Skin Needling & Numbing Cream: Why I Don't Use It

Skin needling (when performed correctly by a trained professional) can be an amazing treatment for acne, scarring, pigmentation, ageing, rosacea, and more. And while it's an incredibly effective treatment for long-term skin change, it can sometimes be uncomfortable. Clients often ask me if I use or recommend numbing cream before needling, and I completely understand why.

This is also a very hotly debated topic online right now among beauty industry professionals.

Here's why I don't use it, as a trained skin therapist with over a decade of industry experience, who understands skin anatomy and physiology. During skin needling (or microneedling) sessions, different needle depths are used depending on what's being treated, and the way your skin responds tells me exactly where in the skin I'm working. For example, all-over redness without bleeding may indicate working in the epidermis (the top layer of skin), whereas pinprick bleeding usually means I'm working within the dermis (middle layer of skin).

This is really important because everyone's skin varies in thickness depending on many different factors, and your skin's thickness may actually change from one appointment to the next. During treatments, I'm constantly adjusting needle depth based on how your skin is responding, so I know I'm always treating the area correctly so you get the best possible results. Numbing cream constricts blood vessels - this means that during your treatment, your skin doesn't have the same vascular response it usually would, and I'm therefore relying purely on guesswork to know which layer of skin I'm working on. This absolutely affects the results we're able to achieve. 

A lot of industry professionals argue online that because the vasoconstriction is only temporary, it doesn't affect results, and that's partly true.

Numbing cream doesn't majorly affect the skin's healing processes or the growth factors released during and after treatment - so if a salon or skin clinic is working with set needle depths (e.g. 1mm to treat ageing, .25mm to treat pigment etc) then no, the use of numbing cream won't necessarily change anything, because needle depth isn't changing throughout the treatment.

But by using those set needle depths and not adjusting based on how each individual client's skin is responding, you're not actually getting the best results anyway, because as mentioned above, everyone's skin is a different thickness and your practitioner may not actually be treating the layer of skin they need to, to achieve the result that you want. There's another reason I don't recommend it though, which has absolutely nothing to do with results.

Depending on which numbing cream is used, there are also safety concerns based on the size of the area, how much is applied and how long it's left on. Numbing creams contain local anaesthetic drugs, which can be absorbed into the bloodstream, and this absorption can increase when they're used on compromised or needled skin. In excessive amounts (such as to cover your entire face), local anaesthetics can cause serious toxicity, including seizures, cardiovascular problems and, in extreme cases, can be life-threatening. For me, when I can perform the treatment safely without introducing that additional risk, I don't believe it's necessary.