Roll your own. Face. |

Roll your own. Face.

Does this man look 70 years old to you? He is.

He published an article in 2006 about a procedure he has used fifty times.

Dr. Desmond Fernandes is a celebrity in skin rejuvenation, ever since he published “Minimally invasive percutaneous collagen induction” in the 2006 edition of Oral and Maxillofacial  Surgical Clinics of  North America. In that article, Dr. Fernandez described the benefits of a minimally invasive skin treatment that is now recognized effective in the management of many skin conditions including scars (particularly acne scars), stretch marks, and wrinkles. The “father” of dermarolling demonstrated that the minor trauma created by using small diameter needles to create hundreds of perforations per square centimenter in the skin resulted in a robust healing response that produced fibroblast proliferation with coincidental secretion of collagen and elastin. Dermarolling can be used to treat practically any skin surface and is most commonly used on the face.

Most dermatologists now offer collagen induction therapy (CIT) in the medical office setting. Because of its demonstrated safety and efficacy, manufacturers of needling devices now offer models that enable do it yourself treatments at home. While there are certain differences in the indications and types of equipment used for home treatment, the mechanism of action is the same: induce a physiologic healing response through deliberate controlled trauma including creation of thousands of microscopic channels through which topically applied actives can gain ready access to deeper dermal layers, something impossible to achieve with an intact stratum corneum. The major difference between home devices and those used by the professionals is the length of the needles and consequently the depth of penetration into the skin.

People with active infections or those prone to keloid or other abnormal scar formation should not undergo micro-needling procedures.


Subcision, a type of needling used to treat acne vulgaris scars was first described by Orentreich and Orentreich in 1995. An article two years later by Camirand and Doucet described needle dermabrasion using a “tattoo pistol”. When Fernandes described his cylindrical device for use in  percutaneous collagen induction therapy, the dermaroller was born. The standard dermaroller used for acne scars is a drum-shaped roller studded with 192 fine microneedles in eight rows, 0.5-1.5 mm in length and 0.1 mm in diameter. The instrument is sold pre-sterilized by gamma irradiation and medical dermarollers are for single use only. Home devices are often used repeatedly by consumers although care to maintain cleanliness and to preserve needle sharpness are of paramount importance. Of course, the safest course of action is for single use of all dermarollers.

The Principle of Collagen Induction Therapy

In dermarolling, the stratum corneum is pierced to create microconduits (holes) without damaging the epidermis. Rolling over an area fifteen times with a dermaroller with 8 rows of 24 needles (192 needles) creates approximately 250 holes per square centimeter. Microneedling into deeper layers leads to the release of growth factors which stimulate the formation of new collagen (natural collagen) and elastin in the papillary dermis, as well as new capillaries. While of proved benefit in scar reduction, percutaneous collagen induction therapy is of clear benefit in the treatment of photoageing.

In office-based microneedling, the area to be treated is first anesthetized with topical anesthesia for 45 minutes to one hour after which a topical antiseptic is applied. Rolling is then performed 15-20 times in horizontal, vertical, and oblique directions. Pin-point bleeding is to be expected and easily controlled. Once completed, the area is wetted with saline pads. Depending on size of area treated, the procedure lasts for 15 to 20 minutes, A minimum of six weeks is recommended between two treatments as it takes that long for new natural collagen to form. For moderate acne scars, three to four treatments may be needed.

Post Procedure Care

Microneedling is well tolerated. Erythema typically lasts 2-3 days and photoprotection is advised for at least a week. Antibiotic creams can be used although infections are extremely uncommon. Microneedling is cost effective, well tolerated and can be done on all skin types and on areas not suitable for peeling or laser resurfacing, such as near eyes. It can be combined with other acne scar treatments like subcision, chemical peels, microdermabrasion, and fractional resurfacing, to achieve maximal benefits.

Where the Action Is

Micro-needling involves both major layers of the skin. Even the shortest needles are designed to pierce the stratum corneum of the epidermis to allow penetration of medications and active ingredients to reach the dermis. Longer needles pierce the dermis to varying degrees to induce minor trauma and initiate a physiologic healing response that results in fibroblast proliferation and increased collagen and elastin deposition. Because the skin varies in thickness on different parts of the body, different needle lengths are appropriate for different areas. See the chart below.

It is important to stress that in micro-needling, the longer the needle used mandates that the interval between treatments should also be longer. As noted above, needling into the deeper dermal layers requires time for desired changes to occur. More frequent use can produce a state of chronic inflammation that is in fact counterproductive. Use of very short  needles intended only to allow improved active penetration through the epidermis can be more frequent, up to two or three times a week. Perforations in the stratum corneum are short lived and seal within an hour of their creation.

Appropriate Needle Length

Proper needle length is determined by the objective being sought. Needles longer than 1.5 mm should not be used on the face.

Shorter needle lengths (0.25mm) are used to increase penetration of actives into the skin and to achieve overall improvement in skin color and texture

Longer needle lengths (2.0mm, 2.5mm, 3.0mm) are used for more severe cases, deep scars and wrinkles, rejuvenation of badly damaged skin, in areas other than the face.


Other Devices


Miniature versions of the dermaroller called dermastamps have been developed and are used for localized scars, eg. varicella scars.  Needles vary in length and procedures with the derma-stamp can be performed in as little as two or three minutes.




Newer mechanical devices use battery power to repeatedly and rapidly administer dermastamp type needles. They allow controlled and precise delivery of micro-needling to large or limited areas of treatment.

