Microneedling Explained: How It Works, What to Expect and How I Use It in Clinic
Written by Dr. Maha Shariff · June 25, 2026 · Microneedling
How microneedling works, what to expect, and how it is used in clinic to treat acne scarring, uneven skin texture, post-inflammatory hyperpigmentation, and support overall skin quality.
Microneedling Explained: How It Works, What to Expect and How I Use It in Clinic
What Patients Usually Ask Me About Microneedling: One of the most common questions I am asked is: "Does microneedling actually work?"
The short answer is yes - for the right patient, for the right concern and when performed appropriately.
Microneedling has become increasingly popular in recent years, but there is still a lot of confusion about what it can realistically achieve. Many people think of it purely as a treatment for acne scars. Others see it as a way to achieve a temporary post-treatment glow. In reality, microneedling has a much broader role. When used appropriately, it can help improve skin texture, support collagen production and contribute to overall skin quality over time.
Precision microneedling with Dermapen 4
In clinic, I most commonly use microneedling to help improve:
- Overall skin quality and resilience
- Fine lines
- Uneven skin texture
- Acne scarring
- The appearance of enlarged pores
- Post-inflammatory hyperpigmentation (PIH)
Like most treatments that work by stimulating the skin's natural repair processes, the results are gradual rather than immediate. Understanding how microneedling works beneath the surface helps explain why.
What Is Microneedling and How Does It Work?
During treatment we create thousands of micro-channels within the skin using fine sterile needles. Although this may sound dramatic, these tiny micro-injuries are carefully controlled and designed to trigger the skin's natural repair response.
As the skin responds, a series of biological processes begin:
- Growth factors are released
- Repair cells become activated
- New collagen production is stimulated
- Elastin production increases
- The deeper layers of the skin begin to remodel
The treatment itself is simply the trigger. The visible changes occur afterwards as the skin repairs and rebuilds itself.
Why Results Take Time
The surface of the skin often heals relatively quickly. Many patients notice a brighter, fresher appearance within the first one to two weeks. Increased hydration, improved skin turnover and the initial stages of repair contribute to that early glow.
The structural changes take longer. Most patients notice:
- Early recovery within several days
- Improvements in radiance and texture within a few weeks
- More noticeable changes from around 6-12 weeks
- Continued improvement over the following months
This is why I encourage my patients to view microneedling as a process rather than a one-off treatment.
What Makes Someone a Good Candidate for Microneedling?
One of the reasons I use microneedling frequently in clinic is that it focuses on improving the health and function of the skin itself. Patients often attend because they are concerned about a specific issue, such as acne scarring or enlarged pores. However, these concerns rarely exist in isolation. When the overall quality of the skin improves, benefits become more noticeable across multiple areas.
Microneedling can also be used in areas where early changes in skin quality are commonly noticed, including around the eyes, around the mouth and on the neck. I treat the full face and neck as standard because skin does not age in isolated zones.
Microneedling for Acne Scars
Acne scarring is one of the most common reasons patients seek microneedling treatment. Unlike pigmentation or redness, true acne scars represent structural changes within the skin. This is why skincare products alone are often unable to produce significant improvement. Microneedling can help stimulate collagen remodelling within scarred skin, which may improve the appearance of certain acne scars over time.
The degree of improvement depends on several factors, including:
- The type of acne scar
- The depth of scarring
- The severity of scarring
- Individual healing responses
This is one reason why results can vary significantly between patients. Two people may both have acne scars, but the type, depth and severity of those scars can be very different. Some patients achieve good improvement with microneedling alone, while others benefit from combining treatments as part of a broader management plan.
Microneedling for Post-Inflammatory Hyperpigmentation (PIH)
Post-inflammatory hyperpigmentation refers to the dark marks that can remain after inflammation has settled. This is particularly common following acne. In selected patients, microneedling can form part of a treatment plan designed to improve overall skin quality and support the management of post-inflammatory pigmentation. However, not all pigmentation is the same. One of the most important parts of consultation is establishing exactly what type of pigmentation is present before deciding on a treatment plan.
What Microneedling Cannot Do
It is important to understand that whilst there is a lot that microneedling can do, there are certain things it cannot do. For example, it can improve the appearance of acne scars, but it cannot completely remove them. Similarly, it can improve skin quality and texture, but it will not create the same effects as treatments designed to restore lost volume or address significant skin laxity.
Why Depth and Technique Matter
A common misconception is that deeper treatment automatically means better results. Clinically, this is not true. Different concerns sit at different depths within the skin.
Depth usage examples:
- More superficial depths may be used for texture and skin quality
- Intermediate depths are often used for enlarged pores and some acne scars
- Deeper targeted treatment may be required for certain established scars
The aim is precision rather than intensity. The correct depth depends on the concern being treated, the area of skin and the individual patient.
Why Assessment Matters Before Treatment
Before recommending treatment, I assess factors such as:
- Skin barrier function
- Active acne
- Inflammation
- Skin sensitivity
- Previous treatment history
- Long-term goals
In some patients, preparing the skin first leads to better outcomes than proceeding directly to treatment. This may involve improving barrier function, reducing inflammation or gaining control of active acne before treatment begins. Healthy skin tends to heal more predictably and tolerate treatment better. Sometimes the most important decision is not whether to treat, but when to treat.
