Skin treatment guide

Microneedling With PRP vs. Microneedling Alone: What Is the Difference?

PRP is not automatically the “better” version of microneedling.

That conclusion may sound surprising. Platelet-rich plasma, or PRP, is often presented as the upgrade: add your own platelets to microneedling and get a more powerful treatment. Research tells a more useful story.

For atrophic acne scars, adding PRP may improve average outcomes for some patients. For general facial rejuvenation, the added benefit is far less certain. PRP also introduces a blood draw, additional handling, more procedural complexity, and sometimes injections.

The right question is not simply, “Is PRP better?” It is:

What evidence supports adding PRP for my specific concern, using this practice’s actual device and protocol?

Here is what we know—and what you should ask before choosing.

The difference in one minute

Both treatments begin with microneedling. A trained professional uses a device with small needles to create controlled microscopic injuries in the skin. This starts a wound-healing response that can help remodel certain depressed acne scars and improve aspects of skin texture.

Microneedling alone relies on that repair response.

Microneedling with PRP adds a preparation made from the patient’s blood. A small blood sample is processed to separate platelet-rich plasma. Depending on the protocol, the PRP may be placed on the treated skin, injected into it, or both.

That distinction matters. PRP adds:

  • a blood draw;
  • centrifuge processing;
  • blood-labeling and infection-control requirements;
  • possible injections and bruising;
  • additional time and cost.

It may also add benefit—but the strength of that evidence depends on what is being treated.

How microneedling works

Medical microneedling creates a controlled injury in living skin. The body responds through inflammation, cell signaling, fibroblast activity, and gradual remodeling of the extracellular matrix.[1]

The treatment is not the same as using a superficial roller at home. Device design, needle depth, speed, passes, treatment area, and operator technique all affect the injury and its risks.

The FDA has cleared a limited number of microneedling devices for specific uses, including improving the appearance of facial acne scars, facial wrinkles, and abdominal scars in adults age 22 and older. Clearance is specific to the device, treatment area, and indication. It does not mean every device is cleared for every concern.[2][3]

Microneedling also does not treat every scar the same way. Rolling and shallow boxcar scars may respond differently from deep ice-pick scars, tethered scars, or raised scars. Active inflammatory acne can change the treatment plan as well.

What PRP adds

PRP is prepared from the patient’s own blood. After collection, the blood is processed—usually in a centrifuge—to produce plasma with a higher platelet concentration than whole blood.

Platelets help with clotting, but they also release signaling proteins involved in wound healing. That creates a plausible reason to combine PRP with microneedling: microneedling starts the repair process, while the platelet-rich preparation may influence inflammation, blood-vessel formation, fibroblast activity, and tissue remodeling.[4]

But a plausible mechanism is not a guaranteed visible result.

There is also no universal PRP formula. Preparations can differ in:

  • platelet dose;
  • white- and red-blood-cell content;
  • single- or double-spin processing;
  • activation method;
  • final volume;
  • time between preparation and use;
  • topical application, injection, or both.

Researchers have created PRP classification systems because these differences can be clinically meaningful.[5][6] Results from one protocol should not be promised for every treatment called a “PRP facial.”

What the acne-scar evidence shows

The strongest comparison evidence involves atrophic acne scars—depressed scars caused by tissue loss during acne-related inflammation.

A 2022 meta-analysis evaluated 14 comparative studies involving 472 patients. Overall, microneedling with PRP performed better than microneedling alone or microneedling with other controls.[7]

The analysis found:

  • higher odds of achieving more than 50% investigator-rated improvement;
  • a modest average advantage on an established acne-scar rating scale;
  • higher patient satisfaction;
  • no statistically significant difference in severe redness or severe swelling.

An earlier systematic review reached a similar conclusion: adding PRP may improve acne-scar outcomes.[8]

Individual split-face studies support that signal. In this design, one side of the face receives one treatment and the other side receives the comparison, reducing differences between patients.

One 50-patient study reported about 62% improvement on the PRP-treated side and 46% improvement on the control side after three monthly treatments.[9] Another study found improvement with both approaches. Dermatologist assessments favored the PRP side, but patients did not report a statistically significant satisfaction difference between the two sides.[10]

The evidence is promising—not definitive

The studies have real limitations:

  • Most were small.
  • Many were not fully randomized or blinded.
  • Devices, needle depths, and session schedules varied.
  • PRP preparation and delivery methods differed.
  • Outcomes often relied on photographs or rating scales.
  • Follow-up generally lasted weeks or months, not years.
  • Results were not consistently separated by scar type or skin tone.

The practical takeaway is straightforward:

PRP may add incremental benefit for some patients with atrophic acne scars. Research does not show that it is always better, necessary for everyone, or guaranteed to produce a dramatic difference.

