Microneedling: Effects, Methods and Costs of Treatment

Microneedling is a minimally invasive skin treatment in which fine needles create controlled micro-injuries in the skin, stimulating collagen synthesis and elastin production. It is one of the most effective minimally invasive procedures in modern aesthetic medicine. Using ultra-fine needles, the skin is precisely micro-perforated, triggering deep regenerative processes. The result: firmer, more even and youthful-looking skin — without surgery, without lengthy downtime.

What Is Microneedling?

Microneedling — also known as dermarolling or collagen induction therapy (CIT) — is a minimally invasive procedure in which numerous ultra-fine needles penetrate the skin barrier in a controlled manner. The microchannels created are so small they are barely visible to the naked eye, yet reach deep enough into the dermis to trigger biological healing responses.

The principle relies on a simple but highly effective biological mechanism: the body responds to every injury — including micro-injuries — with a cascade repair process. This includes the release of growth factors, activation of fibroblasts, and the formation of new collagen and elastin. The long-term result is younger-looking, firmer and more even skin.

The history of microneedling dates back to the 1990s. South African dermatologist Dr. Des Fernandes is considered the pioneer of the procedure, developing the first needle rollers to improve the penetration depth of topical active ingredients. Since then, technology has advanced considerably. Modern electric microneedling pens like the Dermapen and radiofrequency-based systems like RF microneedling enable more precise, effective and individualised treatments than ever before.

How Does the Mechanism of Action Work?

Understanding the biological mechanism is essential to grasping why microneedling delivers such diverse and lasting results. The process unfolds in several phases.

Phase 1: Inflammatory Response and Release of Growth Factors

Immediately after needle treatment, the body responds to the microtrauma with a controlled inflammatory reaction. Platelets aggregate at the injury sites and release a range of biologically active substances:

PDGF (Platelet-Derived Growth Factor): Stimulates fibroblast proliferation and promotes collagen synthesis.
TGF-β (Transforming Growth Factor-beta): Regulates extracellular matrix synthesis and promotes wound healing.
VEGF (Vascular Endothelial Growth Factor): Promotes the formation of new blood vessels and improves nutrient supply to the tissue.
EGF (Epidermal Growth Factor): Stimulates cell renewal in the epidermis.
FGF (Fibroblast Growth Factor): Activates fibroblasts and supports tissue repair.

Phase 2: Proliferation and New Collagen Formation

During the proliferation phase, which lasts days to weeks, fibroblasts become active. These specialised connective tissue cells are responsible for producing collagen and elastin — the structural proteins that give skin its firmness, elasticity and volume. From the age of 25, the skin loses approximately 1–1.5% of its collagen content annually. Microneedling actively counteracts this degradation by artificially stimulating fibroblast activity.

Phase 3: Remodelling and Long-Term Improvement

The remodelling phase can take weeks to months. Newly synthesised collagen is restructured, densified and integrated into the existing tissue. The skin gains density, texture improves, wrinkles become shallower and scar tissue softens. This process continues — depending on the indication and treatment intensity — for months after the last session.

Indications: When Is Microneedling Beneficial?

Wrinkles and Skin Ageing

By stimulating collagen and elastin production, fine lines and superficial wrinkles are significantly reduced. Deeper wrinkles such as nasolabial folds also respond to microneedling, though they typically require multiple sessions or combination treatments.

Acne Scars

Acne scars — particularly atrophic scars of the ice-pick, boxcar and rolling types — are among the most challenging indications in aesthetic dermatology. Microneedling is today considered one of the most effective therapies for these scar types. Typically 3–6 sessions at intervals of 4–6 weeks are required.

Enlarged Pores

Microneedling tightens the surrounding tissue and measurably reduces the visibility of enlarged pores. The improved collagen structure in the perifollicular zone causes pores to appear optically smaller.

