Why it works
A needle passing through the dermis creates a microchannel that closes within minutes, and the body responds to it exactly as it responds to any wound: a cascade of growth factors, then fibroblast activity, then new collagen and elastin laid down over the following weeks and months.
The point is that the injury is small enough and controlled enough that the repair is regenerative rather than scarring. That is the whole difference between microneedling and a dermaroller bought online, which goes to inconsistent depths at inconsistent angles and can produce exactly the tracking scars it was meant to fix.
Does PRP add anything?
Honestly: some, and less than the marketing suggests. Platelet-rich plasma is a concentration of your own growth factors applied to skin that has just been made unusually permeable, and the evidence for accelerated healing and modestly better collagen response is reasonable rather than overwhelming.
It adds two hundred and seventy-five dollars and twenty minutes. It is worth it for significant acne scarring, where the difference over a course of five sessions is visible. It is a marginal purchase for general texture, and we will say that rather than let you assume the expensive version must be the right one.
Who should wait
Anyone with active inflammatory acne, because needling through it spreads bacteria. Anyone on isotretinoin now or within the last six months. Anyone with a history of keloid scarring. And anyone with an active cold sore anywhere on the face, which needs prophylactic antivirals first.