Written by Mattea, Dermal Therapist
A question I am asked constantly in clinic at the moment: should I book skin needling or CoolPeel, and what is the actual difference between them?
There are so many treatments on the market now that choosing between them can feel overwhelming. I think having a wide range available is a good thing, because it means we can treat different concerns and different skin types properly instead of pushing everyone towards the same treatment. It does make the decision harder from the outside, though. So here is how I explain the difference.
What we use at Clinica Lase
We use SkinPen for skin needling, and CoolPeel, which runs on the Tetra Pro CO2 device from DEKA.
The two cannot be combined in the same appointment. We use one or the other, depending on what we are treating.
Both stimulate collagen, both work on skin health and quality, and both support the skin barrier. Where they differ is in how they create that response and which concerns they are designed to address.
How does skin needling work?
Skin needling works through mechanical injury. We create controlled micro-injuries in the skin with fine needles, using a specific technique, and infuse growth factors to support repair and recovery.
Those microscopic channels activate the skin’s natural wound healing response, which switches on fibroblast cells to produce new collagen and elastin.
Scarring and texture are two of my favourite concerns to treat with needling, because it works directly on breaking down fibrous scar tissue.
We customise it by adjusting the needle depth to reach different layers of the skin. Deeper is not always better. Depth is decided by what we are treating, where we are treating it, and how an individual’s skin responds.
Skin needling is used for
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Acne scarring
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Stretch marks
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Early signs of ageing and fine lines
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Pores and texture
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Maintaining results after pigmentation treatment
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Maintaining healthy collagen
How does CoolPeel CO2 work?
CoolPeel is a fractional CO2 laser. It delivers energy in very short pulses, which means less heat builds up in the surrounding tissue and recovery is shorter than with a traditional CO2 approach.
The primary chromophore for CO2 is water, which is naturally abundant in our skin cells. When the energy is absorbed by that water it creates a controlled thermal injury in the targeted areas, stimulating collagen remodelling, skin renewal and, the important one, resurfacing.
That resurfacing is why CoolPeel is used for sun damage, fine lines, rough texture and uneven tone. It works by encouraging the skin to regenerate.
CoolPeel is used for
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Fine lines and wrinkles
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Sun damage and pigmentation
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Crepey skin
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Pores and texture
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Mild scarring
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Skin health and rejuvenation
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Brightening the skin and complexion
So which one should I book?
Broadly, this is how I think about it.
Skin needling is where I would start if the goal is to strengthen the skin before other treatments, or to maintain it between and after a course of treatments so it stays strong and healthy.
CoolPeel is where I would go if lines, wrinkles, sun damage and crepey skin are the main concern.
Plenty of people end up with both in their treatment plan, just not on the same day. They do different jobs at different points.
What is the recovery like?
Downtime for both is usually one to three days of redness, although this varies between individuals.
Straight after treatment the skin feels warm and slightly sensitive. That generally settles within a couple of hours.
From around day three the skin feels dry and textured, and that can last five to seven days.
Both treatments also carry risks, including prolonged redness, swelling, infection and changes in pigmentation. We go through these with you at your consultation before anything is booked.
What the two treatments have in common
Both can be taken right up underneath the eye area, which is useful for fine lines, crepiness and darkness through that region.
Both can be used across a range of skin tones, from light through to deeper Fitzpatrick types. Settings and preparation are adjusted for deeper skin tones, and CO2 in particular requires additional caution and assessment.
Both are lower downtime options compared with more ablative resurfacing treatments.
Comfort varies between individuals, but both are generally well tolerated.
Who may not be suitable?
Neither treatment is suitable for everyone. You may not be a candidate if you have:
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A skin infection, open wounds or an active cold sore
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An impaired skin barrier, or a condition such as perioral dermatitis
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Inflammatory acne
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A history of keloid scarring
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Uncontrolled diabetes
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Recent sunburn
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Certain autoimmune conditions
Pregnancy is assessed on an individual basis. This is not a complete list, which is why an assessment always comes before treatment.
Common questions
Can I have skin needling and CoolPeel in the same appointment?
No. They are not combined. We use one or the other according to what we are treating on the day.
How many treatments will I need?
It depends on the concern, your skin and what you are working towards. Collagen stimulating treatments generally work best as a course rather than a one-off, and we map that out at your consultation.
Are these treatments painful?
A topical anaesthetic is applied beforehand for both. Comfort varies between individuals and depends on the settings and the area being treated.
Which one do you use for acne scarring?
Skin needling is usually where I start, because of how directly it works on fibrous scar tissue. CoolPeel is used for milder scarring and where texture and tone are also part of the picture.
Where to start
If you are interested in either treatment, book a consultation with one of our dermal clinicians. We will assess your skin, talk through your concerns and put together a plan based on what suits.