Microneedling

Indications

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• Skin quality and texture - Manual microneedling stimulates neocollagenesis and neo-elastogenesis through controlled micro-injury, improving skin texture, pore size, and early fine lines over a defined course of treatment
   

• Acne scarring - Microneedling has a well-established evidence base for improving the appearance of atrophic acne scars through dermal remodelling
   

• Microneedling with Nanofat - The most powerful application of microneedling in my practice is its combination with autologous nanofat. Nanofat, processed from a small volume of the patient's own fat, contains regenerative stromal cells and growth factors that improve skin quality from within. Microneedling creates a controlled delivery channel that allows nanofat to penetrate into the dermis, enhancing its regenerative effect significantly.
  
  This combination is performed as a surgical procedure under local or general anaesthesia in a day surgery setting as the nanofat component requires liposuction harvest from a donor site. It is personalised to each patient's anatomy and goals, typically for scars. The result surpasses what either modality achieves alone.
   

• Melasma as an adjunct with Tranexamic Acid - Unlike laser, which carries a meaningful risk of worsening melasma in Asian skin by targeting the wrong tissue depth and triggering post-inflammatory hyperpigmentation, manual microneedling works differently. It promotes transcutaneous elimination of melanin and, critically, acts as a delivery channel for topical tranexamic acid (TXA) directly into the dermis.
  
  TXA has a well-established evidence base for melasma. A meta-analysis of 22 RCTs published in the Journal of Dermatological Treatment (2024) confirmed that TXA significantly reduces melasma severity across all administration routes, with intradermal and microneedling-assisted delivery showing superior outcomes to topical application alone. A further meta-analysis in Aesthetic Plastic Surgery (2024) found that microneedling-assisted therapy produced significant improvements in melasma severity scores with high patient satisfaction and optimal results at 24 weeks.
  
  Microneedling with TXA may therefore be one component of an evidence-based melasma management plan, not a standalone package, and always discussed alongside photoprotection and appropriate topical maintenance.

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Technique

Treatments are performed personally by me using calibrated manual microneedling devices. Needle depth is adjusted according to the treatment area and indication. For the nanofat combination, nanofat is applied immediately following microneedling to maximise dermal penetration while channels remain open.

Where microneedling is combined with topical agents, only evidence-based, MOH-approved products are used. PRP and exosomes are not offered, as these are not currently approved for such use in Singapore.

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Results & Recovery

Recovery following manual microneedling is mild, with redness and minor swelling typically resolving within 24 to 48 hours. For the nanofat combination, recovery reflects the nanofat harvest site rather than the microneedling itself, which is minimal.

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Results develop progressively over 4 to 8 weeks as collagen remodelling matures. For scars or melasma indications, a series of sessions is typically planned with a defined endpoint.

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Suitability

Microneedling is appropriate for patients with specific skin quality concerns where it is the most appropriate tool, or as part of a combined surgical approach with nanofat. An honest assessment at consultation will determine whether it is right for your situation.