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Dermarolling 101, here’s what to expect from your treatment

Dermarolling a ladies face

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 when it comes to this skincare craze that’s sweeping the nation.

If the rise in clinics offering needle-based treatments and at-home devices is anything to go by.

And you can be forgiven for thinking that all you need is a dermarolling device and a tube of cream, but this treatment is far more complex than you think.

If you are not convinced? Check out the comments in the article Microneedling beware.

We admit navigating the vast world of needling treatments can be confusing.

So we’ve put together this handy guide so you can know exactly what to expect from your treatment.

Book in With an Experienced Aesthetician

Your aesthetician must be experienced in administering a microneedling/dermarolling treatment and have in-depth knowledge of the skin.

A lot depends on their technique, as we have seen many clients with sustained iatrogenic injuries and scarring due to the device being dragged over their skin.

A careful needling professional will be thorough and know the number of passes they will use in the area they are treating and the length and frequency of the needle insertion.

Contraindications that Affect Your Skin’s Ability to Heal

  • diabetes
  • cold sores
  • skin cancer
  • open wounds
  • blood thinners
  • cigarette smokers
  • abnormal skin growths
  • dark or unstable skin types
  • autoimmune conditions such as lupus
  • active bacterial, viral, or fungal infections
  • a history of keloid or hypertrophic scars
  • scleroderma, collagen or vascular diseases
  • blood clotting problems and poor wound healing
  • radiation treatment or chemotherapy within the last year
  • inflammatory conditions like eczema, rosacea or sunburn
  • recent treatments like chemical peels, facial waxing or laser
  • if you have undertaken a course of Roaccutane within the last six months

If these are conditions you may be experiencing, it would be wise not to have a derma roller treatment.

Pre Consultation

You will be advised to come to the clinic four weeks before treatment.

The following should be discussed during the consultation; if not, it could be a potential red flag:

  • photos will be taken of your skin, and you will be given forms to sign around the treatment
  • you will be advised to stay out of the sun for at least four weeks before treatment; sunburn is contra-indicated
  • they will discuss your skin and ensure that you are not affected by any of the above contraindications, discuss the type of treatment
  • your skin type will be assessed, and see where on the Fitzgerald scale you fit (1). If you have a darker skin type, you could be contra-indicated
  • you will be asked to discontinue the use of any Vitamin A creams, acid-based formulas such as vitamin C or peels, and steroids four weeks before treatment as these can thin your skin
  • you will be recommended a straightforward skincare routine with a pure form of hyaluronic acid to prep your skin
  • you will be advised not to wax or use depilatory creams or electrolysis on your face for at least two weeks before your dermaroller treatment as these can thin your skin
  • you will be advised to avoid taking blood-thinning medications such as Advil or Ibuprofen before your procedure. As this could interfere with the natural inflammatory process and may increase the risk of bruising

On the Day of Your Treatment

Depending on your treatment, each procedure may be very different, but your aesthetician will take close-up photos of your skin, so you have before and after records; if you have a poor outcome and your aesthetician denies responsibility, this is your proof.

They will go over your consultation; this will allow you to inform them about any changes in your medical history and medications that you may be on.

First, your skin will be thoroughly cleansed with a sterile gauze and saline solution; good hygienic practices and equipment are paramount to reducing the risk of infection because these devices have the potential for backflow and cross-contamination.

It is important to note that during your treatment, the device should not be used inside the orbital rim, such as eyelids, or inside the vermillion border of your lips.

Post Treatment

Anything applied to your skin after your dermarolling treatment is purely for “sealing” your skin to replenish moisture loss.

This is why we only recommend a pure, high molecular weight hyaluronic acid, and even then, we suggest you wait at least an hour until the channels in your skin have had a chance to seal. This will slow down dermal absorption, which may be responsible for triggering an immune response.

Your aesthetician should recommend that your skincare routine be minimalistic, a topic we discuss in great detail in the article Derma-needling Ingredients Into your skin.

There is a tendency in the industry for some aestheticians to apply ascorbic acid vitamin C immediately after micro needling; however, studies show (2), that this can trigger an immune response which may cause granulomatous scar tissue.

Aftercare is Critical to Ensure Healing

For best results, follow these dermarolling aftercare instructions:

  • do not wash your face for 48 hours
  • avoid direct sun exposure for the first week of healing
  • avoid any heat treatments, such as sauna or swimming, until your skin has settled down
  • avoid taking anti-inflammatory medications for several days, as they may interfere with your body’s healing process
  • allow your skin to breathe; avoid makeup for the first 48 hours, and then only use mineral makeup and clean makeup brushes
  • don’t be tempted to pick your skin, even if you are experiencing mild flaking or dryness; this is a perfectly natural reaction as your barrier function is impaired. These conditions should subside within a week

Your Skin’s Healing Process

Day 1-2: After treatment, your skin may look like it has had a severe sunburn reaction and feel flushed and hot in areas; this is the visible inflammation phase that typically lasts around 48 hours. Applying a cooling mask soaked in pure hyaluronic acid will help reduce inflammation.

Day 3-5: There may be slight swelling and bruising that will reduce after the one-week mark.

Day 6-14: Depending on needle depth, you will notice dryness and flaking due to increased cellular turnover for the first week.

Be patient – skin rejuvenation may be seen as early as one week, or it can take as long as eight weeks to heal. If you are on a course and your skin is not settling down, we recommend not having any more treatments at this stage and contacting your aesthetician for advice.

Temporary Side Effects You May Experience

Micro-needling’s general side effects include pinpoint bleeding, bruising, inflammation, scabbing, dryness, flaking and track marks.

Additionally, your skin may look rough, almost like sandpaper, as your treated skin flakes off and is replaced by new tissue.

Complications

More severe issues include tracks on your skin, a change in texture, raised milia-like bump, changes in skin conditions, orange peel texture, extended pores and sagging.

You may notice dark patches on your skin and, in some cases, hypopigmentation – a lightening of your skin.

If you experience post-operative wound infections, you should contact your specialist immediately; they may need to take a biopsy as you may have an infection.

In the article, microneedling beware, it can damage your skin. We discuss potential side effects in more detail.

To conclude. The naked truth

As you can see, derma rolling your skin is not a simple procedure.

Unfortunately, many aestheticians lack training and are not stringent about treatment protocol, hygiene and the products used.

Because of the risks associated with this treatment, we recommend educating yourself before committing to treatment to guarantee a positive outcome.

After all, it’s your skin and the only one you have

9 thoughts on “Dermarolling 101, here’s what to expect from your treatment

  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.
      Emma

    • Stacy says:

      Hi

      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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