Microneedling has become a popular treatment and many people view it as an alternative to fractional laser. In part, its popularity has to do with the much more affordable equipment and in part the results achieved. In this article we will look at the similarities and differences between microneedling and fractional laser.

The treatment objective for both microneedling and fractional laser is to create micro wounds. This will result in a cascade of biochemical processes following a trauma. Thus, it will start with the inflammatory stage, releasing growth factors. Following are the proliferative stage and then the remodelling stage. This leads to the stimulation of neocollagenesis and formation of a tighter collagen matrix, a younger looking skin.

With micro-needling you puncture the skin and then remove the needle again, causing micro-cuts. Whereas with fractional laser you cause coagulation and/or vaporization of a part of the surface you treat. This distinction is important to understand. With microneedling the body will respond by healing the micro-cuts and with fractional laser the body will build new tissue to fill up the ‘channels’ or ‘wells’ where you have destroyed the tissue.

As usual, it is more complex in reality because you have different needle types and depths. You can choose between needles with or without RF and with RF needles you have a difference between full needle RF and needle tip only RF.

With fractional laser you have different wavelengths that targets different molecules and therefore you can create more of a ‘channel’ where the tissue is destroyed, to be removed and replaced by the body if you use a shorter wavelength like 1550 nm. Or you can use an Er:YAG or CO2, where you mainly target water and will create a ‘well’ where the tissue is evaporated.

The laser treatment is by its nature more ‘aggressive’ than the microneedling treatment and will require longer recovery time. The main benefit of this is that a larger part of the skin will be replaced with new tissue compared to microneedling. In the long run the results from fractional laser will last longer than a comparable microneedling treatment. It is however possible in real life to encounter a skilled microneedling therapist that will provide far more superior results than a less competent laser therapist who works on superior equipment.

It also holds truth for both technologies that you can adjust to a less or more aggressive treatment depending on the client and the desired treatment outcome. Both microneedling and fractional laser have shown their worth when applied correctly.