The Art and Science of Microneedling in Dermatology and Aesthetics

We all do it: we brush our hair, examine our faces in the mirror, check our smile… hoping to look our best. And we all find them: little scars, wrinkles, and spots that make us feel less confident than we want to. It’s natural to want to be confident about how we look. That’s why it’s no surprise that in a recent, wide-ranging survey of 14,584 aesthetically conscious adults conducted by the Aesthetic Surgery Journal and noted in the National Library of Medicine, 81% of respondents said they would be willing to invest in improving their appearance. This quest for self-improvement has led to the popularity of minimally invasive cosmetic procedures, such as microneedling, which stimulate the body’s own anti-aging collagen production.

“I have been a nurse for 15 years and have been in the dermatology and aesthetic field for 3 years,” says Shaffer. “When I first started in dermatology, I quickly realized how much I loved the aesthetic side of nursing and how great it feels to have an impact on someone’s life by making them feel better in their own skin. I perform a variety of treatments like chemical peels, Botox, Coolsculpting, Diamond Glow facials, and my favorite, microneedling.”

It’s important to note that several other minimally invasive treatments exist as well. Each patient’s medical history, individual skin conditions, and overall goals will be unique, so having a personalized consultation and becoming educated on all the potential options is important.

“Microneedling is a very popular aesthetic treatment used to treat a wide variety of skin issues like acne scarring, rejuvenating aging skin, discoloration, and stretch marks,” says Shaffer. Microneedling is incredibly effective, particularly because it helps the skin do these things on its own.” 

Shaffer says that microneedling is a reasonably straightforward procedure, but it’s still not a one-size-fits-all approach. The first step in the process is booking a full consultation so that your dermatology aesthetician can determine the best course of action for your situation.

“Consultations are key in establishing a treatment plan,” says Shaffer. “You need to have trust in the provider you are receiving treatments from and feel comfortable moving forward. I strive to build strong relationships with my patients and help them make informed decisions when it comes to what treatments will be most beneficial for them. Sometimes a specific treatment option may not be the best for you, but once we identify what your skin needs, we can create a treatment plan that is right for you.”

If, together, you and your provider decide microneedling would be beneficial to you, an appointment is scheduled. While microneedling is often thought of as a way to smooth and firm facial skin, it can also be done on the neck, chest, back, legs, and other areas. A series of treatments may be recommended, depending on the areas and conditions you want treated. Each microneedling session involves three basic steps:

“First, we start by applying a numbing cream to the area we are treating,” says Shaffer. “I’m often asked, ‘Does microneedling hurt’ and while there can be some discomfort, this step makes the procedure very tolerable and comfortable.”

“We then move a microneedling pen with tiny needles to make minor punctures and traumas to the skin in the areas that need treatment. By traumatizing the skin, it responds and starts to heal itself by making new collagen-rich cells and tissues in the treated areas,” explains Shaffer.

We also apply a growth factor recovery serum to the skin that will accompany the microneedles directly into the skin. “This serum helps with the healing process and stimulates collagen and elastin production,” explains Shaffer.

“We normally start with 4 treatments, spread out every 4-6 weeks. Some patients will require additional treatments to achieve their skin goals. Different lengths of needles are customized to every patient based on why they are receiving the treatment.”

After a microneedling session, you can go directly home or back to work with minimal downtime. We will provide you with some aftercare procedures to help alleviate the swelling and redness that may be present for a few days. For example, we recommend using an ice pack and staying out of the sun, as your skin will be quite sensitive in the treated areas. We will also advise you on skincare products like our post-procedure kit that will help with healing and advancing the benefits of the procedure. 

One of the things that makes microneedling a good choice for so many patients is that, other than some temporary redness and a little bit of post-treatment swelling, there is very little downtime, and there are few side effects, particularly compared with other skin resurfacing treatments.

“After microneedling, the treated tissue is more even in texture and tone, which creates firmer-looking skin,” explains Shaffer. “The results of this procedure can also reduce redness and discoloration, eliminate acne scars, tighten and firm skin, and reduce hyperpigmented areas on the skin.”

All these effects stem from the micro-traumas induced by microneedling, which triggers more collagen and elastin production within the skin. Generating these processes within the skin lessens the appearance of the redness from scarring too.

