin, the crucial building blocks that give our skin structure and flexibility [4].
Moreover, when it comes to scars, the needles can break down strands of scar tissue and stimulate the growth of new blood vessels and collagen [4].
The technique is also increasingly being used to enhance the delivery of medications across the skin barrier [4]. Some microneedling treatments combine the action of the needles themselves with medications delivered at the same time.
What the Clinical Evidence Shows
The theory sounds plausible. It's essentially the same mechanism some forms of laser therapy use — causing micro damage to stimulate the body's healing response. But what kind of impacts do we actually see in clinical trials?
An early study seemed to confirm the basic mechanism. Researchers assessed 480 patients who had been treated through microneedling for fine wrinkles, lax skin, scarring, and stretch marks. On average, the patients reported a 60 to 80% improvement [5].
But more interesting was what researchers found when they examined skin samples from 20 patients. There was a significant increase in the production of collagen and elastin. And the outer layer of the skin was 40% thicker 1 year after the procedure [5].
This was followed by numerous trials that have tested microneedling on a variety of skin conditions. So let's dig a bit deeper into the research.
Acne Scarring
Let's start with acne scarring. This is a challenging area, because the scars can be deep and difficult to improve through existing approaches. A 2021 review included 9 randomized controlled trials of microneedling as a treatment for this problem [6].
Assessing effectiveness in this area is a little tricky. It typically depends upon judgment of improvements based on a scale, instead of objective measures. But all the included studies used standard grading systems, with evaluations from both participants and researchers.
The included studies used different variations of treatment, but the findings were consistent across studies. Microneedling was effective in treating acne scars. And there were no serious adverse effects reported in the included studies [6].
A more recent meta-analysis found a standard mean difference of about 0.42 with microneedling in the included studies. This indicates a real but modest improvement [7].
Signs of Photo Aging
Let's turn to addressing the signs of photo aging. Here we're talking about things like fine lines and wrinkles.
A 2018 study assessed how 4 microneedling sessions spaced 30 days apart were able to rejuvenate skin. It included 48 participants [8].
Researchers measured wrinkles, skin laxity, and skin texture. They used both a grading scale that relies on expert judgment and a precision optical device that measures skin parameters [8].
At 150 days after the initial treatment, researchers looked to see how patients' skin compared to its condition before the study began. Using the grading scales, they saw significant improvements in wrinkles, skin laxity, and texture [8].
Let me put these numbers into context. The scale used for wrinkles ranges from 0 to 5, with 0 indicating no wrinkles and 5 indicating very deep ones [9]. So the results mean wrinkles improved by more than a whole category on the scale. At baseline, the average score was 3.17, so moderately deep wrinkles. By day 150, it was 2.24. It had moved well into the "shallow wrinkles" category [8].
The change in other measures was similarly significant. And what's really impressive is that the objective measurements they took backed up these scale-based observations. The smile line measurements improved by as much as 57% in a metric that gives the average of the 5 highest peaks and deepest valleys in the skin. That's a truly meaningful impact [8].
Skin Pigment Issues
Another area where microneedling has shown positive results is with skin pigment issues, like vitiligo. This is when patients develop patches of skin where pigment is missing. It's an area where researchers have found that joining microneedling with other therapies can often produce even stronger results.
For example, one study split 46 patients with vitiligo into 2 groups. One was treated with microneedling alone. The other got microneedling treatments along with 5-fluorouracil. At the end of the trial, both groups had areas of vitiligo where more than 75% of pigmentation was restored in response to the treatment. But the combined therapy group had more than twice as many patches with this strong of a response [10].
The Bigger Picture
Overall, an extensive review of the research published late last year concluded that microneedling demonstrates substantial promise across a range of skin problems beyond just improving the signs of aging [11].
But there are some important cautions. At this point, there is a wide variety of different microneedling devices and treatment approaches. Individual trials also use different kinds of metrics to assess outcomes. This makes pulling together results in meta-analyses challenging. And many of the studies are small. So it's a bit difficult to get a sense of the big picture. Existing studies seem to show a pattern of consistent benefit. But the size of the benefit and the most effective approaches to microneedling are less clear.
It's interesting to see, for instance, how microneedling compares to one of the best-established treatments for countering the signs of aging. One study put CO2 laser treatments up against microneedling. (In this case, both treatments were also combined with an additional topical treatment.) The CO2 laser was significantly more effective. And patients were more satisfied with the results — 84.6% reported complete satisfaction with the laser group compared to 50% in the microneedling group [12].
What About At-Home Devices?
This brings us to an important practical question. You can easily find microneedling products advertised online that promise a range of benefits for your skin. Are they worth trying out?
Here's what you need to keep in mind. An important factor for the effectiveness of microneedling devices is the needle length. For treating aging skin, for instance, needle lengths of 0.5 to 1.0 mm are recommended. For scars, up to 2.0 mm might be used [4].
But products marketed for at-home use are often quite a bit shorter. These shorter needles might not reach the deeper layers of the skin that can stimulate the healing process described earlier. The problem is that devices that reach deeper and are intended to treat scars and wrinkles are considered medical devices in the U.S. The FDA hasn't cleared any of these devices for over-the-counter sale — at least as of October 15, 2025 [13].
And they recommend you go to a trained professional to receive treatment with these medical devices [13].
So when we see microneedling products for sale online, at least in the U.S., it's likely that one of 2 things is happening. You're looking at a device that doesn't penetrate the skin very deeply and isn't likely to produce much of an effect. Or, it's a device that the FDA would consider a medical device but that hasn't been tested or evaluated. And here the effectiveness and safety are unknowns. Deeper penetration certainly exposes you to greater risks of infection at the very least.
Let's look at some best sellers on Amazon so you can see what I'm talking about.
The top seller is the Roselyn Boutique Derma Roller. You can see its needles are just 0.25mm. So these aren't going to penetrate to the levels that can stimulate collagen production. And it's interesting because the product page makes basically zero claims about what it does. It's just a "cosmetic beauty instrument."
A bit further down the list (and a lot higher in price), you'll find Dr. Pen. Given the price and the look, this gives off the vibes of a more medical-grade device. But notice the needle length: just shy of 0.3 mm. They clearly state it's non-invasive. And the claims are about exfoliating skin, not improving wrinkles. This also falls into the non-medical device category.
The Bottom Line
So here's where I am right now with microneedling. The theory behind it seems sound, and there are some promising clinical results. Studies have generally found adverse effects to be minimal, so the safety profile is good.
At-home kits are potentially a cheap option, but there are risks of infection and the needles just not being long enough to have an effect.
But I'd like to see bigger and more rigorous trials to get a better sense of its effectiveness and how it compares to alternative treatments. And I'd be wary of at-home devices. For example, I'd love to see a randomized controlled trial that compared fractional, non-ablative laser treatments (which I get done once a year) to microneedling.
References
2. https://link.springer.com/article/10.1007/s002669900081
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC2918341/
4. https://www.ncbi.nlm.nih.gov/sites/books/NBK459344/
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC8450803/
7. https://link.springer.com/article/10.1007/s00266-022-02845-3
8. https://pmc.ncbi.nlm.nih.gov/articles/PMC6122507/
9. https://academic.oup.com/asj/article/42/10/1154/6565988
10. https://pmc.ncbi.nlm.nih.gov/articles/PMC8751692/
