Patient Guide: Microneedling

Microneedling is a collagen induction procedure that uses fine needles to create controlled micro-channels in the skin, triggering the body’s wound-healing response and stimulating new collagen and elastin production. At The London Road Clinic we use the SkinPen medical-grade device. Pricing is confirmed on the microneedling treatment page.

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What microneedling is

Microneedling is one of the most evidence-based non-surgical treatments for improving skin texture, acne scarring, and overall skin quality. The principle is straightforward: by creating precise, controlled micro-injuries in the skin, the procedure activates a wound-healing cascade that the body uses to repair and remodel the treated tissue. The outcome of that cascade is new collagen, new elastin, and improved skin structure.

The device matters significantly. At The London Road Clinic, we use SkinPen, a medical-grade microneedling device with clinical data for acne scarring specifically. The distinction between a medical-grade device and a consumer dermaroller is not cosmetic. Needle depth, motor precision, single-use sterile needle cartridges, and the consistency of needle penetration angle are all factors that determine clinical outcome and infection risk. Consumer rollers cannot reliably deliver controlled depth, and the lateral dragging motion they use through the skin increases trauma without improving the collagen response. This is not a treatment to approximate at home.

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How microneedling works

The wound-healing process that microneedling activates follows a predictable biological sequence, and understanding it explains why results take weeks to develop.

Phase 1: Inflammation (days 1–3). The micro-injuries trigger an immediate inflammatory response. Growth factors, platelets and immune cells are recruited to the treatment site. This phase is visible as post-treatment redness. It is not a side effect to be minimised; it is the start of the repair process.

Phase 2: Proliferation (days 3–10). Fibroblasts migrate to the treated area and begin producing new collagen and elastin. New blood vessels form to supply the repair zone.

Phase 3: Remodelling (weeks 4–12 and beyond). The newly formed collagen matures and reorganises. This is where the visible improvement develops: scar tissue softens, texture becomes more even, pores appear smaller, and the skin’s overall quality improves. A single session initiates this sequence; a course builds on each preceding remodelling phase.

Understanding the role of collagen and elastin in skin structure and quality helps contextualise why this remodelling process produces lasting results when the course is completed.

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What microneedling can address

Acne scarring

This is where microneedling has the strongest published evidence base. The SkinPen device holds clinical data specifically for the treatment of acne scars. The mechanism is directly relevant: collagen induction remodels the scar tissue, improving the texture and appearance of rolling and boxcar scars in particular. Ice-pick scars are more resistant and may require a combined approach. The clinical detail is in the acne scarring guide.

Skin texture and quality

Enlarged pores, rough or uneven skin texture, and general quality decline associated with ageing and sun exposure all respond to microneedling. Where the skin texture concern is accompanied by pigmentation irregularity, a combined approach including Lumecca IPL is often more effective than microneedling alone. The skin texture guide covers the full treatment landscape for this concern.

Fine lines associated with skin thinning

Microneedling is not the primary treatment for deep expression lines (that is anti-wrinkle injections) or structural volume loss (that is dermal filler). It is well-suited to fine lines that reflect reduced skin quality and collagen content rather than muscle activity. These are typically distributed across the lower face, under-eye area, and neck, rather than concentrated at the upper-face expression points.

Stretch marks

Early stretch marks (striae rubra, where the mark is still pink or red) respond reasonably well to microneedling. Mature, white stretch marks (striae alba) are more resistant. A course of sessions over several months is typically required, and expectations should be calibrated at consultation.

Scalp and hair

Microneedling the scalp creates micro-trauma that improves blood flow to the hair follicle and may enhance the uptake of topically applied treatments. At The London Road Clinic, scalp microneedling is considered as part of a broader hair restoration approach alongside polynucleotide injections. The hair loss and thinning guide covers the evidence base and the treatment options in detail.

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The LRC enhancement: exosomes post-needling

One of the advantages of medical-grade microneedling is that the micro-channels created during treatment provide a window of enhanced penetration for topically applied actives, typically lasting 30 to 60 minutes post-procedure. At The London Road Clinic, we use BLESKIN EXXO, an exosome concentrate manufactured by Bleskin, applied topically immediately after microneedling.

Exosomes are extracellular vesicles that carry growth factors and signalling molecules involved in cellular repair and regeneration. Applied through open micro-channels directly after needling, they are delivered to the dermis at a depth that topical application alone cannot reach. This enhancement is optional but commonly chosen by patients undertaking a course for acne scarring or significant skin quality decline, where the combined regenerative stimulus is clinically relevant.

BLESKIN EXXO exosomes at LRC are applied topically only. They are not injected. This is a clinically important distinction from injectable regenerative treatments such as polynucleotides. For a full comparison of injectable regenerative options see the regenerative treatments comparison and the polynucleotides patient guide.

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How microneedling differs from Fractora

Patients frequently ask about the difference between microneedling and Fractora. Both use needles to penetrate the skin; from that point they are distinct procedures with different mechanisms, depths, outcomes and recovery profiles.

