Granulomatous Reactions From Microneedling: A Systematic Review of the Literature.

Daniel P Friedmann, Ryan Harris, Kritin K Verma, Eshani Mehta

Journal: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2025;51(3):263-266

PMID: 39584690

Abstract

BACKGROUND

Microneedling is a common minimally invasive procedure for skin rejuvenation. Granulomatous reactions after microneedling have been rarely reported.

OBJECTIVE

To systematically review the literature for granulomatous reactions from microneedling.

MATERIALS AND METHODS

A systematic review of the Medline, Scopus, Google Scholar, and Cochrane databases was performed for articles describing granulomatous reactions to microneedling.

RESULTS

Thirteen studies were selected for inclusion after full-text review, which described 15 patients (26-74 years old) with non-necrotizing granulomatous inflammation postmicroneedling. Motorized microneedling pen use and topical Vitamin C application were implicated in a majority of cases. Although delayed-type hypersensitivity was commonly proposed as the underlying etiology, patch testing or further workup was rarely performed. Improvement or clearance occurred inconsistently with myriad treatment options, including topical steroids, oral antibiotics, and systemic anti-inflammatory medications.

CONCLUSION

Granulomatous reactions to microneedling and microneedling-mediated transepidermal drug delivery can rarely occur and may be treatment-resistant.

Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Address: Westlake Dermatology Clinical Research Center, Westlake Dermatology & Cosmetic Surgery, Austin, Texas.; Vanderbilt University, Nashville, Tennessee.; Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas; and.; Meridian Dermatology, Meridian, Idaho.
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