Because psoriasis is an inflammatory skin condition, it can be difficult to know which skin treatments are safe and which ones may trigger flares. Is microneedling — a minimally invasive cosmetic procedure — safe for psoriatic skin?

Microneedling treatment is generally seen as safe, but it’s not typically recommended for people with certain skin conditions, including psoriasis. Read on to find out what microneedling is and the potential risks of microneedling with and without psoriasis.

What Is Microneedling?

Microneedling is a type of minimally invasive skin therapy that uses instruments with thin, tiny needles to puncture the skin. The small punctures prompt the skin to produce collagen and elastin as part of its natural healing process, which then helps keep the skin smooth and firm. Because it stimulates collagen production, you may also hear microneedling referred to as collagen induction therapy.

Microneedling is mostly used for cosmetic reasons, such as to reduce the appearance of wrinkles, fine lines, acne scars, or stretch marks, but it also has medical purposes. For example, microneedling may be used to treat hair loss due to a condition called androgenetic alopecia.

Microneedling can be performed by a dermatologist, at home, or at a spa. The best results are usually seen from getting the procedure done at the dermatologist’s office — it’s also the least risky option. Microneedling usually needs to be performed many times over several months to achieve the desired results.

Microneedling and Psoriasis

Microneedling may be used to treat some medical conditions that involve the skin, such as androgenetic alopecia and hyperhidrosis (excessive sweating), but there are conditions that are not appropriate for microneedling. Although microneedling is generally seen as a skin rejuvenation technique and can reduce the appearance of some skin issues, it does not treat skin affected by psoriasis.

Psoriasis is one of the contraindications for microneedling, meaning microneedling is generally not recommended for people with psoriasis. One reason for this is, skin injuries — even minor ones — can trigger psoriasis flares. New lesions may appear in areas where previously healthy skin has been harmed — this is called the Koebner phenomenon.

Thus, the nature of microneedling with its punctures may pose a risk of psoriasis flares. Microneedling instruments are designed to cause minor injury to the skin to stimulate the skin healing process, but that may backfire on someone with psoriasis whose skin is sensitive to even minor injuries.

Microneedling is generally not recommended for treating psoriasis, but some people wonder if they can get this procedure on areas of skin far away from psoriasis symptoms. For example, if you have psoriasis on the face, can you use microneedling on other, unaffected areas of the skin?

More research is needed on if and how microneedling might affect areas of the skin that don’t show symptoms of psoriasis. If you’re interested in getting microneedling on skin patches further from psoriasis patches, talk to your dermatologist before moving forward. A small area of skin not affected by psoriasis can act as a test site.

Risks of Microneedling

Because minor skin injuries may cause a psoriasis flare, microneedling poses a greater risk for those with psoriasis. In addition, microneedling — even for people without psoriasis — still poses a risk of skin damage, including:

• Bleeding areas
• Bruises
• Redness
• Skin feeling tight
• Itchy or peeling skin

Microneedling also poses a minor risk of skin infection from an unclean instrument or the instrument spreading existing pathogens (microorganisms or viruses) on the skin. Infection is a common trigger for plaque psoriasis, along with injury to the skin, thus further increasing the risks of microneedling for someone with plaque psoriasis, the most common type of psoriasis.

At-home microneedling kits, such as microneedle stamps or dermarollers (rollers), are gentler — though less effective — than what you would get at the dermatologist. Still, they still pose similar risks to what you’d experience from getting it done at the dermatologist.

Risks of at-home microneedling include:

• Developing a skin infection from going too deep or unclean instruments
• Scarring from pressing too hard
• Experiencing changes to skin tone or texture
• Having existing viruses like herpes or warts spread over the skin

Microneedling does not cause psoriasis for people who don’t already have it. Psoriasis is an autoimmune disease, and while the exact cause is unknown, genetics and environmental factors are thought to have a role in increasing the risk of developing psoriasis.

Talk to Your Doctor About Microneedling With Psoriasis

Psoriasis can affect people differently and in different places. Although microneedling may not generally be recommended for people with psoriasis, it’s best to speak with your doctor or dermatologist to see if microneedling is safe for you. It may be that you can try microneedling on a small area to see how your skin reacts. However, given the risk of flares, you may feel most comfortable avoiding microneedling and look for noninvasive ways to improve your skin’s appearance.

Always talk with your dermatology specialist before trying any new skin treatment or skin care, and ask about ways to prevent psoriasis flares.

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Have you talked to your doctor about microneedling? What have you learned about microneedling with psoriasis? Share your experience in the comments below, or start a conversation by posting on your Activities page.