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skin deeper when at a 90‐degree angle or perpendicular to the skin. Fernandes showed that with the use of rollers you have an intact epidermis with microchannels spaced out with about a four‐cell width distribution [4]. The provider’s technique with these devices is critical. Tearing of the epidermis may occur if performed incorrectly, with too much pressure, or at an increased speed. The needle rollers themselves are variable based on the materials used, needle length and diameter, and total number of needles. The quality of the rollers is also critical to evaluate.

      Source: marcinm111/Shutterstock.

      Source: Genesis Biosystems, Inc.

      Microneedling is safely used for enhanced drug delivery to the deeper epidermis and dermis by bypassing the stratum corneum. This strategy has been utilized for burn patients and for rejuvenation, allowing cosmeceuticals to be delivered more deeply. Caution is necessary in deciding which topicals to use during delivery, as inflammation may occur and granulomas have been noted.

      Microneedling is a popular treatment in dermatology and aesthetic medicine. Since the development of the first dermaroller over 20 years ago, a variety of new microneedling devices have been introduced. Accordingly, the applications of microneedling in dermatology and aesthetic medicine have expanded indications over the past several years.

      Evidence‐based treatment of the skin for a variety of indications have been shown to be safe on all skin types. Microneedling is an effective modality of treatment, especially in patients with Fitzpatrick’s IV and V skin types because it overcomes the side effects of scarring and hyperpigmentation resulting from other procedures in which the epidermis is compromised. It certainly promises to be a valuable technique with its numerous applications and its ever‐expanding modifications.

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