So you’ve heard about microneedling: maybe from your friends as they rave about their new favourite treatment, maybe as a cautionary tale, maybe just in passing. What is microneedling? What’s all the fuss about? What’s the most important things to know? And what makes the difference between the top-line treatments worth every penny, and the salon-chair horror story? We’re here to walk you through the basics and the need-to-know so you can feel confident in your treatment!

The Basics

What is Micro-needling

Microneedling is a cosmetic procedure whereby needles are used to cause controlled inflammation and damage to the skin. It is a minimally invasive procedure and can help with both medical and cosmetic concerns. It is effective for treating an impressive range of concerns and can be performed almost anywhere on the body. Its ability to stimulate skin rejuvenation without compromising healthy tissue has made it “a well-established and widely used treatment in aesthetic medicine, supported by a growing body of scientific research that validates its safety and effectiveness” (Cureus, 2024).

how does it work?

When the needles pierce the skin, blood-flow is increased and the immune response is triggered. As the controlled damage triggers the skin’s natural healing response the acceleration of the skin’s own regeneration systems. This accelerated regeneration ultimately results in a more youthful, healthier, and resilient skin.

Micro-needling ABC’s

So here’s our list of Microneedling ABCs! Non-exhaustive (because you really don’t want to sit through the whole alphabet) – but let’s get through the important things!

A

is for Acne and Vitamin A

Acne

Is microneedling an effective treatment for acne scars? Yes!

In our opinion, microneedling is the best treatment option for acne scars – both pigmentation and textural irregularities. This application of microneedling is broadly accepted and has been widely shown to have amazing results.

Does microneedling benefit active acne? This is more controversial…

Many providers avoid microneedling over active acne lesions, treating only the scars after the active acne has been cleared by other means, while others profess its potent acne-clearing powers. The rationale behind microneedling over active acne is that the bacteria responsible for those raised, pus-filled lesions are deathly intolerant to oxygen. By microneedling active lesions, oxygen is introduced and the environment becomes inhabitable to the P. acnes bacteria, effectively eliminating active breakouts while kickstarting the healing response, reducing healing time for PIE (the red afterimage that remains months after the acne itself has cleared).

If you’re uncertain whether microneedling is the right treatment for addressing your acne concerns, ARTEBELLA offers personalised advice and comprehensive acne support plans. Contact us to learn more!

Vitamin A

Friend or foe of microneedling? Vitamin A, commonly known as retinol, and its derivatives known as retinoids (retinal, retinyl esters, retin-A, etc.) is a top skincare ingredient loved for its efficacy and range of benefits. Retinoids come in many different forms and each formulation has its own unique properties. For this reason, it’s important to know the differences, and know the details of whichever one you are using. Did you know? Retinoids were originally introduced in skincare as acne treatments (you may know it as retin-A or tretinoin), only later recognised to have anti-aging and pigmentation benefits, ultimately leading to its widespread popularity in cosmetics today.

So what does vitamin A have to do with microneedling? Firstly, it can be a great ingredient to support your skin’s ongoing rejuvenation or treatment: it accelerates cellular turnover, supporting and amplifying the effects of microneedling. On the other hand, retinol and its derivatives can potentially increase sensitivity, and may negatively interfere with microneedling treatments. For this reason, it is important to pause the use of any retinoids 3-5 days ahead of and after the treatment, or as directed by your aesthetician.

B

is for Blood and Benefits

Blood

Do you always bleed with microneedling? Nope! Some pinpoint bleeding is typical for most microneedling treatments and is nothing to be concerned about. When microneedling at lower depths, such as to treat epidermal pigmentation for example, you might even have little to no bleeding at all.

Blood disorders and use of anticoagulants (medications that prevent blood clotting) may contraindicate microneedling. Ask your provider if you have any concerns!

benefits

Microneedling is one of the most versatile treatments in terms of what it can effectively address. The secret is in how it works: by triggering the skin’s healing response, it is simply telling the skin to actively repair itself, boosting its healthy functioning in a natural way. Microneedling is thus a great treatment to address…

• Acne (including post-inflammatory erythema/pigmentation and atrophic acne scars)
• Enlarged pores
• Scars
• Hyperpigmentation, age spots, sun spots, and sun-damaged skin
• Stretch marks
• Cellulitis
• Hair loss and alopecia
• Sagging, loose, and “crepe-y” skin
• Dehydrated, dull, and devitalized skin
• Fine lines, wrinkles, and crow’s feet

Bonus – Vitamin B!

Niacinamide, also known as vitamin B, is a great multitasking skincare ingredient. Its benefits include stimulating ceramide production to prevent transepidermal water loss (better hydrated skin), increases skin barrier function, reduces inflammation, aids in collagen production, regulates sebaceous activity (reducing severity of acne), and addresses pigmentation by inhibiting melanin distribution. Phew! As with other actives, consult your aesthetician when microneedling whether it is appropriate to pause use during a series of microneedling.

