Microneedling has become one of the most misunderstood practices in modern skincare. Somewhere along the way, it was reduced to a buzzword associated with redness, pain, and dramatic “before and after” photos. That version of microneedling is not what I practice and it’s not what I believe in.

My approach is grounded in physiology, not trends.

This philosophy is informed by The Concise Guide to Dermal Needling by Dr. Lance Setterfield, M.D., a foundational medical text that reframes microneedling as a tool for cellular communication and regenerative skin health, not controlled damage.

1. Skin Health Comes Before Skin Correction

At Olive Younger, we believe that healthy skin will always look its best.

Healthy skin is not defined by how aggressively it has been treated. It is defined by:

• A strong epidermal barrier
• Balanced cell function
• Even pigmentation
• Resilience and hydration
• An intact dermal-epidermal junction

Dr. Setterfield emphasizes that when skin is healthy, appearance improves naturally — without thinning, trauma, or long-term compromise. Microneedling, when done correctly, supports all of these goals simultaneously.

2. I Do Not Chase Inflammation

One of the most important distinctions in Dr. Setterfield’s work is between regenerative healing and fibrotic (scar-based) healing.

Prolonged inflammation:

• Degrades growth factors
• Encourages fibrosis
• Disrupts melanocytes
• Weakens long-term skin integrity

If inflammation is the goal, the biology has already been misunderstood.

Shallow, cosmetic microneedling stimulates signaling pathways without triggering a prolonged inflammatory cascade, allowing skin to remain in a balanced repair state rather than a chronic wound state.

3. The Epidermis Is Not Disposable

Many aesthetic treatments sacrifice the epidermis to access the dermis. Dr. Setterfield strongly challenges this approach, emphasizing the critical role of keratinocytes.

Keratinocytes:

• Release epidermal growth factors (EGF)
• Regulate melanocyte behavior
• Coordinate fibroblast activity
• Maintain barrier function

When the epidermis is preserved and gently stimulated — rather than destroyed — results are more natural, more stable, and more sustainable over time.

This is a key reason I favor frequent, low-depth microneedling over aggressive, infrequent treatments.

4. Frequency Matters — But Depth Matters More

Not all microneedling is the same.

Dr. Setterfield clearly distinguishes cosmetic microneedling from medical microneedling.

Cosmetic microneedling:

• Is non-ablative
• Operates at shallow depths
• Preserves epidermal integrity
• Supports normal maintenance and repair

When depth is appropriate and inflammation is minimized, frequency becomes a feature, not a risk.

5. My Personal Microneedling Practice (Cosmetic Only)

For transparency, I want to share how I personally practice cosmetic microneedling.

• I use a Dr. Pen device for cosmetic microneedling.
• I alternate between a 36-pin cartridge and a nano cartridge, depending on skin condition and tolerance.

In terms of depth:

• 0.25 mm around the eyes, where skin is thinner and more delicate
• 0.3 mm on the rest of my face and neck

These depths remain firmly within cosmetic microneedling, designed to stimulate the epidermis and dermal-epidermal junction without creating ablative injury or prolonged inflammation.

This reflects Dr. Setterfield’s emphasis on preserving epidermal integrity while enhancing cellular signaling — not forcing deeper injury for short-term results.

6. Why Microneedling Enhances Skincare Absorption

One of the most compelling and often overlooked benefits of cosmetic microneedling is its impact on topical absorption.

Dr. Setterfield notes that microneedling can increase skin care absorption by up to 90%, making it uniquely effective for delivering medically appropriate, barrier-compatible ingredients.

This matters because skin rejuvenation is not just about stimulation, it’s about providing cells with the building blocks they need to respond properly.

Microneedling does both:

• It signals the skin what to do, and
• It improves delivery of what the skin needs to do it

7. What Are Ablative Treatments and Why I Avoid Them

In dermatology, ablative treatments are procedures that intentionally destroy or remove layers of skin to trigger a wound-healing response.

Examples include:

• Deep chemical peels
• Laser resurfacing
• Aggressive energy-based devices
• Treatments relying on heat or chemical destruction

Dr. Setterfield is highly critical of ablative approaches because they:

• Thin the epidermis
• Damage keratinocytes
• Disrupt the dermal-epidermal junction
• Inactivate essential growth factors
• Promote fibrotic (scar-based) healing rather than regenerative healing

Heat-based and chemical injury increase inflammatory mediators associated with abnormal collagen formation, which explains why aggressively treated skin can look tight initially, but deteriorate over time.

In contrast, microneedling is a non-ablative mechanical stimulus that:

• Preserves epidermal integrity
• Minimizes inflammation
• Encourages embryo-like regenerative healing
• Produces structurally normal collagen

This distinction is foundational to my philosophy and why I deliberately avoid ablative approaches.

Final Thought

I don’t microneedle to damage my skin. I microneedle to communicate with it.

When done gently, thoughtfully, and consistently, microneedling becomes less of a treatment and more of a partnership with your skin’s natural intelligence.