Pigmentation Disorders and Melasma

Hyperpigmentations including melasma, age spots and post-inflammatory hyperpigmentation can be improved by microneedling through accelerated cell renewal and enhanced penetration of brightening active ingredients such as vitamin C or tranexamic acid.

Hair Loss (Alopecia)

Microneedling on the scalp has established itself as a promising adjunct therapy for androgenetic alopecia. Clinical studies show that microneedling combined with topical minoxidil or PRP significantly improves hair density and growth compared to minoxidil alone.

Stretch Marks (Striae)

Microneedling is one of the few procedures proven to achieve improvements in stretch marks. With deeper needling (1.5–2.5 mm), the atrophic collagen-poor scar tissue is stimulated to form new collagen fibres. Typically six or more treatments are necessary.

Methods and Devices Used in Microneedling

Dermaroller: The Classic Needle Wheel

The dermaroller was the first widely used microneedling instrument. While affordable, it has significant drawbacks: needles strike the skin at an angle rather than perpendicularly, leading to uneven micro-injuries. In professional practices the dermaroller is increasingly replaced by more precise systems.

Dermapen and Electric Microneedling Pens

Electric microneedling pens like the Dermapen represent the modern generation of microneedling technology. A needle head with multiple needles (typically 9–36) is motorically driven into the skin in a vertical motion at high frequency (up to 1,800 punctures per minute). Key advantages include perpendicular needle insertion, precisely adjustable needle depth (0.25–3.0 mm) and the ability to treat hard-to-reach areas uniformly.

RF Microneedling: Needles Combined with Radiofrequency

RF microneedling combines mechanical stimulation with radiofrequency energy delivery at the needle tips. This creates controlled heat zones in the dermis, producing additional, deeper and more effective collagen contraction and formation. Leading systems include Morpheus8, Sylfirm X, Potenza and Genius. This procedure is considered the most effective purely minimally invasive skin tightening method.

Needle Depths for Different Skin Problems

Depth	Application	Downtime
0.25–0.5 mm	Active ingredient penetration, home use	None
0.5–1.0 mm	Fine lines, mild pigmentation, texture improvement	1–2 days redness
1.0–1.5 mm	Wrinkle treatment, enlarged pores, photoageing	2–4 days redness
1.5–2.5 mm	Deep acne scars, stretch marks, severe laxity	3–7 days

How Many Sessions Are Necessary?

The number of sessions depends on the indication, skin condition and desired results. As a general guideline:

General skin rejuvenation: 3 sessions, 4–6 weeks apart
Acne scars: 3–6 sessions, 4–6 weeks apart
Stretch marks: 6+ sessions
Hair loss: 4–6 sessions, then maintenance as needed

Treatment Costs

Treatment	Cost per Session
Standard microneedling (face)	€150–€400
Microneedling with PRP	€300–€600
RF microneedling	€400–€900
Microneedling (body zone)	€200–€500

Costs vary depending on the region, practice type, device used and extent of the treatment area. Health insurance generally does not cover purely aesthetic microneedling treatments. Some insurers may cover treatment of post-surgical scars — this should be clarified in advance.

Combination Therapies

Microneedling is frequently combined with simultaneous application of active ingredients. During or immediately after needle treatment, substances such as hyaluronic acid, peptides, vitamin C serum, growth factors or PRP are applied. Through the open microchannels, these substances are absorbed significantly better and deeper than through passive topical application — studies report an increase in active ingredient penetration by a factor of up to 1,000.

Frequently Asked Questions

Is microneedling painful? With topical anaesthetic cream applied 30–60 minutes before treatment, the procedure is very well tolerated. Most patients describe a mild tingling or scratching sensation.

Who is not suitable for microneedling? Contraindications include active acne, open wounds, skin infections, known blood clotting disorders, pregnancy and certain medications such as isotretinoin.

How long do results last? Results are long-lasting, as newly formed collagen is stable. Regular maintenance sessions (1–2 per year) extend and reinforce the results.