Journal September 26, 2026 5 min read

What markers track microneedling?

Microneedling is studied through clinical scoring indices, tissue growth-factor levels, and split-side comparisons of topical agents delivered through the microchannels it creates.

peptides-pro Editorial

Microneedling is a minimally invasive procedure in which fine needles create controlled microchannels in the skin or mucosa, and the markers used to track it fall into three broad groups: validated clinical severity indices, tissue-level mediator concentrations, and split-side or split-mouth comparisons of an active topical against a control delivered through the same channels. The formal name for the procedure in the literature is microneedling; synonyms include percutaneous collagen induction and, when energy is added, fractional microneedling radiofrequency. The evidence block does not supply a sequence, formula, or molecular weight for the procedure itself, because microneedling is a technique rather than a molecule; the compounds studied alongside it do carry identifiers, such as tranexamic acid at 100 mg/mL (Kapron® ampoules, 500 mg/5 mL; Amoun Pharmaceutical Co.) in one striae rubra protocol [1].

The mechanistic work centres on growth-factor signalling, specifically platelet-derived growth factor (PDGF) and connective tissue growth factor (CTGF) in hypertrophic scar tissue [6].

Research Studies

Tranexamic acid and striae rubra in a split-side clinical trial

A registered trial evaluates microneedling with topical tranexamic acid against microneedling with placebo in striae rubra [1]. One side of the affected area receives topical tranexamic acid at 100 mg/mL followed by a microneedling session; the contralateral side receives 0.9% normal saline followed by microneedling performed in the same manner [1]. Sessions are conducted every three weeks, up to a maximum of five sessions [1]. The design is a within-participant comparison, which means each subject serves as their own control for the topical agent while the needling stimulus is held constant.

Tranexamic acid, metformin and modified Kligman's formula in melasma

A randomized, parallel-group trial compares microneedling-assisted topical metformin, topical tranexamic acid, and modified Kligman's formula against microneedling-assisted saline in adult women with melasma [2]. Eighty participants are randomly assigned to one of four treatment groups [2]. The primary outcome is the change in Melasma Area and Severity Index (MASI) score from baseline to the end of follow-up [2]. MASI is the marker here: a validated clinical index rather than a laboratory analyte.

PDGF and CTGF in hypertrophic scar tissue

A trial compares fractional microneedling radiofrequency against intralesional steroid injection, with and without microneedling, on tissue levels of PDGF and CTGF in hypertrophic scars [6]. This is the clearest example in the evidence block of a tissue-level mediator being used as the tracking marker rather than a surface score.

Glutathione gel and gingival depigmentation in a split-mouth trial

A split-mouth clinical trial compares gingival depigmentation using microneedling alone against microneedling with glutathione gel [4]. The rationale given is that gingival colour is an important determinant of smile esthetics and that gingival depigmentation has gained popularity among periodontal plastic surgical procedures [4]. The split-mouth design mirrors the split-side design used in the striae work [1], with the same logic: the needling is applied to both sides and the topical agent is the variable.

Hyaluronic acid and thin gingival phenotype

A trial evaluates microneedling alone versus microneedling with hyaluronic acid in thin gingival phenotype [5]. The periodontal phenotype is defined as the combination of gingival phenotype and buccal bone plate thickness, or bone morphotype [5]. Gingival phenotype can be evaluated in a standard and reproducible way, whereas the full periodontal phenotype cannot be fully assessed [5]. Gingival recession is usually observed with trauma and inflammation in thin phenotypes, while pocket formation has been reported in thick phenotypes [5]. Conventional soft tissue augmentation options include sub-epithelial connective tissue graft, free gingival graft, modified roll technique, and acellular dermal matrix, with the drawback of a second surgical site [5].

Polynucleotide and skin-booster formulations

Skin boosters are injectable and topical treatments designed to improve dermal quality and restore skin health, and typically include hyaluronic acid formulations, biostimulatory agents, platelet-rich plasma (PRP), growth factors, and polynucleotides [3]. Polydeoxyribonucleotide (PDRN), derived from the DNA of salmon or trout, is described as having dual regenerative and anti-inflammatory properties, promoting tissue repair by supplying nucleotides essential for DNA synthesis [3]. This evidence is a study record describing the category rather than a completed comparison, so it should be read as background on the compounds that microneedling is used to deliver.

Comparison of markers across the evidence

Marker	Type	Condition studied	Source
MASI score change	Clinical index	Melasma	[2]
PDGF and CTGF tissue levels	Tissue mediator	Hypertrophic scars	[6]
Split-side active vs saline	Design-based comparison	Striae rubra	[1]
Split-mouth active vs alone	Design-based comparison	Gingival depigmentation	[4]
Gingival phenotype assessment	Anatomical measure	Thin gingival phenotype	[5]

Barrier and delivery considerations

The stratum corneum presents a significant barrier to transdermal delivery, and a cooling-assisted delivery device has been developed to enhance skin penetration, with potential synergistic effects when combined with microneedling systems such as the Turtle pin (0.5 mm) and MTS (1.5 mm) [9]. That work was performed ex vivo in human-derived skin tissue models [9], so it is not a clinical finding. Separately, reviews of topical strategies for acne-induced hyperpigmentation note that post-inflammatory hyperpigmentation and post-inflammatory erythema are common sequelae of acne, particularly in individuals with skin of colour, with up to 85% of patients with Fitzpatrick phototypes IV–VI developing post-inflammatory hyperpigmentation following inflammatory acne lesions [8]. A multicenter investigation of temporally optimized antioxidant serums evaluated complementary day and night formulations in the context of sensitive skin, oxidative stress, barrier dysfunction, and disrupted skin biorhythms [7]. Neither of these two reports is a microneedling study, and neither should be read as establishing a microneedling marker.

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