Microneedling has been around since 1995, when it was first documented as a medical technique for treating depressed scars and wrinkles. Over the past three decades, it has evolved from a rudimentary needle-based procedure into a widely used skin rejuvenation treatment performed in dermatology offices worldwide.
The First Clinical Use in 1995
The earliest documented form of microneedling appeared in 1995, when dermatologists Desmond Orentreich and Norman Orentreich published a technique called subcision. The method used a fine needle inserted beneath the skin to release depressed scars and wrinkles from their attachment to deeper tissue. It was a simple concept: controlled, small-scale injury to the skin could trigger a healing response that improved the surface appearance. Their paper, published in Dermatologic Surgery, laid the groundwork for everything that followed.
Desmond Fernandes and the First Roller Device
The technique took a major leap forward in 1997, when South African plastic surgeon Desmond Fernandes began experimenting with needling entire areas of skin rather than targeting individual scars. After attending a conference for the International Society of Aesthetic Plastic Surgery, Fernandes started treating patients with a standard tattoo device to stimulate collagen production across broader surfaces. He eventually designed a dedicated roller with 3 mm needles, along with a stamper and a “rocker” device, which he submitted for patenting.
His early results were promising but required persistence. Fernandes found that a single treatment wasn’t enough. After three sessions over two months on his initial patients, he saw meaningful improvement. He expanded to treating photoaging, acne scars, and even burn patients, though the process was slow and caused significant inflammation. The critical finding came from biopsies of treated skin: there was no evidence of scarring from the needling itself. The skin was regenerating rather than forming scar tissue, which gave Fernandes confidence to refine the approach further.
This is also when the formal name entered the medical literature. The term “percutaneous collagen induction therapy” was coined in 1997 to describe the principle behind the treatment: creating tiny, controlled punctures in the skin to trigger new collagen production.
Early Research Confirmed It Worked
For the first several years, microneedling’s evidence base was mostly clinical observation and case reports. That changed in 2005, when German scientists Schwarz and Laaff published a double-blind study measuring what actually happened beneath the skin after needling. Using a roller with 1.5 mm needles, they found that treated skin produced new layers of type III collagen, the same variety found in young, healthy skin. The average increase was 206%, with some individual cases reaching up to 1,000%.
The same researchers later examined skin samples from ten patients with post-traumatic and acne scarring. They found significant increases in elastin, collagen fibers, and overall skin thickness, with deeper needle penetration producing more pronounced changes. These studies moved microneedling from a promising idea to a procedure with measurable, reproducible biological effects.
From Manual Rollers to Automated Pens
The original dermaroller was a drum-shaped cylinder covered in tiny needles that practitioners rolled across the skin. It worked, but it had limitations. Needle depth was fixed, the rolling motion could bend needles at an angle rather than puncturing straight down, and treating curved areas of the face evenly was difficult.
In the early 2010s, automated microneedling pens like the Dermapen began replacing manual rollers in clinical settings. These electric devices moved needles straight in and out at high speed, offered adjustable depth settings, and allowed practitioners to treat small or contoured areas with more precision. The shift to pens made treatments faster, reduced the risk of uneven results, and gave clinicians more control over how aggressively they treated different areas of the face.
FDA Clearance and Mainstream Adoption
For years, microneedling devices existed in a regulatory gray area. Rollers and pens were widely available, but none had gone through formal review by the U.S. Food and Drug Administration. That changed in 2018, when the SkinPen Precision System became the first microneedling device to receive FDA clearance through the de novo classification pathway, which is reserved for novel devices without an existing regulatory category. The FDA classified it as a Class II medical device for aesthetic use.
That clearance was significant because it established microneedling as a distinct, recognized device category with safety and performance standards. It also drew a clearer line between professional-grade devices and the flood of consumer-grade dermarollers being sold online, many with no regulatory oversight at all.
Where It Stands Now
In roughly 30 years, microneedling went from a single published technique for releasing scar tissue to one of the most commonly performed cosmetic procedures in dermatology. The global market for radiofrequency microneedling alone, a newer variation that combines needling with heat energy, is projected to grow from $470 million in 2026 to $830 million by 2033. That doesn’t include standard microneedling devices, at-home rollers, or the broader ecosystem of serums and aftercare products designed to complement treatments.
The core principle hasn’t changed since 1995: tiny, controlled injuries prompt the skin to rebuild itself with fresh collagen and elastin. What has changed is the precision of the tools, the depth of scientific evidence supporting the technique, and the sheer number of people using it for everything from fine lines and acne scars to stretch marks and uneven skin texture.