After treatment and risks

Day of treatment

The face is cleaned and numbed. Pin-point bleeding is expected. Redness and swelling follow.[1][2]

Days 1 to 3

In the SkinPen trial, redness, itching, peeling, discomfort and tenderness affected 31% and lasted 1 to 3 days. Burning affected 9%.[1]

Days 1 to 7

Dryness affected 12% for 1 to 6 days. Most reported side effects in the literature resolve within 7 days.[1][2]

First 2 weeks

The FDA lists a tan or planned sun exposure in the 2 weeks after treatment as a reason to avoid the procedure. In the SkinPen trial, one subject developed lines on the face after sun exposure against instructions.[1][2]

Weeks 3 to 8

The next session follows 3 to 8 weeks later. In the 120-patient scar series, patients had 1 to 6 monthly treatments.[1][2]

3 to 6 months

New collagen keeps forming for about 3 to 6 months after the last session. No adverse events persisted at 6 months in the SkinPen trial.[1][2]

Redness, dryness and peeling

The most common effects. In the SkinPen trial: redness group 31%, dryness 12%, burning 9%, rough skin 7%, tightness 4%, all short-lived.[1][2]

Pigment change

Darkening or lightening of skin is listed as less common by the FDA. A meta-analysis of 12 trials found less post-inflammatory hyperpigmentation with microneedling than with comparison treatments.[1][2][3]

Infection and cold sores

The FDA lists infection and reactivation of herpes cold sores. Reusing a needle cartridge is unsafe, even if cleaned.[1]

Bloodborne infection

Five HIV diagnoses from 2018 to 2023 were linked to PRP microneedling facials at an unlicensed New Mexico spa that did not follow infection control.[1]

Granulomas

A systematic review found 15 patients with granulomatous inflammation after microneedling. Motorized pens and topical vitamin C were involved in most cases. Some cases resisted treatment.[1]

Tram-track scarring

Tram-track scarring after microneedling of acne scars appears in isolated reports and is listed among persistent adverse effects.[1][2][3]

Burns, fat loss and nerve damage with RF

The FDA warned in October 2025 of burns, scarring, fat loss, disfigurement and nerve damage with RF microneedling. A MAUDE review found 224 events in 114 reports from 2013 to 2025.[1][2][3]