Micro-needling Enhances Penetration of Actives

The skin, particularly the stratum corneum, is extremely effective at keeping the outside world “out”, making it difficult for topical application of therapeutic substances to reach deeper skin layers. Each dermarolling session creates thousands of “channels” that provide direct penetration to the dermis. Actives can be applied during or after the dermarolling although patency of the channels following the procedure is limited in duration. For maximum effect, they should be applied immediately following the procedure.





Results that Speak for Themselves

Rejuvenation of aging skin




Treatment of post-acne scarring





Treatment of striae (stretch marks)





We will do a “part 2” on this soon. Stay tuned.

DISCLAIMER: as we say in our terms of use, and repeat ourselves often, we are here as “beauty bloggers” not as practitioners of the healing arts.  We cannot give you medical advice over the internet. The information here is of an general and  educational nature only.  Refer to your own physician for advice as to whether any of the devices or techniques discussed here are appropriate for you.


  1. Sylvia says:

    Love this site. Thanks for the good information.

  2. Robert says:

    “Needles longer than 1.5 mm should not be used on the face”….but the doctor above uses 3.0mm on his face….I’ve seen pics of his face covered in blood….not pretty….he said you must see blood to see results while others like Sarah Vaughter say it is not necessary to see blood…..who knows…

  3. Drgeorge says:

    I appreciate your comment about the length of needle Dr. Fernandez uses. If he is treating his own face, he can do whatever he wishes. There are several sites from which to learn about dermarolling and the consensus of no longer than 1.5 mm on the face seems fairly common. The two URLs below discuss pros and cons of needle lengths and may be major influencers in that policy. They are links to information about and from Dr. Fernandez. The longer needle is described as “faster and more effective” in achieving results but the price of going into seclusion for at least 5 days so no one can see your edematous and contused face may enter into the decision to opt for shorter needles and more frequent treatment. What can be said is this man is the godfather of the procedure and his own results certainly attest to its effectiveness…and apparent safety.


  4. Robert says:

    Thank you for that. It’s very informative. A couple of things that made me wonder. He says with a 1.0mm roller it takes 40 minutes to do the whole face. WTH????? I do mine in maybe 5 minutes tops. My face would be like a piece of meat after being tenderized…lol. And he says the patient comes back every week or two for six sessions. That goes against what I’ve learned to be true which is wait around 4-6 weeks between sessions using a 1.0mm or higher roller.

  5. Bess Gallanis says:

    This is fascinating and thank you. I was not familiar with the backstory and thought this technique was a bit of quackery. Will reconsider. Would facial acupuncture fall into the same category? Many thanks, BG.

    • Drgeorge says:

      Facial acupuncture is not a similar concept for several reasons. 1) acupuncture is based on stimulation of specific points or meridians to treat a variety of conditions that may be local or at a distance from the site of the needle insertion; 2) the needles are typically extremely thin and designed to cause minimal trauma; 3) even multiple acupuncture needles used on the face at one time produce but a tiny fraction of the number of punctures that occur during dermarolling…in the neighborhood of hundreds per square inch.

  6. Susan says:

    In the link Dr. George sent, it says you need to draw blood when derma rolling in order to have any benefit. Supposedly the bleeding releases whatever it is that causes collagen to increase. Is this true? Most advice I see online says you are not supposed to cause the treatment area to bleed; it should just be a little red similar to a light sunburn.

    • Drgeorge says:

      Susan, thank you for your question. Dermarolling is done to achieve one or both of two major purposes: 1. Enhancing penetration of actives topically applied to the skin. In order to do so, the difficult to penetrate stratum corneum needs to be pierced. Short needles that do not necessarily draw blood are sufficient to achieve that objective. One is relying on the cellular effects of the actives on deeper layers to achieve results. 2. “Controlled trauma” to the papillary dermis to induce cellular repair responses which promotes fibroblast proliferation and consequent collagen and elastin deposition. The papillary dermis is the layer immediately deep to the epidermis and is the vascular interface that provides nourishment and oxygenation to the deeper epidermal layers. Trauma to the papillary dermis does result in bleeding.

      If one wants only enhanced penetration of actives, bleeding is not a necessary endpoint. If one wants to create trauma to the papillary dermis, bleeding will occur as part of the process. I hope this explanation answers your question.

      • Susan says:

        I’m still confused. I think you are saying that to induce collagen growth you must create trauma to the dermis and that would mean bleeding so therefore you must induce bleeding to stimulate new collagen growth, correct?

        • Drgeorge says:

          Not exactly. Dermal trauma from longer needles indeed stimulates a healing response, part of which is induction of collagen production. There is associated bleeding. Perhaps surprising to some is shorter needles (without bleeding) can also stimulate collagen production by enabling enhanced penetration of topical actives known to promote collagen. Included among such actives are carnosine, certain short chain peptides (oligopeptides), vitamin A in its various forms, and others. The enhanced penetration of dermarolling assures delivery of the active to deeper layers where they exert their effect. Hope this explanation helps.

          • Traci says:

            What is the minimum length of needles needed to achieve enhanced penetration of topical actives? Thanks.

