What Microneedling Actually Is
Microneedling, or in professional Hebrew "treatment with tiny needles", is a protocol based on a medical principle called Collagen Induction Therapy, or CIT for short. That name is not marketing. It is an accurate description of what happens in the skin.
The device, a professional pen with a sterile cartridge holding between 9 and 36 tiny needles, moves across the skin and creates thousands of controlled microscopic channels. Penetration depth ranges from 0.5 mm for delicate areas such as around the eyes, up to 2.0 mm for work on scarring. The needles do not cut. They create a controlled, rapid injury that the body recognizes, which starts a natural healing pathway.
That healing pathway is the reason we do the treatment. It has three phases. The first, controlled inflammation, lasts 24 to 72 hours. The second, new tissue formation, lasts up to three weeks, during which the body produces collagen and growth factors at the puncture sites. The third, tissue remodeling, lasts up to six months, during which the new collagen organizes into higher-quality fibers.
This is why a genuine microneedling result becomes visible only after three to six sessions, and why the peak effect arrives months after the final treatment. If an aesthetician promises you a result in one treatment, she is not talking about microneedling. She is talking about a temporary effect of gentle swelling and hydration, which passes immediately.
The Difference Between a Home Dermaroller and Clinical Microneedling
This is the most important point in the whole article, and I want you to read it slowly. Before we discuss price, variations, or indications, you need to understand that the microneedling you buy on Amazon is not the same as the treatment you receive in a clinic. The two things carry the same name, but they are not the same treatment.
A home dermaroller is a small roller with needles 0.2 to 0.5 mm long. Its needles are usually no longer sterile after the first use, even if you cleaned them with alcohol. They bend after 4 to 6 uses and stop puncturing, tearing the skin layer instead. The depth they reach, if they reach at all, is not enough to trigger a real collagen-production pathway. What does happen: superficial irritation, improved penetration of topical serums, and sometimes infections that lead to post-acne marks and post-inflammatory pigmentation.
Clinical microneedling uses a motorized device, with sterile needles discarded after every client, at controlled depths matched to the facial area and the skin type, with a topical anesthetic, and with medical-grade serums that are not sold at a pharmacy or on Amazon. The difference is not only technical. It is clinical. A home dermaroller will, at best, do no harm. At worst, it will spread pigmentation, worsen scarring, and create new scars.
A home dermaroller is not a budget version of microneedling. It is an entirely different treatment, with different results and different risks.
If you are considering buying a home device in order to "save money", I would rather you save up and come for one clinical treatment every two months than buy a device that causes damage whose correction will cost significantly more.
The Five Variations I Work With
The term "microneedling" is an umbrella. Beneath it are several variations, each suited to a different concern, a different skin, and a different goal. Here are the five main ones.
Classic Microneedling
The basic version. Mechanical needles only, no heat, no active substances inside the needle. The goal: collagen production, texture improvement, reducing the appearance of pores, work on superficial acne scarring, and improvement of superficial pigmentation. In my clinic this is the first treatment I consider for skin aged 28 to 40, with no deep structural concerns.
Recovery: redness for 24 to 48 hours, mild dryness for 3 days. Course: 4 to 6 treatments at 4 to 6 week intervals. Maintenance: once or twice a year.
RF Microneedling
The most advanced clinical variation. The needles do not only create mechanical micro-wounds, they also deliver radiofrequency energy into the deep layers of the skin, at a depth of 1.5 to 3.5 mm. This heat produces two effects that classic microneedling cannot achieve. First, immediate contraction of the existing collagen fibers, which shows as a subtle lift the same day. Second, stimulation of higher-quality collagen production at greater depth.
Recovery: redness for 2 to 5 days, mild swelling on the first day. Course: 3 to 4 treatments at 6 to 8 week intervals. Suited to women from age 38 with signs of laxity, deeper acne scarring, and skin that needs structure and not only texture.
The deeper reading on the difference between the two is in a separate post of mine: Fractional RF or Microneedling: A Detailed Comparison.
Gold Microneedling
A variation on RF. Gold-coated needles, with an insulating coating along the shaft of the needle. It is the insulation that prevents heat from dispersing through the epidermis, while the gold allows efficient conduction and high biocompatibility. The result: energy concentrated in the dermis, with reduced impact on the upper layer.
This is my preferred variation for Fitzpatrick 4 to 6 skin, meaning skin that tans easily and rarely burns, through to darker skin, which has a high tendency toward post-inflammatory pigmentation. The classic RF variation can be problematic on such skin. Gold solves the problem.
Microneedling With Exosomes
The newest variation in the field, and one of the most interesting. Exosomes are tiny vesicles secreted by stem cells, containing growth factors, proteins, and active RNA. When they are applied to the skin immediately after microneedling, they penetrate through the channels that have been opened and reach a depth they would not otherwise reach.
The research on exosomes in skin is still young, but the clinical data show a significant improvement in the efficacy of the treatment, a reduction in recovery time, and an improvement in the quality of the new collagen that forms. In my practice this variation is recommended mainly for deep acne scarring, for chronic post-acne, and for women going through an intensive anti-aging protocol before a significant event.
