Does microneedling hurt? What it feels like and how we numb

Microneedling causes mild discomfort rather than pain. A topical anesthetic cream is applied before treatment, and once it has taken effect most patients describe the sensation as pressure and vibration with some warmth [1]. Two factors determine how much is felt: the needle depth selected for your concern, and the area being treated. The most noticeable discomfort usually comes afterward, when the skin feels sunburned for 24 to 48 hours.

What to expect at each stage

Discomfort should lessen each day, not increase. Contact our office if the area bleeds for more than 24 hours, blisters, or is still swollen after a week [1], or if a cold sore appears, which the treatment can trigger in people who get them [4].

How needle depth affects discomfort

Medical microneedling devices use needles of approximately 0.5 to 2 millimeters, and the depth is selected for the indication [1]. Fine lines and surface texture are treated at shallow settings, where the procedure is nearly painless; atrophic acne scars require deeper settings, and discomfort increases with depth [3]. Deeper passes produce pinpoint bleeding, which is the intended clinical endpoint: it indicates the needles have reached the dermal layer where new collagen forms [3]. The thinner skin around the eyes and mouth is treated at a shallower depth than the cheeks, and the provider reduces pressure over bony prominences, which both limits discomfort and prevents track-mark scarring [3].

The device also affects comfort. The motorized pen devices the FDA has cleared for acne scars and wrinkles drive the needles vertically, and they are reported to be less painful than the earlier hand rollers, which pulled needles through the skin at an angle [3][4]. Our guide to how microneedling works describes what the micro channels do after the session.

How the skin is numbed

Topical anesthesia. After cleansing, a lidocaine-based anesthetic cream is applied to the entire treatment area and left in place for 30 to 45 minutes before treatment begins [1]. Published dermatology protocols use the same approach, a eutectic lidocaine mixture applied for up to an hour [3]. The application time is what determines comfort during the session: a thin layer or a shortened wait leaves the deeper skin less anesthetized. Topical anesthetic blocks sharp pain but not pressure or vibration, so the movement of the device remains perceptible even when the skin is fully numb.

Allergies and medications. Any previous reaction to a local anesthetic should be reported at the consultation so an alternative can be planned [4]. Aspirin, ibuprofen and other medications that thin the blood increase bruising and pinpoint bleeding, so they should not be taken beforehand to reduce discomfort; the topical anesthetic is sufficient, and your provider can advise on acetaminophen for use after treatment.

After treatment. Because the anesthetic is topical and no sedation is used, you can drive yourself home. The micro channels remain open for a period and increase the absorption of anything applied to the skin, so products from your usual routine can sting on treated skin [4]. Use only the products your provider recommends for the first 24 hours.

When treatment is postponed

Inflamed skin is more sensitive and heals less predictably, so certain conditions require rescheduling. Sunburn or a recent tan, active acne, a cold sore or any infection in the treatment area postpones the session until it has resolved [2]. Patients who have taken isotretinoin must wait at least one month after the last dose [2]. Bleeding disorders, anticoagulant therapy, a compromised immune system, eczema or psoriasis in the treatment area, and a history of keloid scarring do not necessarily exclude microneedling, but they change the treatment plan and must be disclosed at intake [1][4].

Does it get easier over a course?

Usually, yes. Most treatment plans at our Cincinnati office consist of three to six sessions spaced approximately four to six weeks apart, with each session's result developing over four to six weeks as collagen forms. By the second session patients know what the sensation is and how quickly the post-treatment redness resolves, which reduces anticipation. Published guidance places typical spacing at three to eight weeks, with new collagen continuing to form for three to six months after a course, so the discomfort is brief while the result develops gradually [1][3].

Sources

• [1] Cleveland Clinic. Microneedling: What It Is, Uses, Benefits and Results. https://my.clevelandclinic.org/health/treatments/23113-microneedling
• [2] American Academy of Dermatology. Microneedling can fade scars, uneven skin tone, and more. https://www.aad.org/public/cosmetic/scars-stretch-marks/microneedling-fade-scars
• [3] Singh A, Yadav S. Microneedling: Advances and widening horizons. Indian Dermatology Online Journal, 2016;7(4):244-254. https://doi.org/10.4103/2229-5178.185468
• [4] U.S. Food and Drug Administration. Microneedling Devices: Getting to the Point on Benefits, Risks and Safety. Content current as of 10/15/2025. https://www.fda.gov/consumers/consumer-updates/microneedling-devices-getting-point-benefits-risks-and-safety
• [5] U.S. Food and Drug Administration. Microneedling Devices, including the October 15, 2025 safety communication on radiofrequency microneedling. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/microneedling-devices