            • Drgeorge says:

              The stratum corneum varies in thickness depending on the area of the body – between 10 and 40 μm (thousandths of a millimeter). The shortest dermaroller needles I am aware of are .15 mm long and therefore capable of penetrating the stratum corneum anywhere. Hence, enhanced penetration is accomplished.
              Trauma to dermal layers requires longer needles and as posted elsewhere, bleeding is a positive sign that trauma has been achieved. This is not to imply, however, that wholesale “bloodletting” is necessarily a good thing or required to achieve dermal stimulating effects. Since the shallowest layer of the skin that contains blood vessels is the papillary dermis, erythema (redness) indicates some impact upon this layer.

  7. Emily says:

    What actives besides carnosine and vitamin A would you advise to use after a product penetration roll? thanks

    • Emily says:

      I am currently applying a 1st generation (GHK) CP serum

    • Drgeorge says:

      Dermarolling is a fairly common home treatment about which there is substantial blogging ongoing. Common topical actives mentioned are vitamin C, copper peptides, vitamin A in its various forms, for starters. I suggest doing some searches and finding what has worked for others. I personally have never dermarolled but have seen some pretty amazing results. We were recently sent unsolicited photos by a woman who achieved very positive results on her chronic acne scarring and post-inflammatory hyperpigmentation using an available combination active product twice daily combined with dermarolling every three weeks. The pictures are impressive and ample proof she has plenty of reason to be pleased.

  8. Robert says:

    I did my first roll last night with a 2.0mm roller. Numbed my face first with Deep Numb. Hardly any pain at all and only a few tiny blood spots. Used a 1.5mm on my neck.
    I noticed there are a couple of revisions to the dermarolling directions at
    One is she no longer recommends rolling in a star pattern. She say’s the center of the pattern gets a much greater prick density than the perifery does.
    She also recommends and sells Chloramine-T for sterilizing the roller after use. Say’s its better than using alcohol.
    Her PDF instructions are very helpful and can be found at her site.

  9. Sue Ski says:

    I have been dermarolling my face for 3 months using a 1 .5 mm roller. I can’t say that I’ve seen much results …between my eyebrows only. I am 63yo. I have sagging jowels. When rolling I have achieved some bleeding on forehead and around eyes. No blood on cheeks or jowels. Is this because I have thicker skin in these areas? Should I see better results later?

    • drjohn says:

      Sue- At 63, you have lost significant elasticity. Probably dermarolling alone won’t give you the results you seek in your jowls. You might consider something like RF with microneedling (Venus Viva) which has a great track record for tightening jowls.

      • drgeorge says:

        Sue, if you are rolling 1.5 mm, you’re tough as nails or using an anesthetic. A couple questions for you: 1) How often are you rolling? If you have read Dr. Lance Setterfield’s book (The Concise Guide to Dermal Needling), you will understand that needling that deep should not be done any more than once a month since it takes that long to achieve full healing. In fact, Dr. Setterfield currently teaches that 0.5 mm is sufficient to cause enough cellular wounding to initiate a cascading growth factor and cytokine “conversation” into deeper tissues. Shorter needles to enhance penetration of actives (~.25 mmm) can be done much more often. 3) What topical products are you using, if any?

        As to your questions, yes, the skin is thicker in certain portions of the face so you will see less visible injury than if you are treating thinner sections. Also, the major improvements you will see are more in the skin surface than the deeper structures. Skin rejuvenation is the hallmark improvements seen with dermal needling, but it can be very significant. We have seen results that rival laser resurfacing. Critical to these improvements is what was used for topical products for the procedure and afterwards. The best results we have seen were in patients who (gotta toot our own horn here) received medical needling using a product we created in consultation with Dr. Setterfield, plus our anti-aging system twice daily between microneedling sessions. The bio-signals in our products, derived from bone marrow mesenchymal stem cell cultures, are contributing to such results. The bio-signals are pro-healing and anti-inflammatory, which is what an aging person needs to restore more youthful healing.

        A word of caution: we are seeing nasty reactions with microneedling when people apply substances that are not normally found in skin. A big culprit has been so-called snail “growth factors”, as well as peptide and vitamin serums. With the greatly enhanced penetration that microneedling provides, giving foreign substances easy entry to deeper skin layers can be problematic. Remember, it may not be the peptide or vitamin per se, but something else in the concoction that was never intended to be introduced into wounded skin.

        Good luck. If you care to learn more about our products, go to, or send an email and we’ll get back to you.

  10. Skin rf says:

    I ordered. A 2.5 mm for face thinking this was the width of
    The roller. It’s the length of the needles Wow!
    So should I dare do a test spot on my forehead with 2.5mm? Or order another one. Like 1.5
    Or 1.00? I can use numbing cream and not worried about the pain if I only do it monthly Let me know. Where would u use the 2.5 mm? Elbows, knees? Décolleté?

    • drgeorge says:

      That is certainly a longish needle, too much for dermal rolling on a routine basis. Needles that length are typically used to address deep lines and wrinkles, scars, stretch marks i.e. pronounced aberrations in contour and texture. Unless you have focal areas you want to address aggressively, I would recommend getting something shorter, especially if overall rejuvenation is your desired goal, especially on the face. Faces are usually treated with needles up to 1.0 mm, maybe 1.5 mm in real problem areas, commonly 0.5 mm.

      Unless you have focal areas needing aggressive treatment, you may want to return that roller, or put it into the kitchen utensil drawer for tenderizing meat, not your face.

  11. Kristen Dutcher says:

    If you have acne scarring on face but have 50 small keloids on chest from acne could you possible cause keloids on you facial acne scarring if you used this type of procedure to eliminate the acne scarring to n the face??

