Microneedling: I’m Not Looking for the Reddest Skin

And this is where experience, knowledge and understanding of the skin really matter.

There is something I want to challenge when it comes to microneedling.

Somewhere along the way, the redness immediately after treatment has become almost a badge of honour.

The redder the skin, the deeper the treatment must have been.The more uncomfortable the treatment, the better the result must be.

I don't agree.

In fact, when I perform microneedling, I am absolutely not looking for the reddest skin I can create.

I'm looking for the right response from your skin.

Microneedling is about controlled stimulation — not trauma

Microneedling works by creating tiny, controlled microchannels within the skin.

These micro-injuries communicate with the skin's natural repair mechanisms, stimulating a healing response involving processes such as collagen and elastin production, cellular activity and tissue remodelling.

That is where the magic happens.

But there is a very important distinction between controlled stimulation and simply creating as much trauma as possible.

Your skin doesn't need to be beaten into submission to produce a healing response.

The skill is knowing how much stimulation your individual skin needs.

And that is where treatment becomes much more than simply moving a pen over someone's face.

Redness is a response — not a result

Of course, redness after microneedling can be completely normal.

The skin has been stimulated, so increased blood flow and inflammation are part of the body's response. Some people will naturally become much redder than others.

But redness alone does not tell me whether a treatment has been successful.

Two people can have the same treatment and have completely different levels of erythema afterwards.

One person may be naturally very reactive and become extremely red.

Another may have thicker, more resilient skin and show comparatively little redness.

The colour of the skin immediately after treatment is not a measurement of the quality of the treatment.

What matters is what happens beneath the surface — and, ultimately, what happens during the weeks and months that follow.

This is why I don't numb the skin simply to push harder

This is another area where I take a very different approach.

Microneedling can feel uncomfortable. It is a repetitive sensation — sometimes scratchy, warm or prickly — but it shouldn't be about inflicting unnecessary pain.

I also want you to be able to communicate with me throughout your treatment.

Your skin is giving me information.

I am watching it.

I'm feeling the way the device moves across the skin.

I'm observing the level of erythema, the condition of the tissue and how your skin is responding.

And I'm listening to you.

If the skin is telling me that something needs to change, I want to hear it.

Topical anaesthetics such as lidocaine work by numbing the nerves and reducing the sensation of pain. They are medicines and their use needs to be appropriate to the particular product, circumstances and practitioner.

There are absolutely situations in clinical microneedling where topical anaesthesia may be used — for example, NHS scar-treatment information describes anaesthetic cream being used before certain microneedling procedures.

But for the type of skin-health microneedling I provide, I don't believe that making the skin completely numb simply so I can work more aggressively is the definition of a better treatment.

Your skin is not a canvas I am trying to damage

This is perhaps the biggest difference in my approach.

After more than three decades working with skin, I don't look at a face and see an opportunity to simply "go deeper."

I look at the skin as a living organ.

I consider its condition, thickness, sensitivity, barrier function, pigmentation, vascular response, previous treatments, current skincare and what we are actually trying to achieve.

Because one depth does not suit every face.

One treatment does not suit every person.

And more is not automatically better.

Sometimes the cleverest treatment is the one where I deliberately don't push the skin as hard as I could.

That's not being cautious.

That's understanding skin.

What I am actually looking for

I'm looking for a controlled response.

I'm looking for healthy stimulation.

I'm looking at how your skin behaves during treatment — not just how dramatic it looks afterwards.

And I'm thinking about what happens after you leave my clinic.

Because the treatment doesn't finish when the microneedling pen is switched off.

That's when your skin's repair processes begin.

Over the following days and weeks, the skin moves through its natural healing and remodelling processes. The aim is to support that process rather than overwhelm it.

And that requires knowledge.

It requires understanding skin physiology.

It requires knowing when to stimulate, when to stop and when less is actually more.

So if you're choosing a microneedling therapist...

Don't just ask:

"How red will I be?"

Ask:

"Why are you choosing this depth for my skin?"

"What are you trying to achieve?"

"How are you assessing my skin?"

"What happens if my skin doesn't respond as expected?"

"What products are you putting onto my skin afterwards?"

And perhaps most importantly:

"Are you treating my skin — or are you trying to create a dramatic before-and-after moment?"

Because those are two very different things.

I don't microneedle for the photograph.

I microneedle for the skin.

For its health.

For its strength.

For its ability to repair and remodel.

For the long-term improvement we are working towards together.

And after all these years working with skin, that's what I believe good microneedling should be about.

Not the reddest skin.

Not the deepest treatment.

Not the most dramatic reaction.

Just intelligent, controlled treatment based on the skin sitting in front of me.

And that's exactly why your skin should never be treated by a protocol alone.

It should be treated by someone who understands skin.