C

is for Collagen and Vitamin C!

Collagen

If there’s one letter to remember, C is definitely the star of the show! Collagen, the major driver behind the host of microneedling benefits, is the main reason people keep coming back for more and deserves an entire journal entry of its own. Microneedling’s alias, Collagen Induction Therapy, highlights the importance of this key molecule.

Collagen is the most abundant protein in the body, accounting for roughly 30% of your body’s total protein. There are, however, several different types of collagen, found in different places and performing different functions. The collagen types found in the dermis are types I (1) and III (3). As we age or engage in certain behaviours (smoking, UV exposure, etc.), these fibers begin to break down, resulting in wrinkling, sagging skin, hollowing around the eyes, and other signs. So how do we reverse this process?

The immune and healing response triggered by microneedling stimulates the production of collagen and elastin (more on that in a moment), resulting in restored elasticity and firmness. It’s teaching your skin to set back its own clock!

Vitamin C

Did you know that your skin needs vitamin C to make collagen? It is a critical cofactor for the enzymes responsible for synthesizing collagen. In other words – no vitamin C, no collagen! While your body delivers orally-derived vitamin C to your skin, topical vitamin C is available more directly to the skin, enhancing efficacy. That said, don’t skip your nutritional dose of antioxidants either!

Like vitamin A, topical vitamin C comes in may forms – you may see it listed on your ingredient lists as “L-ascorbic acid”, “ascorbyl glucoside”, “ascorbyl palmitate”, “tetrahexyldecyl ascorbate”, “magnesium ascorbyl phosphate”, and more. Each has its own properties, benefits, and limitations. Be cautious when choosing your vitamin C as certain forms at certain concentrations can cause sensitivity and/or irritation.

Our personal favourites, ascorbyl glucoside and tetrahexyldecyl ascorbate are popular choices for stable, non-irritating, sensitive skin-friendly yet potent formulations. Don’t miss out on this key ingredient for your microneedling companion routine, but always consult your aesthetician on best practices.

D

is for

Downtime

Does microneedling have downtime? Minimally!

For the first 24 to 48 hours following treatment, you may experience some mild discomfort, burning, or irritation as well as redness, and swelling on treated areas. These side effects can be minimised by applying specialised products and masks at the end of the session, and/or taking certain OTC pain relievers at home – (see entry N for more details). Some people may experience some dryness and flaking during the healing process as well.

ARTEBELLA microneedling sessions offer booster and recovery options to minimise discomfort and downtime, as well as mineral SPF foundations specially formulated for post-procedure skin, helping accelerate the healing process.

Most people can resume their normal activities within 24 hours, but other precautions are advised (flip to G for more). Aftercare instructions will be provided at the time of your treatment.

E – F

is for Exosomes, Elastin and Fibroblasts

Exosomes

Have you heard of Korean skincare’s newest darling? Exosomes are the up-and-coming rage in global skincare. This is one of the good ones.

So what are exosomes and why are they so popular?

Exosomes, to put it simply, are skin-cell-friendly messenger molecules. They carry cellular information. Vital for RNA exchange, protein delivery among immune cells, fibroblasts, and keratinocytes, and cellular communication, exosomes promote tissue repair and regeneration.

Okay, sounds great. But what does that have to do with microneedling?

So glad you asked! These nano-sized vesicles, filled with cytokines, growth factors, and genetic materials can be employed in a mesotherapy context (see entry M). They have been shown to trigger the same response as microneedling: stimulating fibroblasts and other cells for collagen, elastin and other ECM protein synthesis. The result? Improved texture and reduced lines and wrinkles, reduced long-term inflammation, and promotion of new blood vessel growth. Excited? So are we!

Look out! Exosomes can be plant-derived, but are often human-derived. It’s good to do your research ahead of time to make informed decisions about what is right for you.

Elastin & Fibroblasts

You’ve heard of that trio before: Collagen, Elastin, and Fibroblasts. But what are they exactly and how do they relate to each other?

If collagen is the protein responsible for supple, firm, skin, elastin is responsible for elasticity. Try it: pinch a bit of the skin on the back of your hand and observe how quickly it snaps back. Younger skin, richer in elastin, will “bounce back” more quickly than aged skin which will remain in its warped state.

Both collagen and elastin are formed by fibroblasts: connective tissue cells responsible for producing and maintaining the ECM: the extracellular matrix. The core mechanism of collagen induction therapy is the healing response: microneedling triggers the release of growth factors, including the fibroblast growth factor, activating the fibroblast and setting it in motion to produce collagen, elastin, and other proteins.

G

is for

Good practices

Looking to optimise your microneedling sessions? Keep these in mind and you’ll be off to a great start!