    • drjohn says:

      Might be at more risk, but that just means paying special attention to an anti-inflammatory healing environment. We would favor lots of TGF-B3 to diminish that possibility, and start in one small area to test.

  12. Lauren says:

    I own the Derminator machine and I just started micro needling. I have to say I do love using the Derminator because it allows me the flexibility of adjusting different length of needle penetration for different areas of the body.

    I was curious if I can use 0.25mm or 0.5mm on the eyelids without causing injury to the eyes?

    • drjohn says:

      Lauren, the skin over your eyelids is very thin. The bottom part, near your eyelashes, is as thin as 0.3mm. That should rule out not just 0.5mm but also 0.25mm needling. Keep in mind that the the actual depth of penetration of the needles cannot be precisely controlled – it depends not only on the needles as manufactured but also such things as the strength of the motor (if motorized), how hard you press, etc. We recommend staying away from eyelids for home microneedling.

  13. jess says:

    I was wondering why so many sources on the internet say to roll at intervals of 2-3 weeks for needles 0.5 and longer? I use 1 mm dermaroller on my face and a 0.5 stamp under my eyes every 6 weeks since I was under the impression that it took 6 weeks for new skin cells to regenerate. Also was my understanding that anything more frequent then 6 weeks could damage the turn over cycle of new skin cells. Is this correct?

    • drgeorge says:

      There are different opinions on the interval between rolling that is optimal. Certainly, one would like the majority of healing to have taken place prior to inducing new damage that needs to heal.

      Our consultant guru, Dr. Lance Setterfield is of the opinion that four weeks is certainly adequate time between treatments. Of course, short needle treatments induce less injury, especially ones that are .3 mm and shorter which do more to enhance penetration of active, so they can be at shorter intervals. Dr. Setterfield is also a fan of 0.5 mm treatments, long enough to initiate keratinocyte cytokine and growth factor output, but not so long to damage deeper tissues.

      Our particular focus has been on producing adjuvant topical for use at time of needling that ameliorate inflammation quickly, setting the stage for fibroblast proliferation and collagenesis.

  14. Hello dr
    I would like to know the treatement For deeply Acne Scars?
    How deep should the needle info the face? With dermapen?
    0.5 o 1.5
    Thanks for your help

    • drgeorge says:

      There is disagreement among the microneedling glitterati. Dr. Lance Setterfield, an internationally recognized authority and author of The Concise Guide to Dermal Needling feels that 0.5 mm incurs enough injury to initiate the healing cascade of bio-signals (cytokines and growth factors) from injured keratinocytes into deeper layers. More traditional views have been that different parts of the face, having different thicknesses of skin, need anywhere form 0.5 to 1.5 mm needling. Males, having thicker skin, need somewhat longer length than females. What is quite agreed upon, however, is that deep needling is not needed UNLESS one is addressing specific conditions, one of which is acne scars. In that case needles of 1.5 to 2.0 are typical. A fairly good summary article can be seen at:

  15. val says:

    I needled my eyelid and damaged a blood vessel–ended up with a black eye for a week–that;s what I get for being nosy

    • drjohn says:

      Good point val. The skin on the eyelid is the thinnest epidermis of all areas of the face, about 0.4-0.5 mm thick. Near the eyelashes it can be even thinner. Cosmetic needling at 0.25 mm but you can buy roller style needling devices over the internet with needles that are 0.5mm and longer. We do not recommend anyone who is self treating to needle the eyelids for this reason. In the clinic it is possible to do so with relative safety, using adjustable pen style needling devices.

  16. Sabrina says:

    Hello and thanks for this article. I’m 52 and just bought a .50 mm derma roller for home use. I read your article about problems when people use certain serums or creams during or after the rolling. Fearing that, I used nothing during. I can’t find anything online so far as to whether that’s bad or not (using nothing).

    About 20 minutes after, my skin felt tight and very slightly burning (likely from the water + 91% alcohol I swabbed over it before rolling. And I soaked the roller in the alcohol, too and let it dry for 20 minutes before using it.) So I used a tiny bit of a coQ10 serum I have from Timeless Skincare — a company you have to order online from. I like them because they have pretty pure formulas without any unnecessary chemicals in them.

    Until I find out more I won’t use anything during *or* after for fear of introducing something damaging to my skin. I assume after 24 hours or so I can use whatever I usually use? (Matrixyl 3000 serum, a Coq10 serum and a Vitamin C 20% serum – in rotation.)

    If we can’t get access to the serum you use during and after rolling, is there anything you can recommend that’s readily available for home use? Or would you recommend using nothing during or after? Thank you!

    • drgeorge says:

      Thanks for your questions, Sabrina.
      If you’ve spent much time on BFT, you know we are sticklers when it comes to what one should put on their skin during and after dermal needling. For the first several hours after treatment, there are literally thousands of microscopic perforations in the stratum corneum (even deeper with longer needles) which means the barrier function of the skin is greatly reduced. That allows greatly enhanced penetration of topically applied substances which, depending on what is applied, can be good or really bad. Our opinion, and that of our dermal needling guru, Dr. Lance Setterfield, is that only substances “native” to the skin should be applied. Native substances are ones that are found naturally within our skin. AnteAGE, AngeAGE MD, and AnteAGE HOME microneedling solutions are formulated to meet that criterion. Bone marrow stem cell conditioned media, hyaluronic acid, synthesized TGF-beta3 (in the MD version) and something to keep it all fresh and sterile (globally accepted preservatives, the same as are used in vaccines and injectible medicines) are the ingredients. Many scores of thousands of doses have been used and we have yet to hear of an adverse reaction. You can email or submit another comment if you want to try any of these products. We’ll contact you privately.

