Microneedling & Dermaroller in North Cyprus

Microneedling is not a single fixed protocol; needle depth fundamentally changes the treatment and must be matched to the target concern:

• 0.25–0.5 mm — home use, serum penetration: Reaches the uppermost layer of the epidermis; collagen stimulation is limited. The primary benefit is improved absorption of serums (vitamin C, hyaluronic acid, niacinamide). Insufficient for treating acne scars or stretch marks.
• 0.5–1.0 mm — facial rejuvenation, fine lines: Reaches the papillary dermis. Preferred for skin smoothing, fine expression lines and superficial acne scars. Recovery 24–48 hours.
• 1.0–1.5 mm — enlarged pores, moderate acne scars, early stretch marks: Upper reticular dermis. The most commonly used adult depth range in clinical practice; produces a significant collagen response.
• 1.5–2.5 mm — deep atrophic acne scars, established stretch marks: Used for deep ice-pick, boxcar and rolling scars, and for striae albae. Recovery 3–5 days; 6–8 weeks between sessions.

Saying "I want microneedling" is as general a statement as saying "I want surgery"; depth, treatment area and number of sessions are determined after assessment. We share the chosen parameters with you in writing.

A dermaroller is a first-generation device with 180–600 fixed needles on a cylindrical head that is rolled manually over the skin. The needles are not perfectly vertical; pressure and direction cause the depth to vary, and lateral tissue trauma is greater. A Dermapen (automatic microneedling pen) uses a motor-driven pen to move 9–36 needles rapidly in a vertical direction; depth is precisely adjustable from 0.25 to 2.5 mm; the needle tip is a single-use cartridge. Its practical advantages are:

1. Controlled depth — different depths can be applied to different zones within the same session.
2. Access to narrow and curved areas (sides of the nose, around the eyes, upper lip).
3. Less lateral tissue trauma and bruising.
4. Single-use cartridge — minimal contamination risk.

In modern clinics, an automatic Dermapen-type device is the standard; the term "dermaroller" is used generically in marketing language to cover both devices. At Nis Clinic, we perform all treatments with a Dermapen-type automatic device.

RF microneedling (Morpheus8, Endymed Intensif) is a different technology: radiofrequency energy is delivered through the tips of the needles, adding thermal injury to the mechanical micro-injury. It operates at depths of 0.5–4 mm and is markedly superior to classic microneedling for skin tightening (laxity), lower-face and neck remodelling. For skin texture, acne scars and stretch marks, classic microneedling combined with PRP remains cost-effective; for patients where skin laxity is the primary concern, RF microneedling is the stronger choice. We compare both options explicitly during consultation.

Microneedling is effective on its own; combined with PRP (platelet-rich plasma), the biological response becomes two-layered. The mechanism: microneedling opens micro-channels in the skin and provides a mechanical trigger for collagen signalling; in the same session, PRP — prepared by centrifuging a sample of the patient's own blood — is applied to those channels. The growth factors in PRP (PDGF, TGF-β, VEGF) amplify collagen stimulation and accelerate healing.

In the media this combination is known as the "vampire facial" — a marketing name that went viral via a celebrity social media post. In the medical literature it is called "PRP-augmented microneedling". Whatever the name, the procedure is identical: 15–20 ml blood drawn from the arm → centrifuged in a CE-marked closed-system kit → topical anaesthesia (20–30 minutes) → Dermapen micro-channels → PRP application (soaking into the channels plus superficial injection).

Practical advantages of the PRP combination: recovery is shortened by 1–2 days; because the collagen response is amplified, the total number of sessions for acne scar and stretch mark cases may fall from 5–6 to 3–4; PRP is autologous and therefore adds no allergy risk. We actively recommend PRP combination particularly for atrophic acne scars and stretch marks. At Nis Clinic we do not market this as a "vampire facial"; if that name is familiar to you, the treatment it refers to is medically the same PRP + microneedling protocol.

We offer consultations in person at the clinic or online via WhatsApp or Zoom. The assessment covers three areas:

• Skin examination and Fitzpatrick type: Your skin phototype (I–VI) is established. In darker skin types (IV, V, VI) the risk of post-inflammatory hyperpigmentation (PIH) is markedly increased; depth and session interval are selected with this risk in mind. Active acne, active rosacea, active herpes and sunburn are temporary contraindications.
• Target concern and priority: Skin texture rejuvenation, acne scars (ice-pick / boxcar / rolling), stretch marks, enlarged pores, fine lines, post-surgical scarring — depth and number of sessions vary according to the target.
• Medical history: Anticoagulant use, isotretinoin (Roaccutane) use, active cancer treatment, pregnancy or breastfeeding, keloid tendency and autoimmune skin conditions are specifically explored. A 6-month waiting period after stopping isotretinoin is the widely accepted safety standard.

