demystifying skincare with science

Microneedling at home has been increasing in popularity and when done safely and correctly, I’m not necessarily against it. For me, it comes down to the person and how willing they are to do their research and invest in the right equipment and supplies. However, with the recent popularity of DIY treatments at home I’ve noticed a trend toward deeper microneedling and this does worry me. So today we will be looking at microneedling depth, the research, and if an argument can be made for the deeper microneedling we’re seeing.

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This is not an intro to microneedling or how to get started. For information on microneedling, see the Units in my Skincare and Beauty 101 Facebook group.

DIY skin treatments have been getting a lot of attention this last year or two, from microneedling and peels (which some dermatologists are even okay with) to the much more potentially risky DIY filler and threads. While I don’t lump the former in with more extreme procedures, I do think that the DIY approach has trickled over to microneedling and it’s what has spurred this post. More does not always equal better.

First, we should discuss the origin of microneedling. Dr Des Fernandes is widely considered the “godfather of microneedling” and really pioneered their treatment. He’s been tremendously influential and I highly respect his work and knowledge. Without him, we probably would not have the microneedling we do today.

However, Dr Fernandes is often used as an argument for deeper microneedling. His original methods do use longer needles and treatments were done more frequently but this was early on and a derma roller was also used, not a pen. With pens especially (particularly Dr Pen models), accuracy of depth decreases the farther we get past 1.5 mm and can lead to an even deeper treatment than intended.

The other even more important consideration is that the science has really come a long way since the start of microneedling. When you know better, you can do better. Essentially, we’ve learned more along the way and this should change our approach where applicable.

I’ve had concerns about deeper microneedling for home use from the start, beyond just my concerns for people microneedling at home in general. For collagen induction therapy, a 0.50mm depth is typically all you need with perhaps .75mm for areas with thicker skin. This will reach the dermis just fine and produce the intended result with less risk of complications and shorter healing time.

Deeper microneedling mainly has evidence for scar revision and this should really be done by a doctor who can correctly identify the type of scar and if it will be responsive to microneedling. I later found a research article as well that compared 1mm to 2mm and 3mm depths while microneedling and found no benefit to needling deeper. That settled the matter for me.

However, it was Dr Lance Setterfield that actually convinced me that microneedling at 0.50mm (aka the dermal-epidermal junction) may actually be the better way to go as far as the actual treatment outcomes too. Dr Setterfield is another well known figure in the field of microneedling and has made valuable contributions in addition to being known for his focus on safety. I can not recommend his book, The Concise Guide to Dermal Needling, enough.

Cosmetic vs Medical Microneedling

It’s important to understand the difference between cosmetic microneedling and medical microneedling to understand why deeper needling isn’t necessarily better.

If you’re familiar with the epidermal wound healing process, you’ll know it’s incredibly fast. There’s still an immune response but because there’s no blood supply to the epidermis, there’s no need for clotting or a vasoconstrictive response. Since there’s no deeper skin remodeling, you just have re-epithelialization mainly which is very fast and odds of scarring are low.

While very few studies have been done, cosmetic microneedling carries less risk and you still get the release of our skin’s growth factors at play with the added benefits of epidermal thickening and serum infusion. Interestingly, research indicates that epidermal skin cells may regulate dermal fibroblasts.

Medical microneedling is much more involved as you’ve got the full wound healing cascade occurring which is a very complex process involving regulated pathways, growth factories and cytokines, and inflammatory cells in each of its stages. Microneedling creates micro injuries that trigger this process, resulting in the release of growth factors as well as the skin remodeling that ultimately results in new collagen formation.

Cosmetic Microneedling Benefits per Dr Setterfield

• micro injuries result in release of growth factors which improves cell function and epidermal thickness
• better distribution of pigment thanks to needling encouraging cellular cross-talk between keratinocytes and melanocytes
• delivers skincare ingredients to the cells above for better results
• influence on keratinocytes which can regulate fibroblasts

Microneedling the Dermal-Epidermal Junction

So we can see above, the potential benefits of cosmetic microneedling are very promising even though more research is needed there. The benefits are a result of the wound healing response yes but are due to upregualtion, not inflammation. But how does this impact medical microneedling and what depth we should be needling at?

In addition to the study that found no benefits to needling deeper than 1mm, a study by Schwartz and Laaf found that new collagen only occurs in the first 0.6mm if the skin despite needling at a depth of 1.5mm interestingly enough. Dr Setterfield also performed case studies that found .30mm and .50mm to perform better than deeper microneedling treatments over the years. And there have been a handful of smaller tests with similar findings.

In addition to more superficial microneedling being just as effective, it may actually be more beneficial since you get both the benefits of cosmetic and medical microneedling without the added inflammation. It’s also safer with less side effects and less discomfort.

Benefits of Targeting the Dermal-Epidermal Junction while Medical Microneedling per Dr Setterfield:

• corrects loss of structural integrity, the main cause of wrinkles, without forming scar tissue
• increases formation of multiple collagen types by upregulation of relevant genes while not upregulating pro inflammatory ones
• helps restore the basement membrane (one of the regions making up the D/E Junction) of the epidermis which is often damaged by UV radiation
• prevents further aging by downregulating inflammatory growth factors and cytokines and increasing anti inflammatory ones
• less side effects, downtime, and discomfort

For more information, please consider purchasing Dr Setterfield’s incredible book. A must-have if you’re interested in microneedling and purchasing supports his wonderful contributions to this field.

Note: while specific needle depths like 0.50mm are mentioned, the goal is the D/E junction and you may have to adjust for skin thickness, device, or needle count.

What’s the takeaway here?

More aggressive does not equal better and faster results. When it comes to skin, results cannot be rushed and we really need to respect the process. Actual changes to the skin take time. Trying to rush the process can result in excess inflammation, scar formation, and just not allowing the skin remodeling process to properly take place.

Don’t be influenced by influencers who don’t support their content with evidence and safety measures. It’s unfortunate that we have videos put out to larger audiences with people microneedling at 2-3mm without a balanced discussion of the pros and cons. Not only could this be less beneficial and more harmful but they could be going deeper than they realize and more so with the Dr Pen models based on some reports. There’s no benefit to microneedling subcutaneous tissue.

As always, the final decision is yours. My goal is always just to put the most information I can into your hands so you can make an informed choice with your body. While we only allow microneedling and mesotherapy in our FB group as we feel they’re the riskiest treatment that the majority can do safely, we have lots of DIYers who do more outside the group and that’s okay too.