  17. Liz says:

    I am 68 and have Rheumatoid arthritis and am taking Tofacitinib, a biologic to suppress symptoms. Is it safe to do microneedling for vertical lip line wrinkles?

    • drgeorge says:

      Liz, you will need to ask this question of your physician; BFT cannot offer opinions where such a significant and substantial risk/benefit analysis has to be considered. Tofacitinib is indicated for people with moderate to severe rheumatoid arthritis. It is a kinase inhibitor that works by blocking certain substances in the body that contribute to inflammation. It does have downsides that must be compared to the benefit of improving vertical lines on your lip. While microneedling is exceedingly safe and infections of the face are nearly unheard of, your case is different. The information below is from

      “Tofacitinib may increase the risk of serious and sometimes fatal infection. Patients who also take medicine to suppress the immune system (eg, methotrexate, corticosteroids) may be at greater risk. Reported infections have included tuberculosis (TB), shingles, and other bacterial, viral, and fungal infections. You should be tested for TB before you start tofacitinib. Discuss with your doctor the benefits and risks of using tofacitinib.

      Contact your doctor right away if you develop symptoms of infection (eg, fever; chills; persistent cough or sore throat; increased or painful urination; unusual muscle aches; red, warm, swollen, painful, or blistered skin; tiredness; loss of appetite or unusual weight loss; night sweats).”

      On a personal note, a close friend on this drug suffered a near-fatal lung infection last year, the fairly rare kind typically seen in people with severe immunodeficiency. Not sure that risk is worth it to have a prettier lip.

  18. Rachel says:

    I’m 32 and like the thought of preventative anything. The more I read about skin care, the more I’m fascinated by the science of it (so much so that I’m considering an attempt at going to school again and maybe making a career of it). I’m pretty much your standard person trying to trudge my way through ALLLL the crazy info on the internet, so pardon me if my question seems silly. Does derma rolling have impact on the hayflick limit, and if so, is 32 too young to start doing it?

    P.S. I LOVE your website.

    • drgeorge says:

      Great question, Rachel, and proof that BFT readers are real thinkers. For those unfamiliar, the Hayflick limit is a theoretical concept that simply says that a given cell has a fairly well defined number of times it can undergo mitosis (replicate) before it becomes senescent or undergoes apoptosis (“cell suicide”), something programmed into its DNA. That number is 50 to 70 replications. It has to do with telomere shortening, the process whereby with each replication small portions of the DNA strand located on the ends of chromosomes (the telomere) shortens. At some point a critical length is reached and the cell loses its ability to replicate, pushing it into senescence or apoptosis. For a couple reasons, this does not seem to be operative when it comes to skin, skin repair, and skin regeneration.

      It has been speculated that the limited replicative capability of human fibroblasts in culture may have significance for human aging, even though the number of replications observed in culture is far greater than the number that would be expected for non-stem cells in vivo during a normal postnatal lifespan. Although it had been thought that the replicative capacity of human cell lines was inversely correlated with the age of the human donor from whom the cell lines were derived, it is now clear that no such correlation exists.

      It is interesting to note that studies have shown that human skin fibroblasts taken from biopsies have a replicative lifespan of approximately 200 years. So it’s possible that aging in humans isn’t limited by replicative potential. The study only represents fibroblasts; other tissues might have shorter limits. Furthermore, Hayflick limits apply to fully differentiated cell lines. Your skin is not made entirely of differentiated skin cells. It also has stem cells, progenitor cells that can divide fairly indefinitely. These produce new differentiated skin cells.

      It may seem logical to conclude that if corneocytes, differentiated cells removed upon exfoliation, are subject to the Hayflick limit, then exfoliation will thin the skin. However, this conclusion ignores the unique feature of keratinocytes—they do not regenerate. They are designed to die off cyclically, about every 35 days, a cycle which slows down with aging.

      Exfoliation speeds up that cycle by the removal of corneocytes, signaling the formation of newer replacements. Thus, a new layer of younger, healthier skin emerges. If this were not so, then there would be a limit to our body’s ability to heal wounds by regenerating new cells and the corneocytes that protect them.

      Corneocytes are not affected by the Hayflick limit because they have already reached their regenerative limit. Once they are removed by exfoliation or slough off naturally, they are replaced by new corneocytes that have emerged from the epidermal stem cells, which are not affected by the Hayflick limit. The good news: you will not run out of skin. Keep dermarolling!!

  19. Liz says:

    Hi there. I love your website. It is so helpful. It’s nice to get the truth from people who know what they are doing! I love my Derminator — the only thing I don’t like is that it doesn’t glide smoothly across the skin. You kind of have to push and pull it over your skin.. Is it okay to moisten the skin with water or something that would make the skin more slick so it would be easier to move the Derminator around. I think most products would sting which is why I mentioned water. Using the Derminator is so much less painful then rolling and stamping. The only area I numb when using the Derminator is my upper lip. I find it a lot faster too. Thank you so much.

    • drgeorge says:

      Water is fine but another choice might be saline (physiologic salt water solution) which can be obtained at a pharmacy. Either should be fine.