Statistical improvement also does not answer a personal question: Is the likely benefit worth the added cost, blood draw, discomfort, and complexity for you?

What about wrinkles and general “rejuvenation”?

This is where broad marketing claims outrun the research.

Evidence involving acne scars cannot automatically prove that PRP improves wrinkles, laxity, pores, brightness, or overall skin rejuvenation. Those are different goals with different outcomes.

A small randomized split-face trial published in 2024 tested that question directly. Eighteen women received microneedling across the face. One side also received PRP injections, while the other received saline. Through 24 weeks, researchers found no notable added PRP benefit for skin laxity, wrinkles, or roughness.[11]

The study was small, so it does not prove that PRP never helps. It does show that the benefit is not established enough to promise a visibly better rejuvenation result.

If your goal is general skin quality rather than acne-scar treatment, ask what evidence supports PRP for that exact goal—not simply whether PRP contains growth factors.

Is microneedling with PRP FDA approved?

No—not as a combined cosmetic procedure.

The FDA has cleared specific microneedling devices for limited indications. It also states that microneedling devices have not been cleared to deliver PRP, other blood products, cosmetics, vitamins, topical medicines, drugs, creams, ointments, or gels into the skin.[2][3]

A PRP preparation device may have its own regulatory clearance. That does not mean the FDA has approved microneedling with PRP for facial rejuvenation, acne scars, or every purpose advertised online.

Before treatment, ask:

  • Which microneedling device will be used?
  • What is that device cleared to treat?
  • What PRP preparation system does the practice use?
  • Will PRP be applied topically, injected, or both?
  • Who performs each step?

What does treatment feel like?

A microneedling appointment may include cleansing, topical anesthetic when appropriate, treatment with a sterile single-use needle cartridge, and post-procedure skin care.

PRP adds blood collection and processing. Depending on the protocol, the finished preparation may be placed on the skin, injected, or both. That can add time, cost, and bruising from the blood draw or injections.

Neither option is universally painless or truly “downtime free.” Temporary effects may include:

  • redness and warmth;
  • swelling;
  • tenderness, stinging, or burning;
  • pinpoint bleeding;
  • dryness, flaking, or crusting;
  • temporary sensitivity.

Intensity and recovery vary with the device, treatment depth, number of passes, area treated, products used, and individual response.[2][3]

Risks and side effects

Microneedling disrupts the skin barrier. Potential complications include infection, cold-sore reactivation, acne or folliculitis flares, prolonged redness, pigment changes, irritation, and abnormal scarring. Rare granulomatous reactions have been reported, particularly when inappropriate or nonsterile products enter fresh microchannels.[12][13]

PRP comes from the patient’s own blood, but “autologous” does not mean risk-free. It adds risks related to collection, processing, labeling, handling, application, injections, and bruising.

In 2024, the CDC reported likely HIV transmission associated with PRP microneedling facials performed at an unlicensed New Mexico spa. Investigators found unsafe infection-control practices and inadequate patient records.[14]

That report does not mean properly performed autologous PRP inherently transmits HIV. It demonstrates why any blood-based cosmetic procedure demands strict aseptic technique, sterile single-use supplies, accurate patient identification, qualified personnel, and traceable records.

Who may need to wait or choose another approach?

Tell your treating professional about your complete medical, medication, and skin history, including:

  • active acne, infection, cold sores, or open wounds;
  • eczema, psoriasis, or inflammation in the treatment area;
  • keloids, raised scars, or poor wound healing;
  • previous post-inflammatory hyperpigmentation;
  • immune suppression, uncontrolled diabetes, or cancer treatment;
  • bleeding, platelet, or anemia concerns;
  • anticoagulants, antiplatelet medicines, or supplements that affect bleeding;
  • pregnancy or breastfeeding;
  • reactions to anesthetics, antiseptics, adhesives, or metals;
  • current or recent isotretinoin use;
  • recent peels, lasers, injections, or other procedures.

Do not stop prescribed medication for a cosmetic procedure unless the prescribing clinician tells you to do so.

Microneedling may be considered across a range of skin tones, but no treatment is risk-free for every complexion. Post-inflammatory hyperpigmentation can occur. Settings, preparation, and aftercare should reflect your pigment history and skin characteristics.

How many sessions will you need?

There is no honest universal answer.

Published studies use different devices, depths, intervals, PRP methods, and treatment counts. A plan should account for:

  • your goal;
  • scar type and severity;
  • device and labeled indication;
  • skin tone and pigment history;
  • response to the first treatment;
  • other treatment options;
  • tolerance for cost, discomfort, and recovery.

