The adage "beauty is pain" may be commonplace for anyone testing out the latest industry innovations. But it's hard to ignore the extreme dangers that arise when unregulated beauty tools get into the wrong hands, including when it comes to microneedling.
Also known as dermarolling, the process involves moving a handheld tool packed with needles across the face. The goal is to stimulate the production of new collagen and hyaluronic acid by igniting our body's wound-healing response. "By creating new collagen to essentially seal the microscopic wound, we can remodel scar tissue and reduce fine lines and wrinkles, essentially rebuilding the collagen that is lost with the aging process or damaged during acne," says skin expert and facialist Andy Millward. The trend for microneedling shows no sign of slowing down, with Google searches for the treatment and its aliases up over 1500% in the last 12 months alone. With skin-care show-and-tell the new norm, social media has fueled the uptick in popularity, as celebrities and influencers advocate microneedling as the secret to their glowing complexions.
Using needles to regenerate the skin may sound scary (as the hundreds of gruesome yet intriguing images online will corroborate), but Millward explains that it is virtually pain-free and low-risk when performed by a professional using a topical anesthetic. Touted for reducing fine lines and scarring, smoothing the skin's surface, improving skin elasticity, and evening out skin tone, it’s no surprise that the growing popularity of the treatment has caused an exponential rise in DIY devices. However, unlike putting lemon juice in your hair or giving yourself an at-home manicure, perforating the skin with hundreds of tiny needles could leave you with permanent damage if done incorrectly.
Part of the reason at-home microneedling is so risky, Millward explains, is that cosmetic (epidermal-needling) and clinical (dermal-needling) are two very different treatments. "Typically, an at-home device would vary between 0.1mm-0.3mm in terms of needle depth and is primarily designed to enhance skin-care ingredient absorption," he says. With a professional treatment, the depth increases to 0.5mm-1.5mm in an aesthetician's clinic, or even deeper — up to 3mm — in a dermatologist's clinic, as the aim is to create a wound to trigger regeneration.
Frighteningly, these professional-depth rollers are now readily available online for anyone to buy and use at home. "Originally, you had to have either a medical background or be an aesthetician trained in microneedling to be able to access them and perform the treatment," says Lisa Montlake, advanced aesthetician and cofounder of Fern Skin Clinic. "It has only been in more recent years that professional rollers could alarmingly be purchased online by the general public."
The wrong technique can easily cause micro-tears in the skin, leading to scarring and hyperpigmentation.
Prices for professional microneedling treatments start at £200 (about $245) a session, but an online search brings up thousands of professional-depth rollers at a fraction of the cost, some as cheap as $9. Online marketplaces are flooded with these unregulated tools, which are often poor-quality imports with minimal information about the manufacturer or correct usage. The individual needles can prove hazardous, too, if not made from reputable materials such as titanium or surgical steel. This increases the risk of bent needles which, although imperceptible to the naked eye, can cause severe damage to your skin.
After buying a 1mm device online, Lydia* fell victim to an adverse reaction. "I’d wanted to try dermarolling after seeing so many people talk about it. I found a tool that had loads of positive reviews and before and after pictures," she says. "It was so painful because I didn’t use a numbing cream and obviously I was bleeding, but I kept going because I assumed it was meant to feel like that. I used an aloe vera gel to cool my face down but it was on fire for days. I don’t know if it ever fully healed because even now I’ve got scratch marks on my forehead, as well as a sandpapery texture everywhere else."
Millward explains that initial risks arise when people use at-home skin care that isn’t formulated to be used on wounded — and therefore compromised — skin. "Topical skin care is designed to be used on the skin's surface and may contain ingredients such as silicones, essential oils, fragrance, and preservatives that ordinarily wouldn’t be a problem because our skin would filter them out," he says. "But when applied post-needling, they are traveling inside the skin. This potentially triggers an immune reaction which can lead to skin sensitivity, allergic reactions, and rashes."
Granuloma is one such condition whereby white blood cells of the immune system engulf a foreign object but are unable to eliminate it, leading to granulated lumps under the skin. Writer and editor Julia Sullivan experienced granuloma firsthand after using a reputable brand's device with a supposedly "safe" 0.25mm depth. "The first time I used it, it just felt like using a face scrub. The whole process felt noninvasive despite a slight sting and redness the next morning," she says. "Three days later, I used it again and felt a painful stinging sensation. I noticed a white, raised bump on my cheek which was clearly a result of inflammation. I had either punctured too far, or some bacteria managed to get into my skin. I stopped immediately."
There are times when the treatment simply isn’t recommended, which is why clinical needling should only be performed by a qualified practitioner.
Risk of infection is very high when using unregulated devices in an environment that is not clinical or sanitary; it is also very easy to unknowingly roller a part of the face that is already infected. In a clinic, each treatment uses a new, single-use sterile roller per client which is subsequently disposed of, whereas those microneedling at home often reuse rollers multiple times. Using alcohol does disinfect the tool, but it is difficult to sterilize it completely, so not all harmful microorganisms are killed. The needles also become blunt when reused, which severely compromises technique. "Not only can you create bruising and track-mark lines from using too much pressure, but the wrong technique can easily cause micro-tears in the skin, leading to scarring and hyperpigmentation," Montlake says.
Despite the trend, not everyone is a suitable candidate for microneedling. "There are times when the treatment simply isn’t recommended, which is why clinical needling should only be performed by a qualified practitioner following an in-depth consultation and skin assessment," Millward says. He adds that while skeptics may think this is to protect profits due to the financial cost, client safety is key. Montlake agrees, advising that attempting at-home microneedling with anything higher than 0.5mm will inevitably do more harm than good. "A consultation allows the professional to be able to assess the appropriate needle size for each individual client's needs, resulting in a highly effective treatment with minimal downtime," she says.
We may have been forced into more DIY beauty practices as a result of quarantining and social distancing during the pandemic, but there are severe risks associated with at-home microneedling. For those on the hunt for a glowing complexion, the reality is that making microscopic wounds in your skin should undoubtedly be left to the professionals.