What is skin needling?

Skin needling, also known as micro-needling therapy, or collagen induction therapy (CIT), is a minimally invasive skin-rejuvenation procedure that involves pricking the blood vessels under the outer layer of the skin by using a device that contains fine needles.

The needles are used to puncture the skin, creating a controlled skin injury. The procedure causes bleeding, releasing platelets (responsible for the regeneration of tissue and the build-up of collagen and elastin.) Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin. As a result, there is a significant improvement in skin texture, firmness, stretch marks and pigmentation.

The earliest theories behind skin needling started with tattooing in the early 1990s. Tattoo guns were used without ink to treat surgical scars. Using these advancements, Dr Des Fernandes, invented and pioneered the first-ever skin-needling roller for treating wrinkles, introducing a stunned world at the International Society of Aesthetic Plastic Surgery (ISAPS) Congress in Taipei in 1996.

Identifying that tattoo needles were not deep enough, in some cases, the needle holes were too close together, he developed a roller fitted with 3mm-long needles to penetrate the skin safely and effectively. Since this invention, the practice of skin needling has grown dramatically with skin clinics offering the procedure and at-home devices gaining prominence in the market. There have been many others who have tried to replicate his devices, worldwide, however, Dr Des continues to be at the forefront of this skin treatment.

Skin needling is not without its critics, but Dr Des ensures that the procedure is not dangerous and its techniques have become internationally recognised as the safest, MOST EFFECTIVE way of treating lax skin, wrinkles, scars and stretch marks. What are the different types of Environ® Skin Needling and how are they different?

There are THREE different types of skin needling:

Cosmetic Needling

(can be done daily)

Needles range between 0.1mm and 0.2mm in length; the instrument is purely to help cause tiny holes in the skin that enhance the penetration of active ingredients into the skin. In fact, it allows active ingredients deeper into the skin – cells function better and increase collagen production. Many people get confused and think that it is the trauma of the cosmetic needler that induces collagen due to mild injury, which is incorrect. It is a procedure that does not involve any pain, blood or the need for topical anaesthetic cream.

Medical Needling

(a minimum of 6 sessions recommended)

Needles on the Medical Rollers range between 1mm and 1.5mm long. These needles penetrate the papillary dermis and cause bleeding and discomfort, therefore the skin needs to be anesthetized with an effective topical anaesthetic. The skin bleeds due to a minor injury when you do a number of passes over the same area, changing direction each time after lifting the roller off the skin. Once the area that is being needled bleeds it will eventually stop due to the platelets in the blood. The platelets cause the blood to clot, releasing growth factors in the skin that lead to the stimulation of healthy new collagen being laid down. The whole process of creating this mild injury is to trick the skin into healing itself. The more you needle, the better the results.

Surgical Needling

Needles on Surgical Rollers are 3mm long, therefore, penetrating the skin into the regular dermis, going a lot deeper than the medical needler. The downtime after this procedure is about 5-7 days; the skin is a lot redder, bruised and sensitive. Unfortunately, this procedure needs to be done by a medical doctor using a general anaesthetic or a twilight sedative where there is also access to resuscitation equipment. Surgical needling is recommended mainly for severe acne scarring, burn scars and skin grafts.

Skin Needling from Environ’s point of view – Dr Des Fernandes


Watch the pioneer himself, Dr Fernandes talking to Skin Health Canada on the
benefits of Medical Skin Needling:

“Skin needling will do more for your skin than any kind of peel or any kind of laser because it will instigate the regeneration of new tissue. The instigation of collagen from a fractionated laser is from the death of tissue, whereas with Environ skin needling, you get regeneration through the release of platelets from the bleeding. There is no tissue destruction, hence there is no finite number of treatments of skin needling and you cannot detect any scarring. There is much more collagen disposition and more elastin. It is the disposition of elastin that seals the fact that this is regeneration and not simple collagen formation because no other treatment described so far has stimulated the production of elastin.” – Dr Des Fernandes

 Watch the Full Interview

Q: The idea of a doctor deliberately causing bleeding seems to be counter-intuitive to the concept of medicine and healing, and yet CIT begins with bleeding. How do you explain that?

A: “It certainly does seem strange to expect that pricking the skin to cause bleeding results in scarless healing. However, we have long known that pinpricks, even from thick needles do not leave scars. Our other experience of needling has been the art of tattooing. Tattoos do not create scars, but they do create thicker healthier skin. I believe this is because the body’s natural response to the tiny trauma is to release growth factors in order to start the healing process.

Needling is a strange injury because there is no open wound and no exposure to high levels of oxygen etc. I believe that is why there is an important difference in TGF-beta growth factors. One of the most common misunderstandings about Collagen Induction Therapy (CIT) is that you can just needle the skin without making it bleed and expect to see dramatic results. This is simply not true. Without the release of platelets, there can be no release of growth factors and the collagen and elastin will not be stimulated to grow. Consequently, there will be no increase in the thickness of the epidermis.”

Dr Des Fernandes