We asked EV expert and Ashley Aesthetics Founder, Dr Emmaline Ashley, to talk us through all things microneedling. Here's everything she had to say…

What is microneedling?

Taking advantage of our understanding of skin physiology and wound healing, microneedling is the act of puncturing the skin with very fine, sterile needles to create microscopic channels that trigger the skins natural repair responses. Namely, making more collagen and elastin. Found in the middle layer of the skin these proteins make up the scaffolding and structure of our skin, and give that bounce and plumpness that we associate with youthful, smooth skin.

What skin conditions benefit most from microneedling? 

Microneedling can benefit your skin quality as a whole, targeting fine lines and wrinkles, smoothing out texture, and reducing the appearance of pore size. It can also be used to target specific skin concerns, including acne scarring, stretch marks, hyperpigmentation, and hair loss conditions like alopecia. This is all thanks to the increase in blood vessels, blood circulation as well as all important collagen and elastin production.
 

Do needle sizes vary?

Needle size varies depending on what skin concern you want to target. However, in general, skin on the forehead, lower eyelids, and bridge of the nose are treated with needle depths from 0.5mm to 1.0mm. While the cheeks, around the mouth, scars, stretch marks, and skin anywhere else on your body are treated at depths of 1.5mm to 3mm. Generally, the thicker the skin the deeper the needle, but it will be up to your clinician’s assessment and their experience to select the depth.

Can this treatment be performed at home? 

There are some manual dermal rollers  that are available for at home use. However, they barely penetrate the skin, it’s difficult to ensure a sterile environment, and you need to be careful about what ingredients you apply after you’ve disrupted its barrier. This is why ideally your targeted microneedling treatments should to be carried out by a qualified medical professional.
 

How is microneedling performed in clinic? 

In clinic microneedling can be done manually or automatically. Manually it is performed with a dermaroller, which is a cylinder with multiple needles that can be rolled over a larger skin area. Microneedling can also be performed with a ‘pen’, which is a device containing needles that automatically puncture the skin at a pre-set depth. These automated skin devices give greater flexibility and control as users can navigate the contours of the face more easily, and they achieve a very precise depth of skin penetration.

There are also specialised forms of the treatment like radio frequency microneedling. This technique uses specially designed needles that are insulated except at the very tips where they emit radio frequency energy. This means that energy is only delivered at the targeted depth chosen by your practitioner. The heat energy produced will cause very controlled and precise trauma to that microscopic area in your skin, again stimulating collagen and elastin production.

Microneedling has also been used as part of combination treatments, with platelet-rich plasma therapy, and chemical peels making for popular choices. Practitioners may also elect to topically apply a serum after the procedure so it will absorb more deeply. Common ingredients used with microneedling include collagen boosting peptides, hydrating hyaluronic acid, and barrier protecting ceramides.
 

How should you protect your skin post procedure? 

Although it is unlikely that you’d be able to see the microscopic punctures in your skin, some studies have suggested that they stay open for up to 20 hours, representing a temporary break in your protective skin barrier. For this reason, it’s best to be gentle with and protect your skin for at least a day after a session. Do this by avoiding anything that will cause irritation or inflammation, like excessive heat or sweat from activities like intense exercise, sun exposure, tanning, saunas, and so on.

Check with your practitioners which skincare products are safe or recommended to use after a treatment. Generally, we advise to avoid wearing makeup for the next 24 hours to reduce the risk of skin contamination or infection, and its usually recommended that retinoids or Vitamin C, should not be applied for 48 hours post treatment. And as always, make sure you are wearing SPF in the weeks following your treatment.

Is microneedling painful? 

This treatment can sometimes be slightly uncomfortable although it should not cause pain. Usually, if a treatment is being performed at a shallow depth it will be completely painless. However, if treating a condition that requires a needle depth of 0.5mm practitioners will apply a topical local anaesthetic to the area to ensure that you are comfortable during the procedure.

How many sessions are needed to see results?

The number of sessions people need varies depending on the specific skin concern and type of microneedling device used. Although you can see noticeable results soon after the first treatment, generally, full results will not be seen for 4-8 weeks as the skin needs time to produce new collagen and elastin.

For the best results you should expect to have an average of four to six treatments, booked about four to six weeks apart. Once the programme is complete, expect the results to last from six months to two years, with maintenance or top-up treatments required thereafter.

Does this treatment have short or long-term side effects?

Immediately after your treatment your skin will likely feel sensitive and may appear red or itchy, but these side effects will self-resolve quickly. There may be some mild swelling and bruising. Occasionally, you may have minor flaking or skin peeling or suffer from milia or temporary skin darkening. These should last no more than 48 hours, with most people being able to return to their normal daily activities immediately after the procedure.

In terms of lasting side effects, when used appropriately, microneedling should not have any significant long-term side effects. Issues can arise with overuse of microneedling, when you do not allow your skin barrier to heal completely between sessions, which can lead to damage to the fine blood vessels in your skin.

Are all skin types and tones suitable for microneedling?

All skin types and tones are suitable for microneedling. In fact, many of the research studies conducted focus on patients with darker skin tones because there is particular interest in microneedling as an alternative to laser therapy or other forms of skin resurfacing for skin of colour, as darker skin tones carry an increased risk of post inflammatory hyperpigmentation.

However, contraindications to microneedling include inflammatory acne, active infections like herpes on the face, a history of keloid scarring, or immunosuppression.

How much does a microneedling treatment usually cost?

Expect treatments to start at £200 for simple microneedling and go up from there, depending on the device used and treatment area. Radio frequency microneedling will typically start from £400, while combination treatments will often start at £700.