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Difference’s in Needle Size and their Effects on Skin Needling

October 16, 2021

Advice By Dr.Lance Setterfield

Renowned as a world authority for the use and benefits of dermal needling, Dr. Setterfield has traveled globally sharing his extensive knowledge. His training is purely scientific and educational as he is not linked to any needling devices or skincare companies. However, he has written an amazing manual and delivers an online training course, which is proving very popular, as with COVID-19 travel and face-to-face training has been severely hindered.

APAN is honoured to be the official organisation hosting his training program which is available on our website (see link) as well as stocking his latest manual The Concise Guide to Dermal Needling – Third Medical Edition – Revised and Expanded. 

A few weeks ago, we ran out of these manuals, however, Dr. Setterfield has forwarded a couple of boxes, so they are now back in stock.  If you would like to purchase one you can access it here however, they are moving fast, and we currently only have 14 remaining. The manual covers detailed information, protocols, and modalities for treating various skin conditions, risks to avoid, and contraindication.  It really is a must for anyone who wants to excel in this modality. 


When working with the various needle depths, it is important to understand their differences and how they impact the skin.  Here is a brief explanation:

  • Cosmetic rollers:  These are considered (0.2 and 0.3mm).  The create micro-injury to the epidermis and stimulate keratinocytes to release growth factors and promote upregulation of epidermal growth factors (and many other growth factors and cytokines).  Within this range of needles, rollers can be safely used by patients and trained aestheticians.
  • Medical rollers: These are considered (0.5-3.00mm). This depth trigger wound healing cascade to stimulate keratinocytes and fibroblasts with resulting upregulation of TGF-Beta3 and increased epidermal cell turnover, collagen, elastin and GAGs. This size of roller is used by appropriately training and qualified technicians, nurses and doctors. 


Cosmetic needling achieves results through increased quantities and access of cell nutrients to the skin, thus optimising cell function.  In addition, injury to the keratinocytes promotes epidermal growth factors (EGF) and increases cell turnover. The cosmetic roller and other home devices use very fine stainless-steel needles to make channels into the epidermis. This allows up to 80% more product into the skin (compared to just 7-10% with normal topical application), providing essential cell nutrients for stimulating your own collagen naturally. (Using 0.3mm results in eightfold increase flux with hydrophilic substances and 0.2 mm fourfold).

Needing, or any other treatment modalities for that matter, will always deliver inferior results if not combined with the building blocks of topical nutrients with which the cells can work.

Effects of the Epidermis

The epidermis is influenced by cosmetic needling in the following way:

  • Micro-injury in the keratinocytes leads to release of several growth factors, such as epidermal growth factor, which causes epidermal thickening and upregulation of cell function.
  • Cellular crosstalk between the healthy keratinocytes and melanocytes, that result from dermal needling, is improved, which leads to better distribution of melanin pigment.
  • It increases the delivery of the right ingredients to the depth of the keratinocytes and melanocytes.

Effects on the Dermis

The dermis is influenced by cosmetic needling in the following way:

  •  By increasing the delivery of the right ingredients to the depth of the fibroblasts. Fibroblasts, (cells that play a role in keeping skin young), require nutrients, including vitamins A and C to make collagen and elastin.  Modern skincare is not just about the right ingredients, but also about delivering those ingredients to the depth of the fibroblasts, where they do the most good.  The skin’s natural hydrophobic barrier hinders the penetration of skincare products, especially those that are water-based, e.g. most vitamin C products.
  • By cellular signalling from the keratinocytes, through various growth factors and other molecules, which govern fibroblast response.

MEDICAL NEEDLING: How does it Work?

The medical devices use very fine, surgical stainless-steel needles to make channels into the epidermis and dermis to release growth factors that promote scarless healing and the deposition of normal woven collagen rather than scar collagen.

This is not dissimilar to Fraxel, only without the negatives of loss of dermal papillae, the potential destruction of melanocytes, abnormal scar collagen, coagulated vasculature, and growth factors.  (From a business perspective, it also does not have the exorbitant initial cost outlay.)  Granted, there are some things that dermal needling cannot achieve, such as removal of telangiectasia and so the combination will need to be included. 

Further information is available from The Concise Guide to Dermal Needling – Third Medical Edition – Revised and Expanded

Click here to find out more

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