  20. Corina says:

    I’m very intrigued by the volume of information on this site. Very helpful and explained thoroughly. I would like to know if there is a product that does not contain human stem cells or troublemakers for use after CIT. Would Retin A be acceptable post rolling? I know from my reading here that using nothing is better than using something that causes trouble. I’d like to maximize my results without the use of stem cells because it raises a small degree of unrest in my being. Not sure why. What would you be able to recommend?

    • drgeorge says:

      Corina, you are wise to be cautious as to what you apply to your skin while it’s barrier function has been compromised by the thousands of tiny albeit temporary perforation created by microneedling. Our mantra is to apply only ingredients that are physiologic and naturally intrinsic within the skin. That includes hyaluronic acid and bio-signals produced by bone marrow stem cells, migratory cells responsible for command and control of healing in each and every human being. The bio-signals are the same in everyone, from birth until death. Not sure why there is “unrest” in your being. Our stem cells are from adults, not infants or embryos; they are used as “factories” to obtain bio-signals in the laboratory, then discarded. There are no cells in any of our products. As for Retin A, not sure why you think application after microneedling will add further benefit above and beyond appropriate daily use. That’s not the case for bio-signals which are responsible for the cellular functions of healing and inflammation.

  21. Lauren says:

    I tried using skin rollers in 2010 but gave up due to not knowing what the heck I was doing. At that time there were people on the EDS (Essential Day Spa) forum who were really rolling hard and bloody and I did not want to do that without darn good reason. Thank goodness for this site and Dr. Setterfield’s book which I have obtained and read and will read again.

    I have rosacea, loads of IPL and last year Thermage for photoaged and intrinsically aged (now 63yo) facial skin. I have been troubled with regular acne too, and still am. No big scars but lots of big pores. I still think that needling will improve that and have purchased your serum for needling and am excited.

    The big thing is that my upper chest is really much worse than my neck or face and I have DSAP (disseminated superficial actinic porokeratosis) and wonder what if anything CIT will do to or for that problem. The DSAP is mainly on my arms and legs (which look pretty awful) but I have five or so on my upper chest. Should I roll them too or cover I wonder? I have of course tried IPL, laser and cryo on them with no results. Due to sun avoidance they are pale cafe au lait in colour and flat, not inflamed. If that was not enough I also hundreds of seborrheic keratoses also on arms and legs, and trunk and female pattern hair loss. The skin gods have not been kind to me.

    Thank you for all the wonderful advice and not treating consumers like idiots.

    • drgeorge says:

      Thanks, Lauren. You are wise to refer to Dr. Lance Setterfield’s book when it comes to microneedling. We are big fans of his and have been for years. His book, A Concise Guide to Dermal Needling, we regard as the “bible” when it comes to covering the topic in detail.

      From the description of your skin, it does sound like you got shortchanged in the skin genetics lottery. For our BFT readers: Disseminated Superficial Actinic Porokeratosis (DSAP) is an inherited skin condition which causes dry and flaky patches to appear on the skin, mostly on the legs and arms. Lesions caused by this condition present as a spot about the size of a pencil eraser, but can increase to even double that size. The edges of the lesion will be visibly raised, with the interior being either rough or smooth. While the color of these spots will vary from person to person, and can even vary in response to external stimuli, the most common colors are red, pinkish, purplish, and brown. Treatments that may prove helpful include: Cryotherapy, 5-Fluorouracil cream, tretinoin cream, alpha hydroxy acid cream, calcipotrio ointment (a type of Vitamin D), diclofenac gel, phototherapy and laser treatments.

      We are not familiar with microneedling being of benefit for this condition but do know it can be beneficial for a variety of pigmentation issues so perhaps worth a try. If you do decide to mironeedlig, we would recommend use of our microneedling solution to help mitigate post treatment inflammation. Let us know how it goes.

  22. Lauren says:

    Thank you so much for all this wonderful info! I’ve had 4 microneedling sessions over 6 months for small, superficial pitted scarring on my nose. I’m almost 30 and healthy. Unfortunately I haven’t seen any changes (even with superb before and after pictures). It seems like some people respond almost automatically, others respond a number of months down the road, and then some people never respond! Is this true?

    • drgeorge says:

      Great question and one that pertains to anyone with acne scarring. Microneedling, also known as dermal needling or collagen induction therapy, can be an effective treatment to reduce the depth and appearance of any kind of scar, including scars following surgery or burns. It is becoming more and more popular as a management tool for post-acne scars.

      Recall that acne scars are not all equal. They vary in size, depth and morphology. Common types include boxcar, ice pick and rolling. The type and severity does impact what type of microneedling protocol is most likely to improve appearance. Although 0.5 mm dermal needling can be appropriate for general skin rejuvenation, longer needle lengths are needed to create the controlled localized trauma that can help fill in atrophic scars; depths of 2.5 mm or more may be required, depending on scar specifics.

      A series of treatments is required and it takes several months to achieve adequate cosmetic improvements. Because the healing cycle takes approximately four weeks to complete, more frequent treatments may be ill-advised. You don’t provide details as to the depth of your treatments or the interval between treatments. BFT suspects that inadequate needle depth may be why you did not see significant improvements. With proper needle length, sufficient trauma, and appropriate interval between treatments, one should expect to see improvements. We doubt that “some people never respond” if treatments are properly administered and at an appropriate interval.