At the end of the consultation we share a written plan: which areas, which depth, how many sessions, the interval between sessions, any combination protocol, an estimated price range and realistic expectations.

The session-day flow:

• Preparation and topical anaesthesia: The skin is cleaned with antiseptic; a lidocaine/prilocaine cream takes effect over 20–30 minutes. With good anaesthesia, sessions at depths above 1.5 mm remain tolerable.
• PRP preparation (if the combination has been selected): While the anaesthetic takes effect, 15–20 ml of blood is drawn from the arm and separated in a calibrated centrifuge for 10–15 minutes — the two steps run in parallel.
• Device parameter setting: Dermapen needle depth and speed are adjusted by zone (cheeks 1.0–1.5 mm, around the eyes 0.5–0.75 mm, acne-scarred areas 1.5–2.0 mm).
• Microneedling pass: A glide gel is applied; the device advances in linear, cross-hatched and circular patterns to achieve homogeneous coverage. The target sign is pinpoint bleeding — the clinical indicator that the correct depth has been reached.
• PRP application (if included): Immediately after microneedling, PRP is soaked into the open channels; a portion is delivered by targeted injection with a 30-gauge needle.
• Calming phase: A hyaluronic acid–based mask is applied for 10–15 minutes.

A single-zone facial session including anaesthetic waiting time takes 45–60 minutes; a multi-zone or PRP combination session takes 60–75 minutes. Patients return to normal daily activities the same day — excluding make-up and sun exposure restrictions.

Recovery depends on depth: at 0.5–1.0 mm, expect 24 hours of redness and no make-up for 48 hours; at 1.0–1.5 mm, 48 hours of noticeable redness, fine flaking for 3–4 days, no make-up for 3–5 days; at 1.5–2.5 mm, 72 hours of redness and mild swelling, fine crusting for 5–7 days, no make-up for close to 7 days. If social engagements are planned, the patient is advised at the planning stage.

Aftercare rules for the first 14 days (all depths):

• No washing for 24 hours; from 24–48 hours, lukewarm water and a gentle pH-balanced cleanser. Mechanical scrubbing, brushes and exfoliating pads are not permitted.
• Sun protection for 14 days, SPF 50+ mineral formula (zinc oxide, titanium dioxide). In the North Cyprus sun, continuing for 30 days is advisable. Sun exposure is the single biggest trigger of post-inflammatory hyperpigmentation.
• No active ingredients for 5–7 days: Retinoids, AHA/BHA acids (glycolic, salicylic), vitamin C serum — all paused.
• Intensive moisturisation: Hyaluronic acid serum and ceramide-panthenol barrier repair products for the first 7 days.
• Exercise, sauna and steam room avoided for the first 48 hours; swimming pools and the sea avoided for the first 72 hours.

Mild redness and fine flaking are expected findings. Excessive redness lasting more than 5 days, significant swelling, pus, pain or fever suggest infection and require a clinic assessment. Our clinical team is reachable via WhatsApp for 72 hours after each session.

Typical treatment programmes:

• Skin texture / enlarged pores / fine lines: 4 sessions, 4–6 weeks apart. 1–2 booster sessions per year are recommended.
• Atrophic acne scars: 5–6 sessions (3–4 with PRP combination), 6 weeks apart. Expected outcome: 30–50% reduction in depth — scars do not disappear entirely.
• Stretch marks (striae albae — white): 4–6 sessions, 6–8 weeks apart. PRP recommended. Outcome is moderate: stretch marks do not disappear, but the tissue softens and the colour moves closer to the surrounding skin tone.
• Striae rubrae (red/recent stretch marks): 4–5 sessions; newer stretch marks respond better.

Collagen remodelling timeline: Weeks 1–2: mechanical hydration and epidermal renewal (not yet a collagen response). Weeks 4–6: first visible tissue improvement. Months 2–3: collagen response becomes more pronounced; acne scar depth reduces during this window. Months 3–6: mature outcome — Type III to Type I collagen conversion completes. Months 6–12: the effect gradually diminishes; 1–2 annual booster sessions are recommended for maintenance.

Honest expectations: Microneedling does not guarantee scar-free, perfectly smooth skin in any case. The literature average is 30–50% for acne scars, a moderate level for stretch marks, and a noticeable but gradual improvement for skin texture. We share these ranges openly at every consultation.

• Atrophic acne scars: For rolling and boxcar types in particular, classic microneedling combined with PRP is one of the first-line treatments. For ice-pick scars alone it is insufficient; it is combined with TCA CROSS or fractional ablative laser (erbium YAG, CO2). The algorithm is detailed on the acne treatment page.
• Skin texture and enlarged pores: Ages 25 and above, surface roughness, visible pores, dullness. A good response is seen at moderate depth.
• Fine expression lines: Effective for superficial lines; for deep static lines, botulinum toxin and dermal filler are the primary solution, with microneedling as a supporting treatment.
• Stretch marks (striae): Red stretch marks respond better; white stretch marks show a moderate response. PRP combination is recommended.
• Post-operative surgical scars: Visible improvement in mature scars six or more months after surgery. Not performed on fresh scars.
• Neck and décolletage rejuvenation: The collagen response in these areas is slower than on the face; 5–6 sessions may be needed.

