Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
A device passes very fine needles into the skin to a set depth, hundreds of times a minute, in an even pattern. Each channel is a tiny injury, and the skin's response to a great many tiny injuries is to produce collagen and elastin across the following months. Nothing is removed and the surface heals within a day or two, which is why the recovery is so much shorter than resurfacing for a result that, across a course, is not far behind it.
Its great strength is that it does not care about pigment. There is no light and no heat, so the mechanism is identical on every skin tone, and the risk of the pigment change that limits laser treatment on richer skin is very low. For a great many of our clients this is the treatment that does what they were told a laser would do and were then told they could not safely have.
It is best known for acne scarring, and that is a fair reputation — depressed rolling scars improve considerably across four to six sessions, and combining it with radiofrequency or with subcision improves them further. It also does honest work on general texture, enlarged-looking pores, fine lines and stretch marks, all of which respond slowly and cumulatively rather than dramatically.
What it treats, in order of how well
Four honest categories.
Rolling and boxcar acne scars
The best use. Depressed scars with sloping edges lift meaningfully across four to six sessions a month apart. Narrow deep ice-pick scars respond least and often need a different technique alongside. Expect meaningful improvement rather than erasure — and see /acne-and-scarring.html, which sets out what each type of scar realistically does.
Texture, pores and dullness
Reliable and gradual. Skin becomes smoother to the touch and pores look smaller because the skin around them is thicker. This is the improvement most people notice first, usually at around session three.
Fine lines and skin thickness
Genuine but modest. Thicker skin creases less, so fine lines soften. Deep static lines are not removed, and nothing about this treatment lifts or repositions anything.
Stretch marks and surgical scars
Improvable, slowly, over more sessions than the face needs — six to eight is common, and older white stretch marks respond less than newer red ones. We are careful to describe this as improvement in appearance rather than removal, because that is what it is.
The session and the week after
Short recovery, and one aftercare rule that matters more than the rest.
The session
Numbing cream for forty-five minutes, then twenty to thirty minutes of treatment. It feels like sandpaper being drawn over the skin — tolerable everywhere, sharper on the forehead and around the nose. Pinpoint bleeding in places is normal and expected.
The first 48 hours
Red and hot, like a strong sunburn, settling substantially by the second morning. Some swelling, particularly around the eyes on the morning after. Nothing on the skin except what we give you: no makeup, no actives, no sunscreen on day one — which is why you stay indoors.
Days three to seven
Dry, tight and lightly flaking. Makeup is fine from day two or three. Return to your normal routine gradually from day five, actives last.
The one rule
Nothing goes onto the skin in the first day except what we hand you. Freshly channelled skin absorbs whatever it is given, including things that have no business being absorbed, and the reported complications from microneedling almost all come from something inappropriate being applied afterwards rather than from the needling itself.
Risks, and the home devices
A low-risk treatment professionally, and a genuinely risky one at home.
Infection
Uncommon, and the reason sterile single-use cartridges are non-negotiable. Anybody who gets cold sores should have antiviral cover before a facial treatment.
Pigment change
Low risk compared with light-based treatment, and not zero — particularly if treated skin sees the sun in the following weeks. Sun protection from day two onward is part of the treatment rather than an optional extra.
Tracking marks
Fine lines visible where the device was drawn across the skin, usually from too much pressure or too many passes. Uncommon, temporary in almost every case, and a technique problem rather than an inherent risk.
Home rollers
We would rather you did not. A home roller cannot be adequately sterilised, its needles blunt quickly and tear rather than puncture, and there is no depth control. At best it does nothing; at worst it creates the marks people then come to us to have treated. If you own one, the most useful thing this page can tell you is to throw it away.
Microneedling in western Queens
Hundreds of tiny controlled punctures provoke a repair response, and the skin rebuilds slightly thicker and smoother. The workhorse of texture and scarring treatment, and safe on every skin tone.
Every treatment here starts the same way: a full hour at a table in a room with no treatment couch in it, a proper medical history, your skin looked at in daylight, and then a plain statement of what we think would achieve what you described. You are told what it costs, how many sessions it usually takes, how long it lasts, what the recovery looks like and what can go wrong — on paper, to take home and read somewhere other than a treatment room. If the honest answer is a different treatment, or nothing, or a dermatologist, that is what you get instead, and it costs exactly the same.
