Does Microneedling Hurt?
Medically reviewed by
Brian V. Heil, MD, FACS, board certified plastic surgeon
Published November 12, 2026 · Updated
A little. Numbing cream is typically applied first to help reduce pain, and with it on, a RejuvaPen session feels a bit like sandpaper passing over the skin, with scarred areas more sensitive. How much you feel changes with needle depth, since pain increases as the needles go deeper.
Why do you feel microneedling at all?
The needles make controlled micro-injuries. In one review’s words, needle penetration induces a wound healing cascade with minimal damage to the epidermis, and the AAD says microneedling works by stimulating your body to make collagen. Longer needles reach deeper layers that have living cells, nerves, and blood vessels.
A 2021 systematic review found that with every device, procedural pain appears, and redness and swelling are nearly universal, varying in severity and duration. One review describes uniform pinpoint bleeding as the standard endpoint of a session. For what that collagen response does for your skin, see all the things microneedling can do for you.
What makes microneedling hurt more or less?
| Variable | Which way it moves the feeling | Source |
|---|---|---|
| Needle depth | Deeper needles hurt more | Pain increases as needle depth increases, and longer needles reach layers with nerves. On some motorized devices, the practitioner can adjust and control the depth and speed of the needles. |
| Topical numbing and how long it stays on | Numbing first lowers the pain | Most studies apply topical lidocaine before treatment to ease the pain, and one review describes leaving it on for 45 minutes to 1 hour. |
| Device type | A pen hurts more often than a roller | Pain was more likely with the pen than the roller in a 2021 systematic review. |
| Sunburn, infection or breakouts | Treatment waits until it clears | The AAD says to wait until a tan, sunburn, infection, or pimples have cleared, and the FDA lists an active skin infection or cold sore outbreak as reasons it may not suit you. |
How is a session kept comfortable?
RejuvaPen uses a pen holding a cartridge of nine very small needles, and we apply a topical numbing cream first to minimize discomfort. The treatment feels a bit like sandpaper passing over the skin. Scarred areas can be more sensitive, so parts of the session can be less comfortable than the rest. See how a RejuvaPen microneedling session works for the full treatment.
Afterward, discomfort is generally gone, though the area is likely to be sensitive. Your skin will be very red that day and the next, and the redness is typically gone in 48 hours. We recommend two days of downtime out of the sun, and mild, gentle products with sunscreen. We also offer fractional RF microneedling, a separate treatment with its own page.
What is normal afterwards, and when should you call?
Normal: redness, a sunburn-like tightness and mild swelling, which one review describes as slight redness and swelling lasting 2 to 3 days. The FDA says bleeding, bruising, redness, tightness, itching and peeling typically go away without any treatment after a few days or weeks.
Not normal: signs of infection, a change in skin color, or a cold sore flare. The FDA regulates microneedling devices for aesthetic use as Class II devices and lists pigmentation changes, reactivation of herpes cold sores and infection among their less common side effects. After RF microneedling, the FDA is aware of reports of serious complications, including burns, scarring, fat loss, disfigurement and nerve damage. Over-the-counter numbing creams carry a risk of their own: the FDA warns against applying over-the-counter lidocaine products heavily over large areas of skin or to irritated or broken skin, which may cause serious injury.
If anything on the not-normal list appears, call our Upper St. Clair office at (412) 835-5544. More skin questions are on the Acqua Blu blog.
Frequently asked questions
How long does numbing cream need before microneedling?
One published review describes the standard procedure as leaving topical anesthetic on the skin for 45 minutes to 1 hour before treatment. Your provider sets the timing for your own visit.
Does RF microneedling hurt more than regular microneedling?
Not by much, in the small studies available. A 2021 systematic review describes the pain of RF microneedling as mild and similar to that of a rolling microneedling device: two small studies it includes report average pain scores of 5.56 out of 10 for RF microneedling and 5.4 for the roller.
Does at-home microneedling hurt less?
Home devices go shallower, and depth drives the feeling. One review lists home-care rollers with needles shorter than 0.15 mm and says the perception of pain increases as needles go deeper. The AAD adds that at-home microneedling products aren’t meant to puncture the skin, and the FDA has not authorized any microneedling medical device for over-the-counter sale.
Why does skin feel sunburned after microneedling?
The needles leave many tiny wounds, and the skin’s healing response follows. The AAD says treated skin may feel like it’s sunburned, with minor discomfort, burning or swelling, and that these reactions usually disappear in a few days to a week.
To book, start with RejuvaPen microneedling, and see what microneedling costs.
Sources
- 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
- US Food and Drug Administration. Microneedling Devices: Getting to the Point on Benefits, Risks and Safety. Consumer Update. https://www.fda.gov/consumers/consumer-updates/microneedling-devices-getting-point-benefits-risks-and-safety
- US Food and Drug Administration. Microneedling Devices. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/microneedling-devices
- 21 CFR 878.4430, Microneedling device for aesthetic use. Electronic Code of Federal Regulations. https://www.ecfr.gov/current/title-21/chapter-I/subchapter-H/part-878/subpart-E/section-878.4430
- US Food and Drug Administration. Potential Risks with Certain Uses of Radiofrequency (RF) Microneedling: FDA Safety Communication. 2025. https://www.fda.gov/medical-devices/safety-communications/potential-risks-certain-uses-radiofrequency-rf-microneedling-fda-safety-communication
- US Food and Drug Administration. FDA Warns Consumers to Avoid Certain Topical Pain Relief Products Due to Potential for Dangerous Health Effects. 2024. https://www.fda.gov/news-events/press-announcements/fda-warns-consumers-avoid-certain-topical-pain-relief-products-due-potential-dangerous-health
- Singh A, Yadav S. Microneedling: Advances and widening horizons. Indian Dermatol Online J. 2016;7(4):244-254. https://pmc.ncbi.nlm.nih.gov/articles/PMC4976400/
- Gowda A, Healey B, Ezaldein H, Merati M. A Systematic Review Examining the Potential Adverse Effects of Microneedling. J Clin Aesthet Dermatol. 2021;14(1):45-54. https://pmc.ncbi.nlm.nih.gov/articles/PMC7869810/
- Iriarte C, Awosika O, Rengifo-Pardo M, Ehrlich A. Review of applications of microneedling in dermatology. Clin Cosmet Investig Dermatol. 2017;10:289-298. https://pmc.ncbi.nlm.nih.gov/articles/PMC5556180/
Treatments at Acqua Blu Medical Spa in Upper St. Clair are provided under the direction of Brian V. Heil, MD, FACS, the practice’s founder and medical director. A consultation is the best way to find out what fits your skin and your goals.
This is general information, not medical advice. Candidacy and treatment parameters are determined by a licensed provider at a consultation.
