Microneedling isn't a standard rosacea treatment, but some clients with stable, mild rosacea do well with a carefully adjusted protocol. The key is choosing the right clients and the right moment.

Understand the subtype

Rosacea is usually described in four subtypes. Erythematotelangiectatic rosacea causes persistent redness and visible vessels. Papulopustular rosacea causes bumps and pustules. Phymatous rosacea thickens the skin, often on the nose. Ocular rosacea affects the eyes.

Small studies suggest microneedling, sometimes combined with calming serums, may improve redness and texture in stable, redness-predominant rosacea. The evidence is limited, so present it as an option rather than a cure.

When not to treat

• During an active flare
• When there are active papules or pustules
• When redness hasn't been diagnosed; refer to a GP or dermatologist first
• Over broken skin, infection or active cold sores
• When the client has just started a new prescription treatment

Adjusting the protocol

• Start shallow, around 0.25 to 0.5 mm, and adjust by facial zone
• Use fewer passes and stop at mild, even redness
• Extend the interval between sessions to six to eight weeks
• Patch test new serums 48 hours before treatment
• Choose calming, fragrance-free products

Aftercare that reduces flare risk

Recommend cool compresses, a bland moisturiser and mineral SPF, and no heat (saunas, hot yoga, intense exercise) for 48 hours. Ask clients to avoid their known triggers for a few days.

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