History and compliance: truthful, full, and accurate disclosure of your medical history is essential for your provider to be able to give proper recommendations. Once your provider has established recommendations and guidelines, adhering to these is crucial in order to achieve optimal results, and avoid complications.
Avoiding:
– the sun: during a series of microneedling, try to avoid sun exposure as much as possible
– heat: saunas, hitting the gym (sweating, cardio), and other heat exposure
– alcohol: avoid alcohol consumption and products that contain alcohol for a week
– picking / scratching: some people may experience dryness and flaking/peeling following treatment. Never pick or scratch off peeling skin as this can have undesired effects and may induce scarring
– futher treatments: peels, hair removal, laser, and other treatments for at least a few weeks
– tanning (including spray tans!) 2-3 weeks following treatment(s)

H

is for skipping half the alphabet… I know your time is precious, let’s get to the good stuff.

L

is for

Lifting

Microneedling has become famous for its impressive rejuvenating effects. If you’re on the fence about more invasive or surgical treatments, consider microneedling instead! Even if you ultimately decide to go through with the other treatments, your skin will be more healthy and resilient than before and will more than likely improve the outcome as well.

M

is for

Mesotherapy

Is microneedling the same as mesotherapy? Not quite!

Mesotherapy is a form of microneedling that is meant to achieve specific results through the use of specialised “mesotherapy” serums. These are sterile serums formulated for the express purpose of being needled to a specific depth of the skin. Microneedling, or “collagen induction therapy”, can be done “dry” (with a glide) and is premised purely upon the skin’s natural response to the controlled wound induction.

Mesotherapy serums can target any number of concerns and will often include beneficial ingredients such as (dual weight) hyaluronic acid, peptides, and more depending on the indication. A common challenge in skincare is delivery systems: many ingredients applied topically never reach the depth of skin where they will be most effective. By delivering these ingredients directly into the deeper layers of the skin, they are immediately and fully available, resulting in specific and enhanced treatment results!

N

is for

Numbing

Is microneedling painful? It depends…

Pain tolerance varies per person, and different areas on the face and body will be more or less sensitive than others. In our experience, the forehead, nose, upper lip, and jawline are the most painful – similarly to tattooing: the closer to the bone, the more painful it would be. Thick, cushioned areas like the cheeks and areas on the body are typically less sensitive.

Ouch! Do you use numbing? Personally, no – let me tell you why.

Some people feel no need for numbing at all, while others may feel more strongly about it. In our practice, we have avoided the use of topical numbing for two reasons. Firstly, topical numbing agents can cause tissue swelling, resulting in unpredictable depth variations in the skin. A key benefit of professional microneedling is precise control over the depth of treatment: swelling = less precise outcomes. Secondly, topical local anaesthetics (TLA) are metabolized as toxins in the liver – excess use can have hazardous side effects and even cause systemic toxicity. While TLAs may have their place in certain health care settings, ARTEBELLA Skin Health strongly values avoiding unnecessary toxicity. Finally, TLAs may hinder the proliferation and synthesis of collagen, diminishing the ultimate desired outcome of the treatment.

Oral pain medications may help under certain circumstances, depending on the type of medication. Anti-inflammatories (such as NSAIDs) may interfere with the skin’s initial inflammatory response, delaying or even reducing the treatment’s effect – avoid taking any NSAIDs or blood thinners at least a week ahead of treatment. Acetaminophen, as it is not anti-inflammatory, would be more appropriate and may provide some relief taken ahead of a microneedling session.

O

is for

Oxygen

Oxygen isn’t just great for breathing, and isn’t just an acne-killer, it’s also a main factor in that “healthy glow” everyone’s after!

Without enough oxygen, skin is devitalized, leading to telltale signs of fine lines, wrinkles, and a dull, tired appearance. Well-oxygenated skin is recognisably brighter, smoother, and firmer. Thankfully, there are many ways to increase skin oxygenation including facial massage, exercise, oxygenating skincare products and treatments, and more. One such treatment is – you guessed it – microneedling! The microchannels created by the treatment instantly deliver atmospheric oxygen directly to the deeper layers of the skin. Three cheers for the immediate post-microneedling oxygenated glow!

P

is for

Prevention

Can young adults get microneedling? Yes!

Safe for all skin types, colours, and during all seasons, this treatment can benefit virtually any adult skin. For those as early as in their 20s, microneedling preventatively can help slow the aging process, slowing the process of collagen and elastin loss, keeping the skin healthy and vital.

R

is for Run! Run if you see…

Rollers

At-home microneedling rollers are another prime example of the dangers of skincare trends. They became popularised as an accessible, low-cost alternative to high-ticket skincare therapies. All the benefits for a fraction of the price – too good to be true?