      Based on many, many favorable outcomes using products we produce, we are also convinced that use of topical growth factors and cytokines plays an important role in achieving optimal results. Moderating excessive inflammation and promoting the healing process with bio-signals derived from bone marrow mesenchymal stem cells has proved beneficial following dermal needling, radiofrequency microneedling, and semi-ablative laser treatments. In darker skin types, this can be of benefit is reducing the chances of developing excessive pigmentation although the incidence of hyperpigmentation following microneedling is less that that seen with some other types of energy delivery i.e. IPL, laser, RF, etc.

      J Clin Aesthet Dermatol. 2011 Aug; 4(8): 50–57.
      Practical Evaluation and Management of Atrophic Acne Scars
      Tips for the General Dermatologist

      JAMA Dermatol. 2014 Aug;150(8):844-9. doi: 10.1001/jamadermatol.2013.8687.
      Efficacy of a needling device for the treatment of acne scars: a randomized clinical trial.

      • Lauren says:

        Thank you! Treatments have been no less than 4 weeks apart and no more than 8. By the 3rd and 4th treatments, we had worked up to 1.5mm. I’m not opposed to going deeper, but my scarring really doesn’t seem very deep, so it’s baffling to me that I haven’t seen even the slightest of changes. But more importantly with the deeper needles, I’m afraid of further scarring! (I know Dr. Setterfield generally cautions against longer needles). If this is what may help me, how can I ensure the treatments are being performed as safely as can be? We’ve been using an Eclipse micropen.

        • drgeorge says:

          Lauren, thank you for the additional information. It seems your treatment interval and needle length are not out of line. (For BFT readers’ reference, inserted below is a chart of facial skin thickness by regions taken from a study using full thickness biopsies from fresh cadaver subjects.) If your particular scars are deep enough to involve the majority of skin thickness on your nose, there may be limited ability to “fill in” from needling alone. You described your scars as “superficial” but as you can see, skin on the nose is not particularly thick. If needling has not been helpful, we suggest you consider a visit to a cosmetic dermatologist or plastic surgeon for additional options. Because of the improvements we have seen in improving the appearance of acne scars and deep lines when microneedling is combined with the use of topical growth factors and cytokines, you may want to give that a try.

          Facial Skin Thickness by Region

  23. Lauren Lupton says:

    Dear Doctors,
    There are two Lauren’s posting. Mine was on DSAP. You can call me Lu2
    I have tried one session with a 0.5 roller on upper chest with no product during but dilute vit c after. No difference in response on DSAP spots, that is no more bleeding, as they are pretty thin skin. I will continue after a month and have received my Derminator and my Cellese microneedling solution.
    I am keen to try the daily products from Cellese but our weak Canadian dollar is a definite impediment. I had seen somewhere on BFT that readers can apply for a discount?
    I really want to try your hair product when it is available too.
    Thanks, Lu2

    • drjohn says:

      Hi Lauren, Hair is available now, I believe. If you don’t find it on the AnteAGE web site, contact to ask when it will be. It took us years to figure out hair regeneration (much more complicated than skin). We are very excited to have completed that, and the results from our research clinic attest to the efficacy. We will post an update on that soon.

  24. Is there a part 2 yet? I’m also can’t find part 2 Anteage review in partial their microneedling solution.

    And what microneedle solution do you recommend for alopecia?

  25. Susan Benson says:

    Can you continue to microneedle indefinitely, in other words, do a series of sessions in a year then rest for say 6 months, and repeat this every year – or do you need to take a break of a few years at some point? Also, if you can continue to do this, for maintenance treatments would you recommend one session every so often or a series less often, eg. One every 6 month or a series of 3 every year? Any advice would be appreciated.

    • drgeorge says:

      By the content of your question, BFT assumes you mean home microneedling which employs needles of 0.2 to 0.25 mm length. This is in contrast to medical needling which typically is significantly deeper – from 0.5 to 1.5 mm, sometimes even deeper. There’s a huge difference between the two. Shallow depth does not penetrate into the dermis but does create microchannels in the stratum corneum that permits enhanced penetration of products applied within a few hours of microneedling. We see no limit to the amount of home microneedling simply because living tissues are not traumatized. That said, it does not make sense to needle “all the time” so two or three times a week is probably sufficient, and it’s hard to see why this could not continue “indefinitely” BUT, pay attention to what you apply to your skin! Enhanced penetration will enable benign and helpful substances to penetrate more easily and it will allow “nasties” to also gain easier entry.

      Medical needling does incur injury to living tissue which initiates a healing response which does take time to heal. The rule of thumb is four week to heal before the next treatment. Medical needling is typically performed to accomplish a defined improvement of appearance i.e. lines, wrinkles, pigmentation, scars, stetch marks, etc. If more than one treatment is needed, no problem but do so a monthly intervals. If you have several treatments over a series of months, say 4, 5, or six, “resting” the skin for a while makes sense but we know of no study that says that is preferable. What we do feel is prudent is disciplines use of topical products that contain physiologic substances, i.e. substances naturally present within the skin, and avoidance of topicals with obvious foreign substances not native to skin. We are also fans of products that reduce inflammation and promote healing. These were the criteria we used when we formulated our own microneedling products.

      There are some people who feel that frequent medical needling can ultimately lead to “fibrosis”, the creation of excess stiff collagen fibrils which are found in scar tissue.

  26. Marissa says:

    I’m very curious about sonophoresis and iontophoresis in combination with dermarolling to maximize product penetration. I roll with .25 mm followed by AnteAGE, and would love to use the Environ DF Mobile device, or Mira Skin (ultrasound only). Is the AnteAGE Serum compatible with iontophoresis? I’m only a skincare enthusiast, but my understanding from research papers I have read is that the actives mist have a charge, be small enough, and oil-free formula? Really enjoy the deep reads on your site!

