As a society we are constantly looking for ways to look, feel and even act younger. From nasal sprays filled with stem cells to useless supplements to various injections, there are almost endless ways to attempt to keep your body as close to your 20s as is possible for as long as you can.

Most of them, of course, don’t work.

One of the popular ways to try to embrace eternal youth is microneedling. The practice consists of taking tiny needles and sticking them into your skin, mostly on the face but sometimes elsewhere on your body. If you believe the wellness entrepreneurs, these tiny needles will not only cause mild discomfort, and often a rash, but rejuvenate your skin and cause you to both look and feel younger. It’s not quite a miracle cure but if you believe the stories it could be the one trick to looking like a 45-year-old when you’re really in your early 50s.

But is stabbing yourself really based on science? Well, the basic idea isn’t completely far-fetched. Associate professor Deshan Sebaratnam, dermatologist at the Skin Hospital, notes that “the controlled damage can trigger remodelling and leads to improvements in mild skin problems like acne scarring or fine lines”. We’ve known for some time that minor damage can cause your skin to heal itself, which often has the side benefit of resolving other issues such as acne. That’s basically the idea behind chemical peels, of which we have some reasonably good evidence showing that they can improve some skin problems.

So there’s a reasonable rationale for the idea that microneedling might be beneficial when it comes to the things that we know benefit from medical management, such as acne or even acne scarring. But that’s not really the main benefit. Most of the online furore is talking about how you can look younger by rolling a tiny device filled with needles over your cheekbones, not about modest, temporary improvements in acne scars.

Not all of the studies are helpful

This is where we hit a serious issue: the quality of the evidence. There are very few studies that look at whether microneedling has any benefits for skin health, and most of them are terrible. For example, one of the often cited papers in the field is a study conducted in 2010. The authors enrolled just 20 people with acne scars, of whom five dropped out. In the remaining 15 patients, everyone got microneedling on one side of the face and no microneedling on the other. The side of the face with microneedling was, at the end of the study, slightly less scarred than the other, but not enough to reach statistical significance.

Most of the studies of microneedling seem to follow this pattern – very few people, inadequate follow-up, limited assessment of either scarring or wrinkles and a host of other issues. Some of the research is also just not that helpful – there are studies where they’re really testing something else, and so both groups get microneedling. They tell us very little about whether the microneedles help, because they aren’t looking at that specifically.

Professional services or at-home microneedling?

Sebaratnam also noted the difference between professional services and at-home microneedling: “Microneedling devices marketed towards consumers generally do not penetrate as deep as those offered by professionals. This means the chance of side effects is less but the chance of improvements is also less.” While there is no definitive evidence, it is likely that most home devices you’ll come across on Instagram or Tiktok are less likely to have a benefit.

All of this leaves us in a quandary. It’s technically plausible that microneedling could have some benefit. The most likely place where it might work is if you have acne or acne scarring and if it is provided by a professional service.

I’m on the fence about whether there are any other benefits for microneedling. It’s not impossible but I haven’t seen solid evidence yet. There’s also no clear information about the dose needed for microneedling to work – can you do it once per day? Once a week? Once a month? What length of needles?

Microneedling could work perhaps but I personally am not going to go out and get a roller filled with sharp pins just yet. I’d rather wait for better data before stabbing my face repeatedly.

Dr Gideon Meyerowitz-Katz is an epidemiologist and science communicator and a senior research fellow at the University of Wollongong

Antiviral is a fortnightly column that interrogates the evidence behind the health headlines and factchecks popular wellness claims