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Dermarolling: Don’t Go Under the Needle Without Reading This

Dermarolling: Don't Go Under the Needle Without Reading This

It seems there’s nothing we won’t do in the pursuit of beauty.

But are we really willing to plunge thousands of tiny needles into our face repeatedly?

It seems the answer is “yes, absolutely!”. Dermarolling – it’s the skincare craze that’s sweeping the nation.

If the rise in clinics offering needle-based treatments, and the emergence of dermapen at-home devices is anything to go by, we’ve gotten over our squeamishness around these tiny aerators. We are only thinking about the result: glorious, glowing skin. However, all may not be what it seems.

Navigating the vast world of dermarolling treatment can be confusing. The device is used to prick the skin in multiple alternating passes, and a lot comes into play:

  • number of passes
  • area being treated
  • hygiene and sterilisation
  • depth of penetration
  • products used on the skin
  • type of derma needling being used
  • experience of the person performing the treatment.
  • the degree of overlap is highly dependent on the underlying condition
  • the length and frequency of the needle insertion, hygiene, sterilisation

Now, you can be forgiven for thinking that all you need is a derma roller and a tube of cream; however, you are in for a big surprise, as this treatment is far more complex, which you can see in the comments in the article, “Microneedling: Beware“. First, you need to establish the underlying cause of your skin condition and link the appropriate product ingredient if you are to succeed.

Since writing the article, many of my readers reached out to me, asking me to write an article on treatment protocol and what to expect, because, with so much involved, you must go fully prepared. So here is everything you need to know before you consider going under the needle:

Know before you go

  • please avoid the use of Accutane in the 6 months before beginning your treatment sessions, as it can thin your skin
  • the device should not be used inside of the orbital rim, such as eyelids, or inside the vermillion border of your lips
  • begin to use gentle hydrating and skin-strengthening formulas such as DNA Complex before your treatment, to help make your skin more resilient
  • introduce internal supplements such as Zinc, Magnesium, and Vitamin C into your daily regime, to strengthen your skin
  • stay out of the sun for at least 4 weeks before beginning your treatment sessions – avoid treatment if you have any sunburn
  • discontinue the use of Retin A, Retinols, Vitamin A creams, and other topical medications at least 4 weeks before embarking on your treatment
  • ensure you have not waxed, used any depilatory creams, or electrolysis on any area that you are having treated 2 weeks before treatment. Any dense hair present in the treatment area should also be removed before you have the treatment
  • avoid any invasive treatments such as IPL, laser, chemical peels, or microdermabrasion. They are intensive treatments and should be avoided at least 6 weeks before beginning your dermarolling sessions
  • avoid blood-thinning medications such as Advil or Ibuprofen during the week leading up to your procedure. They interfere with the natural inflammatory process that is critical for the rejuvenation of your skin and may increase the risk of bruising

We can’t stress enough, that what you use on your skin pre, during, and post-treatment will mean all the difference between a good outcome and a negative one. Your skincare needs to be kept to a minimum, a topic we discuss in great detail in the article, “Derma-needling Ingredients Into Your Skin”.

What you can expect on the day of the procedure

  • before the procedure, your skin will be numbed with a topical anaesthetic. This should be removed – usually, with an alcohol wipe and time allowed for the alcohol to evaporate.
    Your practitioner must undertake a thorough facial analysis. Inform your skincare specialist about any relevant changes in your medical history and any medications you are taking. If they don’t perform a thorough consultation on you such as this, it’s not a good sign, and you may want to look for a more experienced practitioner
  • good hygienic practices and equipment are paramount to reduce the risk of infection. Your practitioner will thoroughly clean your skin with sterile gauze and a saline solution before treatment. Only sterile saline, or Hyaluronic Acid

Anything applied to your skin after dermarolling is purely for “sealing” your skin to prevent TEWL (Transepidermal Water Loss), and to replenish moisture that was lost as a result of the treatment.  This is why we recommend pure high molecular weight hyaluronic acid, which serves this purpose well because it is film-forming and is extremely safe to apply immediately afterwards. Even then, we recommend waiting at least 30 minutes, as it is thought that the channels close within this time frame, so any dermal absorption of ingredients that may be responsible for triggering an immune response will be kept to a minimum.