Recovery: What Should You Expect?
Expected recovery timeline:
- First 24 Hours: Skin is usually red and may feel warm or slightly sensitive. This is an expected part of the normal healing response.
- Days 1–3: Redness gradually settles. Some patients notice mild dryness or tightness.
- Days 3–5: Most patients feel comfortable and return to their usual routines.
- Days 5–7: For the majority, skin has largely returned to baseline and skincare can usually be gradually resumed according to individual advice.
Downtime is often shorter than patients expect.
Aftercare: What Actually Matters?
After treatment, the goal is simple: support the skin rather than challenge it.
This means:
- Gentle skincare
- Good hydration
- Temporary avoidance of potentially irritating active ingredients
- Daily SPF 50
Once the skin has fully settled, active ingredients can usually be reintroduced gradually. Good aftercare helps support recovery and allows the skin to heal as predictably as possible.
Why I Use Dermapen 4 & Support Recovery
I use the Dermapen 4 because it allows precise depth control and consistent treatment delivery. This is important because different concerns often require different treatment depths. As with any treatment, outcomes depend not only on the device being used but also on the assessment, treatment planning and technique behind it.
Microneedling is a medical procedure and safety should never be an afterthought. In clinic, I always use sterile single-use cartridges and authorised ingredients selected specifically for use alongside microneedling.
Recovery is an important part of treatment. For this reason, I incorporate LED light therapy following microneedling to help support recovery and improve patient comfort after treatment, unless it is not suitable for you. Supporting the skin afterwards is equally important in creating a positive treatment experience.
Frequently Asked Questions
FAQs:
- Is microneedling painful? Most patients find treatment manageable. Some areas of the face can feel more sensitive than others, particularly around the forehead and upper lip, but the treatment itself is relatively quick. The sensation varies depending on the treatment depth and the area being treated.
- Why don't you routinely use numbing cream? Most patients tolerate treatment well without it. Avoiding unnecessary topical products beforehand can also help keep the skin environment more predictable. Skin feedback during treatment is key when tailoring depth and intensity, helping me to adjust treatment appropriately for different areas of the face.
- When can I wear makeup again? I recommend avoiding makeup for the first 24 hours after treatment. After this, mineral-based makeup is often preferred until the skin has fully recovered. Daily SPF 50 is essential following treatment.
- Can microneedling cause breakouts? Occasionally, some patients experience temporary congestion or a small number of breakouts after treatment. This is usually short-lived and settles as the skin recovers.
- Can I have microneedling if I have active acne? This depends on the severity and type of acne present. In many cases, I prefer to gain better control of active inflammation before proceeding with microneedling. This often leads to safer treatment and more predictable outcomes.
- Can I have microneedling during pregnancy? Microneedling is not recommended during pregnancy.
- How many treatments will I need? This depends on your skin concerns and treatment goals. Most patients benefit from a course of three to six treatments, followed by maintenance treatments where appropriate.
- Is microneedling safe for darker skin tones? Microneedling is generally considered suitable for a wide range of skin tones when performed appropriately. However, treatment planning remains important, particularly in patients who are prone to post-inflammatory hyperpigmentation.
Considering Microneedling?
Microneedling can be a valuable treatment for concerns such as acne scarring, uneven texture, prominent pores and overall skin quality. However, the most important question is not whether microneedling works. It is whether microneedling is the right treatment for your skin.
During a Skin Confidence Consultation, I assess your skin in detail, discuss your concerns and explain the options that may be appropriate for you. In some cases, microneedling forms an important part of the plan. In others, a different approach may be more suitable.
Book a Consultation
If you would like to explore whether microneedling could be beneficial for your skin, you can book a Skin Confidence Consultation at Dr. Maha Aesthetics in London W3 9LN.
- Tailored treatment plans
- Expert medical supervision
- Supportive recovery packages
References
- Fernandes D. (2005). Minimally invasive percutaneous collagen induction. Aesthetic Surgery Journal, 25(5), 487–494.
- Aust MC, Reimers K, Repenning C, Stahl F, Jahn S, Guggenheim M, et al. (2008). Percutaneous collagen induction therapy: an alternative treatment for scars, wrinkles and skin laxity. Plastic and Reconstructive Surgery, 121(4), 1421–1429.
- El-Domyati M, Barakat M, Awad S, Medhat W, El-Fakahany H, Farag H. (2015). Multiple microneedling sessions for minimally invasive facial rejuvenation: an objective assessment. Journal of Clinical and Aesthetic Dermatology, 8(5), 36–42.
- Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D. (2014). Acne scarring treatment using skin needling. Clinical, Cosmetic and Investigational Dermatology, 7, 177–183.
- Iriarte C, Awosika O, Rengifo-Pardo M, Ehrlich A. (2017). Review of applications of microneedling in dermatology. Clinical, Cosmetic and Investigational Dermatology, 10, 289–298.