    • drgeorge says:

      Sonophoresis and iontophoresis are used to enhance penetration of topically applied substances to the skin. But, that is exactly what occurs with dermarolling. BFT cannot advise adding ultrasound or the electrical “push/pull” of charged molecules into the skin that has been microneedling because we have no idea of what the topical being applied contains. Just because you CAN do it, does not mean that you should. What we do advocate is topical application of products that contain natural physiologic ingredients to microneeled skin. To intact skin, sonophoresis or iontophoresis may be helpful. To microneedled skin with reduced barrier function, we urge caution.

  27. Diane Sturley says:

    I have been using your products for years and truthfully would not go without them. I have been dealing with Melasma for over 2/3 of my life and have had great results with your medical microneedling and products.

    I purchased the home roller and use it with the home serum, keeping my skin moist while needling. My issue is what can I use immediately after. I find my skin is super dry immediately afterward and if I wait an hour before applying anything my skin is beyond dry.

    I have two questions:

    1. How long should I wait before applying any kind of skincare after using the home roller and serum..
    2. Any suggestions on product I can use. I have the Anteage serum and accelerator but I find it’s not enough hydration for my 56 year old skin.
    It was suggested that Negenesis barrier cream could be used immediately following the rolling but I want to be sure.

    • drgeorge says:

      We appreciate the kind words about our products and are gratified that you are seeing such good results. They were formulated to be “best in class” with more active ingredients in the Serum / Accelerator duo than any other product combination of which we are aware.

      Our home microneedling system includes a 0.25 mm roller, which helps with the penetration of topicals but is not deep enough to traumatize living tissue. Medical needling at depths of 0.5 mm and greater intentionally injures deeper layers of the skin, where self-healing and regeneration results in increases in collagen, elastin and freshened surface skin. Both have a role in optimizing skin appearance and treating or preventing signs of aging.

      With deeper treatments, we recommend several hours (six or more) before topical product application, to ensure that the microchannels have had a chance to re-seal to prevent troublesome ingredients from gaining access to living cells in the dermis. The serious adverse events that occur with microneedling that we have seen were the result of topical ingredients that sensitized the skin or caused allergic reactions. That problem is not such an issue with home needling because the shorter needles are not entering into the dermis.

      That said, you will have less risk with topicals applied after home treatments. Even so, we would recommend you do a test area in a less conspicuous spot to see if there is any reaction. If none, you should be fine. Trial and error will sort that out. A bland moisturizer that you have successfully used in the past can be tried.

      As to NeoGenesis products, we are not fans. Watch BFT for an upcoming post in which we’ll get into chapter and verse about an ongoing brouhaha with their founder and chief scientist. It boils down to this – we have reservations about the scientific integrity of this person, and by extension, the products his company produces. A journal article he published last year significantly distorted important aspects of stem cell science, for obvious financial gain in our opinion.

      The purported “facts” in his article included many that were so seriously distorted from the established science that academic university stem cell scientists wrote a letter to the editor of the journal asking that the article be retracted. They identified dozens of instances of errors in the use of scientific references that had been cited in this article. The errors and misuse fell into several different categories. The pattern was unmistakable to them – the article was less a review of stem cell science, which it purported to be, and more an unethical “diatribe” against a commercial competitor, i.e a “hit piece” masquerading as a scientific review.

      Watch BFT, you’ll see more soon.

  28. Lauren says:

    You’ve stated that needles longer than 1.5 mm should not be used on the face, but I can’t seem to find any information online explaining why this is important. What would happen if someone were to use longer depths on non-scarred skin on the face? What kind of damage might result? Could needling too deeply damage fat cells? I ask because I have just accidentally needled my face too deeply with my needling device. It was not intentional. I confused the depth indicator on the pen with a different marking on the backside of the pen. When I thought I was using 0.25mm under my eyes (on the occipital bone), the pen was actually set to 1.4mm. I also used 1.6mm on my forehead (I meant to use 0.5) and 2.1 on my cheeks and chin (meant to use 1.0). The pen was on the lowest speed setting and I only needled for 3-5 minutes total. I don’t have acne scars, just fine lines and some sun damage What kind of damage should one expect from needling this deeply, how soon would one likely see said damage, and is there anything one could do to mitigate the damage?

  29. DrGeorge says:

    As discussed elsewhere on BFT, the purposes of microneedling include skin rejuvenation, reduction in fine and coarse lines, reducing appearance of scars and stretch marks, addressing pigment issues and enabling enhance penetration of topical substances placed on the skin. Appropriate needle length, in turn, is determined by the purpose of the treatment and the innate thickness of the skin being treated. Microneedling inflicts deliberate damage but in a controlled manner so that the result is healing that looks “better”, not worse. Most indications for microneedling require multiple treatments to achieve the desired result. A single inadvertent “overtreatment” is, in our opinion, therefore not a disastrous event although particularly susceptible individuals could induce excessive pigmentation or scarring. Let us know how it goes. General guidelines are: Fine lines, mild stretch marks, and scaring may be treated with a medium needle depth(approximately 1.0 mm). Deep acne scarring, surgical and deeper scars, wrinkles, pore size, stretch marks, and skin texture can be treated with the deepest needle depth(approximately 1.5mm to 2.0mm).

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