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
No before-and-after photographs, and no promised outcome. There are no before-and-after photographs on this website and there never will be. Every set you have seen somewhere else was chosen from a much larger pile, and the second picture is usually taken in different light, at a different angle, at a different time of day, often with makeup and frequently after retouching. Even an entirely honest pair shows you what happened to somebody else's face. What we publish instead is what a treatment typically changes, by roughly how much, how long it lasts, how many sessions it usually takes and how often people are disappointed. We do not guarantee an outcome, we cannot, and anybody who does is either guessing or selling.
The risks, plainly. Every treatment on this site has side effects and some carry real risks. The common ones are minor and short-lived — redness, swelling, tenderness, bruising, a day or two of looking like you have had something done. The uncommon ones matter more: burns, blistering and long-lasting pigment change from light-based treatment, which is a greater risk on deeper skin tones and on recently tanned skin; infection anywhere the skin is broken; and lumps, asymmetry and, very rarely, a blocked blood vessel from injectable filler, which is the one true emergency in this field. We screen for what makes each of these more likely, we tell you your own risk rather than the average one, and we decline to treat when the answer should be no.
What a med spa does not treat. We treat the appearance of healthy skin, hair and body. We do not diagnose or treat disease. If you bring us a mole, a changing mark, an unexplained rash, a sore that will not heal, skin that has become hard or numb, psoriasis, eczema, an autoimmune skin condition, or hair loss that came on suddenly or in patches, what you will get is the name of a doctor rather than a treatment plan. Aesthetic treatment applied on top of an undiagnosed skin problem can mask it, delay the diagnosis and occasionally make it worse. We would rather lose the booking.
Questions
Microneedling — the questions we are asked most
Is it safe on darker skin?
Yes, and it is one of the main reasons it is used so much here. There is no light and no heat, so the mechanism is the same on every skin tone and the pigment risk that limits laser treatment largely does not apply. Sun protection afterwards still matters, but this is a treatment nobody is turned away from on the basis of skin colour.
How many sessions will I need?
Four to six a month apart for the face, six to eight for stretch marks or body scarring. The result is judged three months after the last session rather than during the course, because collagen remodels slowly. You pay per session and can stop at any point.
Does it hurt?
With numbing cream applied for forty-five minutes beforehand, it is uncomfortable rather than painful — most people describe sandpaper. The forehead and the area around the nose are sharper. It lasts twenty to thirty minutes.
Will it get rid of my acne scars?
It improves them, often considerably, and it does not erase them. Rolling and boxcar scars respond best; narrow deep ice-pick scars respond least and need something else alongside. Anybody promising removal of acne scarring is over-promising, whatever the treatment.
Can I use a home roller between sessions?
Please do not. Home rollers cannot be properly sterilised, blunt quickly and tear rather than puncture, and have no depth control. They range from useless to actively harmful, and some of the marks people bring us to fix were made by one.
What can I put on my face afterwards?
Only what we give you, for the first twenty-four hours. Freshly needled skin absorbs whatever is applied to it, and almost every reported complication from this treatment comes from something inappropriate going on afterwards rather than from the needling. Normal skincare resumes gradually from day three, actives last.
Related
Often seen alongside this
Skin & Facial Treatments
Medical-Grade Facials
A facial performed by a licensed aesthetician using professional-strength actives, chosen for your skin rather than from a menu. It is treatment rather than pampering, and it is where most people should begin.
Read more
Skin & Facial Treatments
Hydradermabrasion Facial
A device that exfoliates, extracts and applies a serum in the same pass, using water and gentle suction. Reliably good at congestion and dullness, and reliably oversold as something transformative.
Read more
Skin & Facial Treatments
Chemical Peels
An acid applied for a controlled time to shed a controlled depth of skin. Depth is the whole game — a light peel is a lunchtime treatment you repeat, a medium peel is a genuinely peeling week and a real result.
Read moreA written plan and a written price before anything is booked
Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.