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  • Writer's picturePenn Smith

Microneedling 101: Nano, Cosmetic, Medical?

Updated: Apr 19, 2023

Microneedlng can be confusing!! Do I use a roller or a pen? Nano or CIT? Can I use serums? How often should I needle? Do I need to numb? The questions that arise are seemingly endless!! But microneedling needn't be confusing nor intimidating.

**Resources, links and FAQs at the bottom of the page/blog.

This blog is all about bringing us back to basics with needling and hopefully simplifying some of the concepts, especially for those who might be new to the modality. If you want more convincing evidence about why you should consider microneedling, have a look at my recent video.


First of all, and to be perfectly clear - the goal with all three 'flavors' of microneedling is healthy skin. Of all home skincare modalities, microneedling is the nearest and dearest to my heart. Why? I know of no other modality that can give such profound results with such simple (yet consistent!!) actions. Once you make the initial investment in learning and some basic tools, the payoff is enormous. The best way to realise this payoff is with slow learning and patience. Remember, our skin turns over about every four to six weeks, and each time we needle within these protocols, we give our body support to do a better job with that renewal.


One of the things I love about microneedling is that you needn’t jump into the deep end of the pool without testing the waters (although the deep end can be safe, as long as you learn to swim before you dive!!)... Think of it this way:

  1. Nano needling is like the shallow end of the pool. When learning to swim, this is where we start!! We ‘test the water’, we get a sense of the sensation, learn to use our little ‘floatation devices’ and generally start to enjoy the experience!!

  2. Cosmetic needling is like going up to, say, chest level in a swimming pool. You can begin to experience more of the wonder of swimming while feeling the security of the pool floor beneath your feet. This is where experience, paired with cautious steps, leads to us learning to swim.

  3. Medical needling (aka Collagen Induction Therapy - CIT) can be thought of as an elegant dive into the deeper waters - maybe you’ve even left the pool and can explore the sea life around you. But we don’t start our deep sea investigations before we test the water and learn to swim!!

Each of these types of 'needling' has benefits - some shared and some unique. Read on to learn more!


Using a micro needling pen with a 'nano' cartridge

The term ‘Nano needling’ is actually a misnomer. There are actually no needles at all on a nano cartridge! In fact, instead of needles, the cartridge contains microscopic silicone or stainless steel cones. When these cones interact with the surface of your skin, they create tiny channels in the very top dead layer of skin - the stratum corneum. While these tiny channels are invisible to the eye, they’re able to gently separate surface skin cells to allow much better absorption of topical products. Products penetrate an average of 97% better when used in conjunction with nano needling! Typically we’ll use serums that address skin issues in top levels: dehydration, dullness and pigmentation issues.

Why I like it: When you chose the right serums to layer in is so good for glow and hydration!! Because nano needling is superficial, we can do it as often as we like without having to 'overthink' protocols, hygiene and what we should/shouldn't do before/after. Learn more about nano needling in my Nano Needling video. I LOVE the glow I get from Nano needling!!

My favorite serums to use: Vitamin C, peptides, anti-pigmentation serums such as tranexamic acid. Queen 7-in-1, Insintree HA

My tips: I love to nano needle my lips and my neck on a regular basis to keep the areas hydrated and infuse products for those specific areas (Isntree HA for my lips, both Isntree HA and Queen 7-in-1 for pigmentation on my neck).


Using a roller or a cartridge at depth 0.2mm to 0.3mm

Cosmetic Microneedling involves using microneedles (always hygienically!!) to create micro injuries through to the epidermis. Because we stay at the epidermis with cosmetic microneedling, we're not going deep enough to injure blood vessels and generally should see a flushed look or erythema rather than bleeding. When the microneedles enter our epidermis, injury to our keratinocytes (the primary cell type at this level of our skin) leads to up-regulation or ‘supercharging’ of genes that, in turn, signal RESIDENT FIBROBLASTS (our collagen producing powerhouses) to make healthy collagen. Because cosmetic microneedling happens WITHOUT piercing blood vessels, we get healthy collagen generation without triggering inflammation - heck yeah! Learn more about Cosmetic Microneedling in my recent blog.

Cosmetic Microneedling is also a way to infuse select ingredients into the epidermis. While we're still needling at a fairly superficial level, I believe you should stick to serums that have simple ingredients that are specifically aimed at hydrating and/or enhancing the function of the skin cells.

Why I like it: It's got more data than you can shake a stick at to support not only its efficacy but also its safety. To be blunt, if I could only bring one 'modality' to a desert island (beyond cleansing, moisturizing, retinoids and SPF!) it would be cosmetic microneedling.

My favorite serums to use: While cosmetic needling using a pen I use a variety of serums. For me pigment is my main concern. I will choose antioxidants and pigment inhibitors with cosmetic needling.

My tips: I like to cosmetic needle once a week and I love to use LED just before I needle, on clean skin.


Using a roller or cartridge at depth 0.5+

Collagen Induction Therapy (CIT), or medical microneedling (0.5mm+) involves injury of blood vessels and platelets. Injured platelets release growth factors and MYOFIBROBLASTS that contribute to the generation of collagen. On the downside, inherently CIT also releases inflammatory cytokines from within the platelets. Additionally, needling at a deeper level creates higher requirements for precise hygiene protocols and (depending on the person) can require the use of a topical anaesthetic.

Why I like it: I've seen stunning results on acne scars using deeper length needles. An experienced practitioner can use the right combination of needling and products to achieve truly remarkable results. For home use I do think that conservative medical microneedling can have a place in a routine.