Microneedling With Mesotherapy
Here the channels created by the needles serve as transdermal delivery routes for a cocktail of hyaluronic acid, vitamins, minerals and peptides. The actives absorb through the channels and are not injected into the tissue. The difference from exosomes is in the components. Mesotherapy is based on synthetic or natural active substances, not on stem cells. Less expensive, less aggressive, suited to thirsty skin that needs intensive refreshment but not a deep "renovation".
When It Is the Right Treatment
The areas in which microneedling shows marked improvement are broad, but there are four main indications where the treatment is usually the right choice.
Superficial to moderate acne scarring. The classic approach to acne scarring was for years a deep peel or a laser. Both are aggressive, long in recovery, and expensive. Microneedling, and especially the RF or exosome variation, may contribute to a gradual improvement in the appearance of scarring over time. Treatment depth for scarring generally ranges between 1.0 and 2.0 mm, and is set individually for each client according to skin type, scar depth, and the evaluation at the assessment appointment.
Superficial to moderate wrinkles. Expression lines around the eyes, around the mouth, on the neck. Microneedling stimulates collagen production in these areas and leads to a gradual improvement in texture and a reduction in the visibility of the lines. It does not replace injectables for deep wrinkles, but it is excellent as maintenance and for lines at an early stage.
Enlarged pores. The cause of enlarged pores is usually a loss of elasticity in the tissue around the pore. Microneedling, by stimulating collagen and elastin production, gradually reduces the size of the pores. A noticeable result from 2 to 3 treatments.
Loss of elasticity and firmness. Especially with the RF and gold variations. The jawline, the cheeks, and the neck. Here the treatment is not only about surface texture, but about the underlying structure of the skin. Result: a subtle lift, a gentle "V-shape effect", renewal of tissue quality.
When It Is Not Suitable
It matters to me to say this clearly. Microneedling is an excellent treatment, but it is not suitable for every woman and every situation. If you are in the following situations, the treatment is either not permitted or needs to be postponed.
Active cystic acne in the treatment area. Needles passing through an inflamed cyst spread the inflammation, worsen the condition of the skin, and create new scarring instead of helping the existing texture. In such a case we first balance the skin, and after significant relief in the active condition, microneedling can be considered.
Severe rosacea. Skin with active rosacea responds unpredictably to mechanical injury. The controlled heat and inflammation that microneedling creates may provoke an acute flare. In cases of mild, stable rosacea it is sometimes possible to work with gentle variations, but every case requires an individual assessment.
Active eczema or dermatitis in the area. The same principle. Inflamed skin cannot respond properly to a treatment that creates additional controlled inflammation.
Pregnancy or breastfeeding. Not because of a direct risk to the fetus, but because of hormonal changes that can make the skin unpredictable in its response, and raise the risk of reactive pigmentation. In my clinic I do not perform microneedling on a woman who is pregnant or breastfeeding.
Isotretinoin. If you are taking isotretinoin now, or stopped the course within the past six months, microneedling is not permitted. The medication affects the skin's healing capacity and significantly raises the risk of scarring after a mechanical procedure.
Active herpes in the facial area. Requires postponing the treatment until full recovery.
Coagulation disorders or anticoagulant therapy. Requires a physician's approval and sometimes an adjustment of the protocol.
Before, During, After: Step by Step
Two Weeks Before the Treatment
Stop using retinoids, strong acids, and peels. Keep to a daily SPF 50 sunscreen. Avoid direct tanning. If you have planned an event in the coming weeks that requires perfect skin, postpone the treatment. In my clinic nobody enters a protocol without a full health declaration and a review of medication history.
Treatment Day
Arrive with a clean face, no makeup. With me the treatment begins with a deep cleanse and neutralizing of the skin. Then a topical anesthetic cream is applied, and I let it work for 30 to 45 minutes. The treatment itself takes 30 to 60 minutes, depending on the areas and the variation. Immediately afterward, a soothing mask and an active serum are applied according to the protocol.
You leave the clinic with a red face, slightly swollen, and with clear instructions for the days ahead.
The First 48 Hours
Strong redness, a sensation of mild heat, dryness. Do not touch the face. No makeup. No sun. No strenuous exercise that raises sweating. No hot showers. Wash gently with lukewarm water and the mild product I provide.
Days 3 to 7
The redness subsides. There may be gentle flaking. Bring the basics back in: niacinamide, peptides, hyaluronic acid. Avoid any demanding active. SPF 50 protection is mandatory, indoors as well.
Two Weeks After
A gradual return to routine. Vitamin C in the morning, a hydrating mask in the evening. You can go back to light makeup. Still not permitted: retinoids, acids, peels, tanning.
One Month After
The next treatment in the course, if one is scheduled. We check the progress of the skin, adjust the protocol, and assess whether a change is needed.