Be cautious of anyone promising a specific result from a fixed package before assessing your skin and scar pattern.

Questions worth asking at your consultation

  1. What exactly are we treating?
  2. What type of scars do I have?
  3. What can microneedling alone realistically achieve?
  4. How much additional benefit might PRP provide, and how certain is that estimate?
  5. Which microneedling device and PRP system do you use?
  6. Is the PRP topical, injected, or both?
  7. Who performs the blood draw, processing, microneedling, and injections?
  8. What licensing, training, and medical supervision apply?
  9. Is a new sterile needle cartridge opened for every treatment?
  10. How is my blood labeled and kept separate from every other patient’s material?
  11. What side effects and complications should I watch for?
  12. Who do I contact if symptoms worsen after treatment?
  13. How will we decide whether another session makes sense?

So, which option is right for you?

Microneedling alone may be the more straightforward choice if you want to avoid a blood draw, possible injections, added expense, or a more complex procedure. It may also make sense when evidence for PRP is weak for your particular goal.

Microneedling with PRP may be worth discussing for some adults with atrophic acne scars. Pooled research suggests an incremental benefit on average, but the size of that benefit for one person remains uncertain.

For broad facial rejuvenation, current evidence is not strong enough to assume PRP will produce a better result than microneedling alone.

A responsible recommendation starts with an assessment of your skin, scars, medical history, priorities, and alternatives. It should include an honest discussion of uncertainty—not a promise that the more complicated option must be better.

The bottom line

PRP changes microneedling, but it does not automatically improve every outcome.

The best evidence for adding PRP involves atrophic acne scars. Even there, studies support a possible incremental benefit—not a guarantee. Evidence for wrinkles and general rejuvenation is much less convincing. PRP also brings additional cost, blood handling, procedural complexity, and safety requirements.

If you are considering either option, focus the conversation on your specific concern, the practice’s actual protocol, and the result that would matter to you.

Interested in discussing microneedling options? Schedule a consultation with Le Sommet Med Spa in South Jordan to review your goals, skin history, possible alternatives, and whether microneedling alone or an adjunctive treatment may be appropriate. A consultation does not guarantee candidacy or a particular result.

Sources

  1. Iriarte C, Awosika O, Rengifo-Pardo M, Ehrlich A. Review of applications of microneedling in dermatology. Clinical, Cosmetic and Investigational Dermatology. 2017;10:289–298. PubMed
  2. U.S. Food and Drug Administration. Microneedling Devices. Updated October 15, 2025. FDA
  3. U.S. Food and Drug Administration. Microneedling Devices: Getting to the Point on Benefits, Risks and Safety. FDA
  4. Alves R, Grimalt R. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage Disorders. 2018. PubMed
  5. DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classification system. Arthroscopy. 2012. PubMed
  6. Magalon J, et al. DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport & Exercise Medicine. 2016. PubMed Central
  7. Kang BK, Lu D. Combined Effect of Microneedling and Platelet-Rich Plasma for the Treatment of Acne Scars: A Meta-Analysis. Frontiers in Medicine. 2022;9:788754. PubMed Central · PubMed
  8. Chang HC, Sung CW, Lin MH. Combination Therapy With Microneedling and Platelet-Rich Plasma for Acne Scarring: A Systematic Review and Meta-analysis. Dermatologic Surgery. 2020;46(8):1118–1122. PubMed
  9. Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling versus microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. Journal of Cosmetic Dermatology. 2016;15(4):434–443. DOI
  10. Ibrahim MK, Ibrahim SM, Salem AM. Skin microneedling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post-acne scars: a split-face comparative study. Journal of Dermatological Treatment. 2018;29(3):281–286. PubMed
  11. Evaluation of Platelet-rich Plasma and Microneedling for Facial Skin Rejuvenation. 2024. PMID 38798929. PubMed Central
  12. Microneedling adverse-effects systematic review. PMID 33584968. PubMed
  13. Microneedling safety systematic review. PMID 34448760. PubMed
  14. Paz-Bailey G, et al. Investigation of Presumptive HIV Transmission Associated with Receipt of Platelet-Rich Plasma Microneedling Facials at a Spa Among Former Spa Clients—New Mexico, 2018–2023. MMWR. 2024;73. CDC

Additional guidance

  • American Academy of Dermatology Association. Microneedling can fade scars, uneven skin tone, and more. AAD
  • FDA. Regulatory Considerations for Microneedling Products. FDA guidance
  • CDC. Preventing Unsafe Injection Practices. CDC
  • OSHA. Bloodborne Pathogens and Needlestick Prevention. OSHA

Book a consultation

Explore microneedling at Le Sommet · All resources