My favorite serums to use: When I medical needle at home using 0.5mm depths I use Cos de Baha Hyaluronic Acid or Timeless HA for slip and then follow Dr. Setterfield's protocol which I write about in this Medical Microneedling blog.

My tips: The more I learn about cosmetic needling, the less I needle at deeper depths. If you want to try needling at the deeper levels, I'd suggest that you only medical needle once every four to six weeks. Additionally, I'd strongly suggest you start with Cosmetic Needling to see if it gives you the results you seek - and also to 'get used to the pool before you do a 'deep dive''.


Which is 'better'?

According to Dr. Lance Setterfield, one of the world’s top micro needling experts, the difference between recruiting MYOFIBROBLASTS (as in Medical needling) and RESIDENT FIBROBLASTS (as in Cosmetic needling) is that the MYOFIBROBLASTS ARE MORE ABUNDANT in making collagen - because the body perceives the injury as an emergency. However, the QUALITY OF COLLAGEN PRODUCED BY RESIDENT FIBROBLASTS (during cosmetic microneedling) IS SUPERIOR. As mentioned before, the inflammatory response that results from platelet involvement is what recruits MYOFIBROBLASTS to the area of injury. Collagen made in an environment of inflammation tends to be scar collagen. So which is ‘better’ for home anti-aging use? I’m 100% in the Cosmetic Needling Camp. My research supports this, my clinical experience supports this. Perhaps most importantly, my SKIN supports this!

To be clear, I’m not here to vilify medical microneedling (I still do this and love it). It certainly has a role in treatments to address scars and stretch marks - all best done by a trained medical professional in a clinical setting. I hope that, with the support of Dr. Setterfield, I’ve made a case as to what Cosmetic Microneedling should get the bulk of your microneedlng attention!

This table summarises some of the benefits of microneedling at different levels. Please refer to my videos/blogs for additional detail on each.

*Penn Smith Skincare is a participant in the Amazon Services LLC Associates Program, an affiliate program. Many links are affiliate links, meaning I am compensated when you shop through these at no extra fee to you.


Setterfield book US

Setterfield Book UK

Dr Pen A6 Device

Dr Pen A6 Nano Cartridges

Dr Pen A6 36 pin (cosmetic needling) cartridges

Dr Pen A6 12 pin (medical needling) cartridges

Dr Pen A7 Device (this is my favorite pen)

Dr Pen A7 Nano Cartridges

Dr Pen A7 36 pin (cosmetic needling) cartridges

Dr Pen A7 12 pin (medical needling) cartridges

UK Pens + Cartridges

Dr Pen A6 device

Dr Pen A6 Nano cartridges

Dr Pen A6 36 pin (cosmetic needling) cartridges

Dr Pen A6 12 pin (medical needling) cartridges

Dr Pen A7 Device

Dr Pen A7 12 pin (medical needling) cartridges (Keep checking- Hard to find right now on Amazon)

Dr Pen A7 36 pin (cosmetic needling) cartridges (Keep checking- Hard to find right now on Amazon)

Dermal rollers at 0.25, 0.3 and 0.5) -


.25 and .5mm rollers


(This roller comes in every length)

Top picks - serums for Nano and Cosmetic - in these categories

- Glow Serum



-Hydration Serum



- Pigmentation Serum

Find more microneedling supplies on Amazon


Q. Do I buy a roller or a pen? How do I choose?

A. It is really up to you and what you are comfortable with. They are both good options!

Q. I already have a roller. How do I know if I should 'splurge' on a pen?

A. If the roller is working for you then no, you do not need a pen. If you want to Nano though, you will need a pen.

Q. When I have microneedling (0.5mm) done in a spa they use all sorts of serum. Why can't I do the same at home?

A. In-office treatments often come with in-office only topicals. There are microneedling serums that have been formulated to work safely. It is always ok to ask what is being used on your skin.

Q. Is there any benefit to going to an esthetician to have microneedling done?

A. An esthetician/practitioner should practice safe hygiene and have training to mitigate adverse reactions etc. If you are unsure about this treatment it is a good idea to seek professional services, not do it at home.

Hope this helps!!



FTC: Links in this post are affiliate ~ Please note that all links on this page are affiliate and I participate in the Amazon Associates program which is an affiliate program. Any time you see an Amazon link it is affiliate. If you choose to use my links please know that I appreciate it!

Disclaimer: This post is not intended to provide diagnosis, treatment or medical advice. Content provided on this blog is for informational and entertainment purposes only. Please consult with a physician or other healthcare professional regarding any medical or skin related diagnosis or treatment options. Information on this website should not be considered as a substitute for advice from a healthcare/skin professional. The statements made about specific products throughout this website are not to diagnose, treat, cure or prevent disease. It is important that you check labels to determine if a product is right for you. Before starting any treatment at home consult a health care or skin care professional to determine if it’s right for you.

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Sasha North
Sasha North
Jun 11, 2021

Hi penn, I’d like to use your link but wondering what you think of the dr pen m8? You don’t have a link to that. it’s supposedly the best seller in Australia where I am.


Nathalie Reners
Nathalie Reners
May 25, 2021

Can you do nano or cosmetic needling when you have a cold soar? Not when there is one on your lip 😉


doxa charalambous
doxa charalambous
May 09, 2021

Can you use the nano cartridge more than once ? And change it every week say ? Since it does not penetrate in the skin ?


Foothill Woman
Foothill Woman
Apr 30, 2021

Do you recommend using a numbing cream first-then, wipe it all off and prep for your at home treatment?


Mar 11, 2021

Penn, I know that you recommend Cos De Baha Hyalurocic acid. What do you think about Environ Intensive Hydrating Serum for medical microneedling?

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