“There are so many skin conditions we can treat with microneedling, but the most common issue I treat in my practice is acne scarring,” shares Shaffer. “While acne can be very troublesome and frustrating on its own, sometimes the worst part of acne is what it leaves behind once it’s under control.” Notably, microneedling can smooth and even out the skin texture to eliminate the deeper, crater-like scars. 

“It is so rewarding to see someone who is ashamed or upset about their appearance due to the scarring and discoloration, feel great and confident in their own skin once the treatments are completed,” adds Shaffer.

“Again, this is not a “one size fits all” when it comes to a procedure like this,” Shaffer says. “Everyone has a different degree of scarring along with different expectations.” During your consultation, we will fully examine your skin, discuss your goals, and choose the best treatment options to achieve those goals.

In addition to the straightforward microneedling application mentioned previously, there are different types of needles, serums, and even radio frequencies (RF) that we can apply in different situations.

RF microneedling uses the same process previously described. However, radiofrequency heat is applied via the microneedles as well, which accelerates the cellular healing of the micro-wounds administered during the treatment.

At Apex, we offer the Exion device for RF Microneedling in select locations.

There are also some home-based products on the market, but using these without proper training or expertise is risky. “As always, it is very important to seek professional advice before starting any treatment like microneedling, and I do not recommend performing this treatment at home,” says Shaffer.

Based on our consultation with you, we will choose which treatment(s) to use to achieve the results you desire. Often, we find that a combination of different treatments and products produces the best microneedling before and after results.

Microneedling can repair several different kinds of skin damage and reverse signs of aging. Some of the skin conditions that we can alleviate and improve through various forms of microneedling include:

Since every patient is unique, we tailor the treatment or combination of treatments to your specific needs, skin condition, and optimal outcome. Professional treatment and personal customization are crucial, as Shaffer explains.

While microneedling is suitable for most patients, there are still some risks that come with the procedure, and we want to make sure you are a proper candidate for treatment. Shaffer explains further: 

“There is a risk for infection, just like any needling procedure,” explains Shaffer. “And microneedling too deep can cause more trauma to the areas and create additional scarring. Also, certain topical and oral medications need to be discontinued before receiving this treatment.”

The typical microneedling appointment time varies depending on the goals and area to be treated, but the downtime after the appointment is quite minimal. You may experience some dryness after treatment that can last for a few days afterward. However, most patients tolerate this well, and you can usually resume your normal skincare routine three days after treatment.

Shaffer also says, “There can be some bruising, swelling, and tightness after treatment, but again, that normally goes away within a few days after treatment. There are products we recommend for post-procedure care that promote healing and can better the results and these can be discussed during the consultation.”

Microneedling procedures can demonstrably improve skin texture for patients who want to reduce evidence of wrinkles, hyperpigmentation, texture problems, and different types of scars, including significant acne scars. Shaffer urges people struggling with any skin condition to come in for a consultation and encourages everyone to ask questions and get educated:

“If you feel like your skin is lackluster, you don’t like the fine lines or complexion you have, you have stubborn acne scarring, or if you have prominent pores, microneedling may be an option for you. Incorporating treatments like microneedling into your skincare routine will give you long-lasting benefits and results, and we can pair the treatments with a skin care regimen tailored to your skin’s needs.”

“We all need to love the skin we’re in, and there are always treatments available to help you achieve your skin goals, and I would love to help you with that!” says Shaffer.

Shannon is an Aesthetic Nurse with Apex Skin. Shannon discovered her passion for the beauty industry during her high school years and pursued her cosmetology license at a vocational center prior to her high school graduation. She worked as a licensed cosmetologist in Kent, OH for over 15 years specializing in several nail enhancement services. During this time, she also attended nursing school and graduated with her LPN license.
She has been a nurse for over 13 years with experience in multiple fields including internal medicine, primary care, orthopedics, and most recently, dermatology. She began as a nurse here at Apex, but soon discovered her passion for the aesthetic and cosmetic side of the profession. She has pursued several trainings to advance her career in medical aesthetics including microneedling, chemical peels, dermaplaning, Coolsculpting Elite, Diamond Glow, and more, and she plans on continuing to expand her services during her career.