In this article, we discuss the dangers of treating a wound in the skin, which can cause a range of skin conditions, including irreversible granulomatous scar tissue and possibly tumour formation.

This is why it is so important to do your research well and ensure you get an experienced practitioner, as much depends on the operator’s technique. A careful needling professional will be thorough and know how to hold, position, and stretch the skin on your face to vary the penetration depth.

The possibility of cross-contamination is genuine during this treatment, and if a derma roller is being used, there is a potential for backflow into the handpiece. Not only is it vital that the dermapen, dermaroller, or micro-needling device is changed for each patient, but the holes should also be thoroughly sprayed to minimise the risk of contamination.

Aftercare is paramount, ensuring the correct healing process

As with any cosmetic skin treatment, it’s important to look after your skin following a face needling procedure. For best results follow these aftercare instructions:

  • avoid any heat treatments, such as sauna or swimming, until the skin has fully settled down
  • avoid taking anti-inflammatory medications for several days, as they could interfere with your body’s healing process
  • let your skin breathe; do not put on makeup for the first 48 hours and then only use mineral makeup using clean makeup brushes
  • give your skin time to heal; dryness, scaling, redness, and swelling may last for several days, depending on the depth of penetration of the needles
  • your barrier function has been disrupted, so post-procedure, you may experience mild erythema, bruising, and some mild oedema; all of which should subside within 48 hours
  • do not wash or touch your face – leave it for 48 hours and do not use any harsh products, actives, and other such chemicals, as your skin will be susceptible following the procedure
  • because the outer layer of your skin has been disrupted, it will be sensitive to the sun. Avoid direct sun exposure for a month, as the stratum corneum (outer layer) takes 28 days to repair itself from dermarolling’s mechanical injury. If that is not feasible, try to avoid the sun for the first week of healing

The healing process

Day 1-2: After treatment, you may typically look like you have a severe sunburn and you may feel flushed and hot in the area treated. Your skin may feel dry or sensitive to touch; this is the visible inflammation phase which typically lasts around 48 hours. Applying cooling masks soaked in pure Hyaluronic Acid can be extremely helpful in reducing inflammation.

Day 3-5: There may be general slight swelling and bruising that fades within 2-5 days, and your skin may feel tight.

Day 6-14: You’ll notice skin dryness and flaking, which is due to an increased turnover of skin cells for about 7 days, this will, of course, depend on needle depth.  DO NOT pick, scratch, or scrub at your treated skin.

Be patient – skin rejuvenation may be seen as early as 2 weeks after, or as long as 6 to 8 weeks.

Temporary side effects of dermarolling

Micro-needling’s general side effects include pinpoint bleeding, slight bruising, redness and inflammation, scabbing, dryness, and skin flakiness. It is not uncommon to see some minimal marks on your skin after the procedure, but these micro-holes should close quickly, not always but sometimes. Additionally, your skin may look and feel rough, almost like sandpaper; these effects generally last 3-7 days as the treated skin flakes off and is replaced by new tissue.


More serious issues include tracts on the skin, a change in texture, raised milia-like bumps across your skin, changes in skin conditions, and extended pores.

For those of you who tan or who have darker skin tones, it can result in worsening the hyperpigmentation, darkening your skin tone. In some cases, it may cause hypopigmentation – a lightening of your skin. This does usually go within 6 months, but it can be permanent in rare cases.

If you experience post-operative wound infection, antibiotic creams are usually prescribed. If you begin to suffer from acute inflammation, we recommend avoiding the use of steroids, which can harm your skin; altering its regenerative repair mechanisms changing the texture, tone, and appearance.

If you experience these or any other problem, you should contact your specialist immediately and ask for a biopsy; chances are you may have an infection.