	Microneedling (SkinPen)	Fractora
Mechanism	Mechanical collagen induction via micro-injury	Fractional radiofrequency energy delivered via insulated needles
Primary stimulus	Wound-healing cascade	RF thermal energy + micro-injury
Depth range	0.5–2.5mm (adjustable)	Up to 3mm (tip-dependent)
Best suited to	Texture, acne scarring, skin quality, hair	Skin laxity, deeper scarring, resurfacing, significant quality decline
Downtime	24–48 hours redness	3–7 days, varies by intensity
Sessions (typical course)	3–6	3–4
Can be combined	Yes, with exosomes, PNs, peels	Yes, often with Forma or other devices

The detailed comparison is covered in a dedicated Microneedling vs Fractora guide. At The London Road Clinic, the choice between the two is made at consultation based on the primary concern, skin type, and how much downtime a patient can accommodate. Both are valid options; they are not interchangeable.

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The treatment: what to expect

Consultation

A consultation with our team is the starting point for any treatment plan involving microneedling. The appropriate needle depth, number of sessions, and whether enhancement with exosomes or combination with other treatments is recommended are all determined based on clinical assessment.

Read more about what to expect at a consultation at The London Road Clinic.

The appointment

A microneedling appointment takes approximately 60 to 75 minutes, including 30 minutes for topical anaesthetic cream to take effect. The anaesthetic is applied before treatment begins and is standard, not optional, because it meaningfully reduces discomfort.

Once the skin is numbed, the SkinPen device is passed systematically across the treatment area. Most patients describe the sensation as a mild pressure or warmth rather than sharp pain. The face is typically completed in 20 to 30 minutes. Immediately after, the skin appears red, similar to moderate sunburn, and may feel warm and tight.

If exosome enhancement is included, BLESKIN EXXO is applied directly after the needling is complete, while the micro-channels remain open.

Recovery

Timeframe	What to expect
Hours 1–6	Redness, warmth, mild swelling. The skin feels sensitive.
Day 1–2	Redness begins to settle. Some patients experience mild flaking or tightness.
Day 3–5	Most of the visible redness has resolved. Skin may still feel slightly sensitive.
Day 7	Skin is typically back to baseline appearance.

For 24 to 48 hours post-treatment:

• No strenuous exercise, saunas or steam rooms.
• No active skincare (retinoids, acids, vitamin C) directly on the treated area.
• Apply only the post-procedure products recommended by the clinic.
• Avoid sun exposure and apply SPF 30 or above consistently. See the sun damage and SPF guide. The skin is more photosensitive after microneedling, and UV exposure in the days following treatment counteracts the collagen-induction process.
• No make-up for the remainder of the treatment day.

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Results: timeline and honest expectations

Timeframe	What typically happens
Days 1–7	Recovery from treatment reaction. No visible result yet.
Weeks 2–4	Some patients notice improved skin texture and radiance as inflammation resolves.
Weeks 4–8	First clear improvement in texture, scar appearance or pore size as collagen remodelling progresses.
Weeks 8–12	Continued improvement as remodelling completes. Full result from each session visible here.
3–6 months (full course)	Cumulative result from the complete course.

What microneedling typically delivers:

• Improved skin texture and a reduction in surface irregularity.
• Softer appearance of rolling and boxcar acne scars.
• Reduced pore visibility.
• Improved overall skin quality and reflectivity.
• For scalp: improved follicle environment and uptake of topical treatments.

What it does not deliver:

• Correction of deep structural scarring (ice-pick scars require additional or different approaches).
• Reduction of pigmentation or vascular concerns (those require IPL or laser).
• Immediate visible change. The biological process takes weeks.
• Permanent results without maintenance. Annual maintenance sessions are typically recommended once the primary course is complete.

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Suitability

Microneedling with SkinPen is suitable for most adults with skin texture, scarring, or quality concerns. It is well-tolerated across skin types including darker skin tones, which is a relevant consideration as RF and laser treatments carry a higher risk of post-inflammatory hyperpigmentation in Fitzpatrick types IV to VI.

Generally suitable:

• Adults with acne scarring, enlarged pores, or uneven skin texture.
• Patients with fine lines associated with skin quality decline.
• Skin types IV to VI where laser treatments carry higher PIH risk.
• Adults seeking general skin quality improvement as part of a broader programme.

Not suitable or requires careful assessment:

• Active acne breakouts in the treatment area. Needling active lesions risks bacterial spread. Acne should be managed before beginning a microneedling course.
• Active rosacea flares. Microneedling can exacerbate active inflammation. Rosacea patients are assessed at consultation; treatment between flares is often possible.
• Pregnancy and breastfeeding.
• History of keloid or hypertrophic scarring. The wound-healing response that microneedling relies on may produce excessive scar tissue in predisposed patients.
• Blood-thinning medications: increased bruising risk; disclose at consultation.
• Patients under 18: all cosmetic treatments at The London Road Clinic are for adults only, in line with UK age-restriction legislation introduced in October 2021.

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