Classic microneedling is limited for skin laxity; RF microneedling or a surgical assessment is required.

Situations where the procedure is deferred or requires special assessment:

• Active skin infection (herpes, acne abscess, impetigo, folliculitis) — treatment is postponed. In patients with a history of recurrent herpes, antiviral prophylaxis (valaciclovir) may be started 48 hours before.
• Active inflammatory acne — acne must be controlled before scar treatment.
• Isotretinoin (Roaccutane) use: Not recommended during active treatment or for 6 months after stopping (risk of atypical scarring).
• Keloid and hypertrophic scar tendency — not performed.
• Uncontrolled diabetes, active cancer treatment, pregnancy, breastfeeding, coagulation disorders, active autoimmune skin conditions (scleroderma, active vitiligo, active lupus), skin with a history of radiotherapy, cosmetic indications in patients under 18.
• Anticoagulant therapy — the decision to pause medication is taken jointly with the treating physician; elective cessation is not always safe. Aspirin/NSAIDs may be stopped 7 days before with medical approval.

Dark skin type (Fitzpatrick IV–VI) — specialist protocol: PIH risk is markedly increased. Depth is conservative (rarely exceeding 1.0 mm), sessions are 8 weeks apart, pre-treatment with a hydroquinone or tranexamic acid–based preparation for 2–4 weeks, post-treatment SPF 50+ mineral sun protection for 30 days, and a pilot test patch at the first session. Fitzpatrick IV is common in the patient profile coming to Northern Cyprus from Türkiye and the Middle East; a conservative depth strategy is our standard approach for this group.

• Dermapen-type automatic device — not a manual dermaroller. A single-use cartridge is opened fresh for each patient; the batch number is recorded.
• Indication-matched depth — depth is determined zone by zone after assessment for each patient. In the same session, the forehead may be treated at 1.0 mm, the cheeks at 1.5 mm, and the sides of the nose at 0.75 mm.
• PRP combination available — actively recommended for acne scars and stretch marks in particular; prepared in the same session using a CE-marked closed-system kit.
• Topical anaesthesia as standard — 20–30 minutes of effective anaesthesia is applied at every session.
• Under Dr. Meyzin's supervision — treatment is carried out within the protocol of and under the direct oversight of Op. Dr. İbrahim Meyzin. A plastic surgery training background — facial anatomy, vascular mapping, wound healing — is a decisive advantage for depth selection and safety margins in sensitive areas.
• Post-session follow-up — the clinical team is reachable via WhatsApp for 72 hours; a review at 2 weeks, and the next session planned at 4–6 weeks.

Atrophic acne scars cannot be resolved with a single treatment; different approaches are combined according to scar type:

• Ice-pick (narrow, deep, V-shaped): Microneedling alone is insufficient. First choice is TCA CROSS (punctiform application of high-concentration trichloroacetic acid) or fractional ablative laser. Microneedling is a supporting treatment.
• Boxcar (box-edged, moderate depth): Microneedling combined with PRP is the primary approach. Subcision (releasing fibrotic bands beneath the scar with a needle) may be added. A 30–50% reduction in depth after 4–6 sessions.
• Rolling (broad, undulating): Microneedling combined with PRP is the first choice. Approximately 40–60% visible improvement with 4–6 sessions; subcision adds further benefit.
• Post-inflammatory hyperpigmentation (colour darkening only, no pitting): This is not a scar; treatment is chemical peel, hydroquinone, tranexamic acid and sun protection.
• Deep, widespread, mixed scar types: A multi-step plan — active acne control → subcision → fractional ablative laser (1–2 sessions) → microneedling combined with PRP for maintenance (3–4 sessions). Steps spaced 3–6 months apart; a programme spanning 6–12 months.

We draw up this algorithm with the patient during consultation. If the expectation of "resolution in one session" cannot be managed, it is better not to begin treatment.

Approximate price ranges (Nis Clinic — 2026):

Price varies with treatment area, PRP inclusion, number of sessions and any package arrangement. All prices are confirmed after consultation; the Dermapen cartridge and PRP kit (if used) are documented with batch numbers and shared with the patient. A package discount does not mean a reduction in standards — the standard remains identical throughout.

Microneedling is a same-day treatment and does not require a medical tourism package; however, it is possible to have your first session at our clinic and the remaining sessions in your home country. If you would like to combine it with another medical aesthetics treatment (PRP, mesotherapy, chemical peel) — we put together an integrated plan at consultation.