Collagen induction therapy is the medical name for microneedling. Fine needles are pushed into the skin in a controlled pattern so the body repairs the area with fresh collagen and elastin, which firms skin, fills scars and, on the scalp, improves conditions for hair growth. A derma roller is the home version of the same therapy, and this guide explains where the term came from, what the evidence says, and what you can realistically expect.
Where the term comes from
The phrase was coined by Desmond Fernandes, a plastic surgeon in Cape Town, who published a description of the technique in 2005. He had noticed that patients whose skin was repeatedly needled during other procedures developed smoother, firmer skin, and he built a roller of fine needles to reproduce the effect on purpose. He used it on wrinkles and scars and called the method collagen induction therapy, or CIT, to separate it from treatments that resurface or remove skin.
The key word is induction. Nothing is injected and nothing is removed. The needles persuade the skin to make its own collagen in the right place. Today the same technique is sold under many names: microneedling, dermarolling, skin needling, percutaneous collagen induction, and clinic brands like Dermapen. They all describe the same underlying process.
What collagen does and why skin runs short of it
Collagen is the protein that gives skin its structure. It sits in the dermis as a mesh of fibres, with elastin woven through it to give stretch. Young skin has a dense, well-organised mesh. From the late twenties the body makes a little less each year, and sun exposure breaks down what is there. The mesh thins, the surface loses support, and lines appear where the face moves most.
Scars are a different collagen problem. An acne scar is a place where the dermis was damaged and the collagen laid back down was patchy, so the surface sinks. Stretch marks are torn dermis that healed thin. In both cases the fix is to get the body to lay fresh, organised collagen into the gap.
How the therapy induces collagen
Each needle makes a channel through the epidermis into the dermis. The skin reads each channel as a small wound and runs its normal healing sequence: inflammation for a few days, then a proliferation phase in which fibroblast cells arrive and make collagen and new capillaries, then months of remodelling in which that rough early collagen is replaced with stronger, better aligned fibres.
Because the channels are tiny and the tissue between them is untouched, the repair is clean and no scar forms. Because there are hundreds of channels over a small area, the whole patch remodels at once. That is the difference between CIT and simply having a cut heal. For the fuller biology, including the growth factors involved, read how does derma rolling work.
The evidence you can rely on
There are three studies worth knowing, and none of them are hard to summarise.
- Fernandes, 2005. The original description of needle rolling for wrinkles and scars, which set out the theory and the clinical observation that repeatedly needled skin thickened and smoothed.
- Fabbrocini and colleagues, 2009. A small study in which patients had two sessions with a 1.5mm roller, eight weeks apart. Acne scar severity was reduced and the improvement was measured rather than just reported by patients.
- Dhurat and colleagues, 2013. One hundred men with male-pattern hair loss. Half used 5% minoxidil twice daily. The other half used the same minoxidil plus weekly rolling with a 1.5mm dermaroller. After 12 weeks the rolling group gained about four times the hair count of the minoxidil-only group. A 2015 follow-up by Dhurat and Mathapati showed new growth in men who had previously failed on minoxidil and finasteride once weekly rolling was added.
These are small studies, done with 1.5mm needles, in clinics. They do not prove that 0.5mm at home gives the same numbers. They do show that the mechanism is real and that the effect on hair, in particular, is large enough to measure in three months.
What CIT treats, and how well
| Concern | How well it responds | Typical needle length | Time to see change |
|---|---|---|---|
| Fine lines and dull texture | Well | 0.25mm to 0.5mm | 8 to 12 weeks |
| Rolled and boxcar acne scars | Moderately well | 0.5mm home, 1.5mm clinic | 3 to 6 months |
| Ice-pick scars | Poorly | Usually needs other treatment | Slow |
| Male-pattern hair loss | Well, with minoxidil | 0.5mm home, 1.5mm clinic | 3 to 6 months |
| Stretch marks | Variable | 0.5mm to 1.0mm | 6 months or more |
| Melasma or dark patches | Risky, can worsen | Not recommended at home | N/A |
The face routine for lines and texture is in our guide to the derma roller for face. For scars, the approach and its limits are in derma roller for acne scars.
Clinic CIT versus home CIT
In a clinic the therapy is done with a motorised pen or a 1.5mm to 2.0mm roller, under numbing cream, by someone who controls depth precisely. Sessions in Lahore, Karachi or Islamabad cost several thousand rupees each and are repeated every four to eight weeks. Skin bleeds, swells and stays red for two or three days. The depth reached is greater, which is why the studies used it. The 1.5mm derma roller guide explains what that depth involves and why we do not recommend it in a bathroom mirror.
At home the therapy is done with a short roller, usually 0.5mm, once a week, with no numbing and no downtime beyond a few hours of pinkness. Each session is milder and you do many more of them. Over a few months the total stimulus adds up. The trade is speed for safety and cost. A course of home CIT with the Dermaroller.pk 0.5mm roller costs PKR 799 for a roller that lasts two to three months, delivered anywhere in Pakistan on cash on delivery.
Many people do both: an occasional clinic session for depth, and weekly home rolling to maintain the result. If you go that route, tell the clinic you are rolling at home so they can space the sessions.
What a course of home CIT looks like
Here is the routine we send out with every roller, in short form.
- Wash the area and pat it dry. Rinse the roller and soak its head in 70% isopropyl alcohol for five to ten minutes, then let it air dry.
- Roll each patch of skin in four directions (up and down, side to side, and both diagonals), lifting the roller between passes rather than dragging it back. Use light pressure. Stop when the area is evenly pink.
- Wait 20 to 30 minutes. Then apply a plain serum on the face, or minoxidil on the scalp. Nothing with acids, retinol or fragrance for the next 24 hours.
- Wear sunscreen the next day and for the rest of the week. This matters more in Pakistan’s sun than almost anywhere.
- Rinse and disinfect the roller again, dry it and put it in its case. Repeat once a week on the scalp, every one to two weeks on the face.
Take a photo in the same light before you start and every four weeks. The change is slow enough that you will not notice it day to day, and the photos are how you know it is working.
Frequently asked questions
Is collagen induction therapy the same as microneedling?
Yes. Collagen induction therapy is the original medical term and microneedling is the common name. Dermarolling is microneedling done with a roller. Our article on what is microneedling lists all the device types under that umbrella.
How many sessions are needed?
In clinic studies, two to four sessions spaced four to eight weeks apart produced measurable change in scars, and twelve weekly sessions produced the hair result. At home with 0.5mm, plan on at least twelve weekly sessions before judging.
Does it hurt?
Clinic depth needs numbing cream. A 0.5mm roller at home stings on thin skin and is barely felt on the scalp. If it hurts enough to make you flinch, you are pressing too hard.
Can collagen induction therapy cause scarring?
Not when done correctly. The channels are too small and too well spaced to scar. Problems come from rolling over infected skin, dragging a dull roller, or using a long needle with heavy pressure. People prone to keloids should ask a dermatologist before starting.
Collagen induction therapy is a sound idea with decent evidence behind it, and a derma roller is the cheapest way to try it. If you want to start at home, we sell one size of derma roller in Pakistan and deliver it free with cash on delivery.