While not everyone may experience complications, it’s better not to risk it. If you’re seeing blood – there’s risk for infection! Improper storage or sterilisation practices can do more harm than good. According to the Mayo Clinic, online or drugstore rollers “won’t deliver the same effects as a professional. Devices from these sources can have contact with the skin at several different angles, causing more damage to the skin.”

Indeed, rollers can cause excessive damage to the skin, particularly the epidermis. The benefits of microneedling are premised upon controlled, small injuries to the skin. For collagen induction, reaching the papillary dermis is ideal. With a pen, the microchannel created by the needle is minimal: multiple, smaller entry wounds are created meaning benefit to the deeper layers is maximised while damage to the top layers is minimised. On the other hand, with a roller, the rotational mechanism inherently means excessive damage to the top layers with reduced access to the deeper layers. Furthermore, while a pen controls the speed and precise depth of needles, a roller has no such control, operating at a single, fixed depth.

Rollers vs Pen – Diagram

Understanding the differences between professional and at-home devices is critical to making informed decisions about your skin health. When opting for a professional treatment, advanced features, higher precision, and professional, trained expertise can make all the difference when it comes to obtaining desired outcomes.

And if you see a roller at a skin clinic…

Re-using needles

Due to the nature of microneedling treatments, risk of contamination or infection if proper sanitation protocols are not followed is high! With either at-home devices or in-clinic treatments, re-use of any kind of needles is highly risky and therefore unadvised.

At ARTEBELLA, we are always happy to show you as we open your sterile needle cartridge, and its disposal at the end of your treatment!

S

is for

Safety

In many countries, aestheticians are a licensed and regulated profession (such as in the USA, South Korea, and the UK, for example). Canada, however, is one of the countries that does not have a centralised regulatory body for aesthetics and regulations vary by province. While certain procedures are still protected, most procedures which work on the epidermis alone (between 0.05 and 1.5 mm thick depending on the part of the body) are not.

Regulatory bodies exist to help consumers make informed decisions. Bodies such as the FDA and Health Canada have certification and regulation processes to improve and enforce manufacturing and sales practices. Other certifications such as CE (European health and safety certification) can help consumers make informed and confident choices.

How can you then navigate the market to find trustworthy providers? Firstly, doing your research is #1! Don’t be afraid to ask questions and wait to start treatments until you are fully confident in your provider.

…
for SPF and staying out of the sun – see entry U-V.

T

is for

Treatment plans

While some may notice significant changes after their first treatment, optimal long-term results for skin rejuvenation and remodelling are found after 4 or more treatments. Due to the nature of the skin renewal, regeneration, and remodelling process, ongoing improvement related to collagen and elastin synthesis and maturation will continue for 3-6 months after the last treatment. Consistent maintenance treatments can also help sustain benefits in the long term, and subsequent treatment series may be implemented for further benefits.

Depending on your specific condition, we may also recommend customized protocols incorporating a specific combination of modalities with microneedling.

In any case, what happens in the treatment room isn’t the only factor determining your outcomes – what happens at home before and after treatments can make a big difference! Adopting a recommended homecare routine leading up to, during, and after a series of microneedling can set the stage for even more dramatic results.

U-V

is for

Ultra-Violet

The sun emits a wide spectrum of electromagnetic energy, most of which we perceive as light, others which are invisible to the naked eye – such as ultra-violet (UV) rays. There are two types of UV to remember: UVA and UVB.

UV-A vs UV-B – did we just restart the alphabet?
Remember the handy mnemonic: UVA Ages, UVB Burns.
While windows typically block UVB rays, preventing immediately noticeable burns, they most often do not block UVA. UVA rays have a longer wavelength than UVB, meaning they penetrate deeper in the skin into the dermis, damaging collagen and elastin fibers.

Damage from UVA radiation may account for up to 80% to 90% of the visible signs of aging, meaning that most of the signs we associate with “aging skin” are in fact signs of sun damage rather than the natural, inherent aging of our cells – and is thus preventable! UVA damage includes wrinkles, “sun spots” or “age spots”, and some forms of skin cancer.

Microneedling can help reverse these signs by regenerating collagen and elastin, breaking up pigmentation, and revitalising the skin. Supplemented with regular antioxidant use to reverse and prevent free-radical damage, and regular use of sun protection, it can be an effective treatment. Remember to always be diligent applying a mineral SPF 30 or higher when exposed to the sun (even inside) and cover up when possible.

For more information on recognising and treating skin cancers, consult your dermatologist.

W

is for When can I book in?

At your convenience, of course.

X

is for extraordinary results! (please grant me this one)

Y

is for the answer to the question – are you ready to start microneedling?

Z

is for the beauty sleep you’ll get knowing your Microneedling ABCs!

Did you enjoy this article? Let us know your thoughts or post your questions below!