Prices in Israel 2026
This is the point where I want to speak plainly. The microneedling market in Israel is wide open. The same treatment that costs ₪600 with one aesthetician can cost ₪2,000 with another. That gap is not always justified. And sometimes it makes perfect sense.
Here are the real ranges in the market, as of early 2026:
Classic microneedling: ₪800 to ₪1,500 for a single treatment. In a course of 6 treatments the average price drops to ₪600 to ₪1,000 per treatment. The least expensive variation, suited to young skin and to maintenance.
RF microneedling: ₪1,200 to ₪2,500 per treatment. The course usually shortens from 6 to 3 or 4 treatments, so the total investment for a course is similar to classic, or only slightly higher. A quality investment for skin from age 38.
Gold microneedling or microneedling with exosomes: ₪2,000 to ₪3,500 per treatment. The premium variations. Suited to specific cases such as deep acne scarring, or to clients looking for a maximal result in a short time frame.
Microneedling with mesotherapy (transdermal delivery): ₪1,000 to ₪1,800, depending on the cocktail and the number of areas.
What affects the price. The practitioner's experience. The level of the equipment (FDA-approved medical devices cost five times what cheap Chinese devices cost). The quality of the serums included. The size of the area treated. And what is not included in the treatment at cheaper practitioners: initial consultation, follow-up, home kit.
I always offer a 20-minute assessment before any course. With me the price includes the consultation, a basic home kit, and follow-up between treatments. To check whether the right protocol for you is microneedling at all or a different treatment, I recommend filling in my skin assessment.
How Many Treatments Are Needed
This is the first question I am asked, and it is the question with the least clear-cut answer. Here are my rules:
For general maintenance of young skin, 28 to 35: a course of 3 treatments at 6-week intervals, followed by a maintenance treatment once a year.
For skin 35 to 45 with early signs of aging: a course of 4 to 5 treatments at 4 to 6 week intervals, with 2 maintenance treatments a year.
For skin 45 and up with marked signs of aging: a course of 5 to 6 treatments at 6 to 8 week intervals (usually RF), with 2 to 3 maintenance treatments a year.
For acne scarring: 4 to 8 treatments at 4 to 6 week intervals. A meaningful result only after the third or fourth treatment, so patience is an absolute condition.
For superficial pigmentation: 3 to 4 treatments, usually combined with gentle chemical peels between the treatments.
The intervals derive from the time the skin needs in order to complete the healing phase and begin building new tissue, roughly 4 to 6 weeks. The collagen remodeling itself continues for months afterward. Treatments that are too frequent do not improve the result. They only break the skin barrier.
Frequently Asked Questions
Does it hurt?
With a topical anesthetic cream, the pain is very moderate. Most clients report a sensation of light pricking, gentle warmth in the RF areas, and no more than that. More sensitive areas such as the upper lip and the bony areas are somewhat more intense, but they are tolerable too. After the treatment there is no pain, only a sensation of heat and dryness that passes within 24 to 48 hours.
When will I see results?
A slight immediate improvement in skin tone and hydration is visible in the first week. A real result in texture and firmness begins to appear 4 to 6 weeks after the second treatment in the course. The peak effect arrives 3 to 6 months after the final treatment, once the collagen-building pathway has completed.
Is it safe on darker skin?
Classic microneedling is safe on Fitzpatrick 5 and 6 as well. The variations with heat (RF, gold) require extra caution, but the gold variation was developed specifically for darker skin, and insulating the epidermal layer from the heat is part of that protection. In any case, a prior assessment and an adapted protocol are a condition of safe treatment.
Is it suitable for me if I have Botox or hyaluronic acid injections?
Yes, but with the right timing. It is advisable to wait two weeks after Botox, and 3 to 4 weeks after a hyaluronic acid filler, before microneedling. The reverse is also true: the injections are done once the skin has recovered from the microneedling, usually 3 to 4 weeks afterward.
Can I have classic microneedling and a chemical peel in the same month?
Yes, if they are timed correctly. In my clinic the structure is usually a gentle peel in week 1, microneedling in week 3 or 4. The peel prepares the skin, the microneedling deepens the effect. But it has to be timed by a practitioner who knows what she is doing.
When to Come to Me
- You are considering microneedling and are not sure which variation suits you
- You had microneedling at another clinic and the result fell short of what you expected
- You have acne scarring and are looking for a long-term protocol
- You are 35 or older and want to invest in serious anti-aging
Not Suitable If
- You are taking isotretinoin or stopped taking it within the past six months
- You are pregnant or breastfeeding
- You have active cystic acne in the treatment area
- You are in a state of active rosacea or eczema
- You have active herpes in the facial area
- You have a history of keloid or hypertrophic scarring
- You take anticoagulants or antiplatelet medication, or you have a clotting disorder
- You have an active autoimmune condition or are on immunosuppressive therapy
- You have a pacemaker or an electronic implant (relevant to RF treatments)
- You have come back from a fresh tan within the past four weeks
- You are taking photosensitizing medication without your physician's approval