When you should avoid the treatment

Contraindications prevent the derma rolling treatment from going ahead, as this will affect the skin’s natural healing ability and could cause unseen problems:

    • eczema
    • psoriasis
    • sunburn
    • diabetes
    • dermatitis
    • pregnancy
    • melanoma
    • cold sores
    • skin cancer
    • open wounds
    • blood thinners
    • cigarette smoker
    • abnormal skin growth
    • signs of active infection
    • sensitive or impaired skin
    • if you are getting anti-coagulant therapy
    • on Roaccutane/Accutane within the last 6 months
    • blood clotting problems or poor wound healing
    • areas of the skin that are numb or lack sensation
    • autoimmune problems of the skin, such as Lupus
    • chemical peels, laser, or IPL within the last 6 weeks
    • if you have active bacterial, viral, or fungal infections
    • active inflammatory skin conditions like hives, rashes, infections
    • scleroderma, collagen or vascular diseases, and cardiac abnormalities
    • if you have had radiation treatment within the last year or chemotherapy
    • very dark or unstable skin types – being a 1, 2, or 3 on the Fitzpatrick scale
    • suspicious Lesions- A practitioner must diagnose these before beginning treatment.
    • history of keloid or hypertrophic scars, poor wound healing, or scars that are less than 6 months old
    • accutane or any related acne medication – they should be discontinued for a minimum of 6 months before undergoing the treatment

Conclusion- Keep it simple, keep it safe

As you can see, it’s not a simple procedure; in fact, it is very technical. Still, from our own experience working within the industry, many practitioners are not stringent enough around treatment protocol and the products used.

The bottom line. Forget about “absorption of product ingredients” being the key function of your treatment. Anything applied after is done purely for “sealing” your skin, thus preventing Transepidermal Water Loss, and replenishing moisture loss. Pure Hyaluronic Acid is a perfect option such as in H₂O Hydrating Complex. As mentioned above, it is safe to use, film-forming and contains no hidden trouble makers, which are often lurking in many hyaluronic formulas such as aloe vera or extracts.

Immediately after your skin needling treatment, your skin is porous and momentarily allows some percutaneous drug penetration. There is a tendency in the industry for practitioners to apply ascorbic acid/vitamin C immediately afterwards. However, studies show this can trigger an immune response which may cause granulomatous scar tissue.


1. Dunkin C.S., Pleat J.M., Gillespie P.H., Tyler M.P., Roberts A.H., McGrouther D.A. Scarring occurs at a critical depth of skin injury: precise measurement in a graduated dermal scratch in human volunteers. Plast Reconstr Surg. 2007;119(6):1722–1732.
2. Zhao M., Song B., Rajnicek A.M. Electrical signals control wound healing through phosphatidylinositol-3-OH kinase-g and PTEN. Nature. 2006;442:457–460. 
3. Kloth L.C. Electrical stimulation for wound healing: a review of evidence from in vitro studies, animal experiments, and clinical trials. Int J Low Extrem Wounds. 2005;4(1):23–44.


8 thoughts on “Dermarolling: Don’t Go Under the Needle Without Reading This

  1. Georgina Dickson says:

    Yes, medical needling compromised my skin barrier. I eliminated all actives for a month and focused only on barrier repair. Samantha has some good products which can help with this.

    Then I reintroduced actives.

    AnteAge is a kit which contains a 0.25mm roller and aftercare solution with stem cells. You follow the protocol included in the kit. Use light, even pressure. Only use the aftercare solution. Every 15 minutes until the capsule is used up. Do not apply any other product to the skin until the next day.
    Be careful with your skin the next day. Do not use hot or warm water on the face. Only tepid water. Use a lot of mineral, non irritating sunscreen and stay out of the sun. Remember to reapply sunscreen every couple of hours. The skin is vulnerable to hyperpigmentation during this time so try to avoid heating it up. This includes strenuous exercise, hot showers, saunas, ovens, fireplaces, sun exposure. I use ultrasun brand mineral sunscreen and top up with color science mineral SPF brush during the day. Don’t use active ingredients (vitamin C or E) the next day either. The skin should go back to normal in a couple of days. Don’t do it more often than once a week.

  2. Georgina Dickson says:

    Hi Samantha, thanks for continuing to write about microneedling. It’s important that people are educated so they can make informed choices about treatment options. I wanted to add a comment that I am hoping will help your readers.

