At-home microneedling

Overview

At-home microneedling devices are increasingly promoted for acne scars, anti-aging, hyperpigmentation, hair growth, and “glass skin.” (1)

Devices are widely available online, including through Amazon, Temu, Shein, TikTok Shop, and international gray market sellers. Certain electronic microneedling pens, including “Dr. Pen” devices, are heavily marketed online despite lack of standardized oversight, authorized distribution, or consistent sterilization practices. (2)

Complications may be amplified when patients apply biologically active serums during or immediately after the procedure.

Commonly applied agents

Per a manual review of TikTok, patients may apply the following during or immediately after treatment:

• Hyaluronic acid (HA)

• Salmon sperm–derived products (PDRN)

• Growth factors

• Peptides

• “Stem cell” serums or conditioned media

• Exosomes

• Vitamin C

• Vitamin E oils

• Botanical oils and compounded serums

Many products are purchased through gray market websites with unknown sterility and ingredient composition.

Potential dermatologic complications

Foreign-body granulomas

Granulomatous reactions have been reported when nonsterile, non–single-use, or topical products are introduced into the dermis, particularly vitamin C serums, PDRN, moisturizers, oils, exosomes, growth factors, or other cosmeceuticals not intended for intradermal use. (3)

Infection

Bacterial infections and abscesses may occur. Risk factors include: (4)

• Nonsterile devices

• Reuse of cartridges or needles

• Contaminated serum bottles

• Poor aftercare

Post-inflammatory hyperpigmentation

Patients with skin of color may be particularly susceptible to dyspigmentation following aggressive or repetitive treatments. (4)

Barrier disruption

Excessive microneedling may worsen xerosis, erythema, sensitivity, burning, and chronic irritation. (4)

Scarring and mechanical injury

Excessive needle depth, dragging, dull needles, or aggressive treatment may increase risk of scarring. (4)

Allergic and irritant dermatitis

Fragrances, preservatives, botanicals, vitamin formulations, growth factor products, and nickel / other metals in microneedling devices may provoke dermatitis. (4)

Rosacea and periorificial dermatitis flares

Repeated barrier injury and occlusive post-care products may exacerbate inflammatory facial dermatoses. (4)

Important history questions

• Have you used a dermaroller or microneedling pen at home?

• What device was used?

• How often were treatments performed?

• What products were applied during or after treatment?

• Were products purchased online or internationally?

• Were needles reused?

• Was the device disinfected between treatments?

• What needle depth was used?

Patients may describe products as “glass skin serums,” “growth serums,” “stem cells,” or “Korean skin boosters.”

Counseling considerations

Dermatologists can counsel patients regarding:

• Risks of introducing nonsterile products into disrupted skin.

• Potential for granulomas, infection, and dyspigmentation.

• Importance of avoiding aggressive needle depths at home.

• Increased risk of complications in patients with melasma, rosacea, eczema, or acne-prone skin.

• Importance of using sterile, fragrance-free hyaluronic acid-based glide serums during treatment and appropriate aftercare (gentle cleanser, bland moisturizer, mineral sunscreen). Patients should avoid introducing highly active products into disrupted skin, including vitamin C, retinoids, exfoliating acids, oils, exosomes, growth factors, and “stem cell” serums.