    I had medical microneedling done last year on a weekly treatment regimen for 4 weeks. I went to a “reputable” skincare clinic which claimed to follow the Dr. Fernandes protocol (who invented microneedling). It was a huge mistake. It disrupted my skin barrier, caused chronic and persistent dryness, orange peel texture, created fine lines in my cheeks when smilling (which weren’t there before), made my cheeks appear to lose “volume”, made existing scars more noticeable and even caused scrape marks in places (which have turned into scars under the skin) where the device was dragged across the skin. 10 months later and my skin is still damaged although fortunately, it has substantially recovered. The depth of needles used was between 1mm and 1.5mm and I followed after-care instructions diligently. But still, my skin had a protracted inflammatory reaction, which resulted in the skin healing as fibrotic tissue, also known “microscarring” instead of normal nice basketweave collagen. The treatment, in other words, significantly worsened the skin instead of improving it.
    Some people get good results from microneedling. So what went wrong with my treatments?
    -I have sensitive type 2 skin.
    -I got the flu after I had the treatment done which lowered my immunity and made it more difficult for my skin to recover
    -I was needled at depths of 1-1.5mm when nowadays experts such as Dr. Lance Setterfield are suggesting that going any deeper than 0.5mm carries a greater risk of scarring and pigmentation
    -I was needled WEEKLY – the skin should have been left at least a month in between treatments to recover
    -In my final treatment, the device was dragged across the skin in straight lines. It should be done in very small, controlled circles with even pressure.

    It was recommended that I use anti-inflammatory skincare products to help the skin recover. Fortunately, I have been using anti-inflammatory skincare for the last few weeks. If I had not, then the skin may have been even more compromised and damaged than it was.

    Ironically, it was also recommended to me by Dr. Setterfield that I embark upon MORE microneedling to fix the damage. This to me seemed completely counterintuitive and downright scary. However, when my skin’s recovery seemed to plateau, I decided to give it a go. I did not trust clinics or providers with my skin so I bought a home microneedling skin kit. AnteAge brand which has a home roller of 0.25mm plus an anti-inflammatory aftercare serum containing growth factors and hyaluronic acid. I tested it on my body and then on a small part of my face. Then finally I tried it on my face. I did not notice any difference at all. Negative or positive.
    However, I have now been doing this twice weekly for two months. The difference between my chest (where I did not needle but was damaged from the treatment) and my face/neck was apparent. The skin is markedly more improved on my face and neck than on my chest. It is now almost (almost) back to where it was before the treatments. So I have started on my chest as well.

    With microneedling, the adage is: less is more. Except when it comes to hygiene then more is more (you must ALWAYS ALWAYS sanitise your skin and device, no exceptions) I notice that even at depths of only 0.25mm, my skin’s sensitivity is increased and I need to avoid using actives for a couple of days after doing it.

    I am not planning to use the kit long term as I believe that there are other ways of maintaining the skin. But for anyone who has been struggling with skin recovery from damage, it might be something considering.

    Other oral supplements that I have used (although I am not sure if they have helped or not): high-quality fish oil, blackcurrant and evening primrose oil, MSM supplement, bone broth with vitamin C and hyaluronic acid, hibiscus and white tea, matcha green tea, a multivitamin, probiotics, anti-inflammatory diet, lots of fresh water and try to get good amounts of sleep.

    After all of this, although I acknowledge that microneedling has helped some people’s skin (or at least, for now) I do believe that it is a seriously risky treatment protocol, and its not something that I would ever recommend to anyone. It has been so expensive and stressful trying to find ways to help the skin recover and all this could have been avoided by simply not having the treatment in the first place.

    Keep it simple, keep it natural, and avoid unnecessary inflammation in the skin!

    • Emma says:

      Hi Georgina — Unfortunately a similar thing happened to me. I too reached out to Dr. Setterfield, who suggested doing more microneedling as well. Out of curiosity, which AnteAge kit did you buy? And what anti-inflammatory products have you been using? How did you get over the fear of microneedling yourself? What protocol do you use? Was your barrier compromised (burning whenever you put anything on your skin)? Thanks for your help.

    • Stacy says:


      What anti inflammatory products have you been using. I had microneedling done 5.5 weeks ago just after I had had Covid and wasn’t giving any aftercare advice so put suncream on the Next day to take my son for a walk and also put face wash etc on the next night wasn’t even 24 hours afterwards. I have now got pitting in my lower cheeks where they used the needle deeper and it’s a bit sore on and off. I am glad your skin is getting back to normal. Has the scarring reduced as I am so upset about having more scaring this is why I got it I’m the 1st place to help some scaring I have from spots when you get. Thank you

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