Working Blind: Why It’s Time to Measure Skin Properly

We perform advanced skin treatments every day—microneedling, PRP, radiofrequency, even active layering—with a calm confidence that often masks a difficult truth:

We don’t really know how deep we’re going.

Most of the time, we’re working blind.

We rely on surface-level visual cues: erythema, mild pinpoint bleeding, a client’s pain threshold. We refer to generic needle guides and face templates written in half-millimetres, calibrated on average thicknesses that don’t account for the actual skin in front of us.

That wouldn’t be acceptable for any other organ.

Why is it acceptable for skin?

The Problem Isn’t Practice. It’s Precision.

Skin isn’t one blanket measurement. It varies across the face. It changes with age, hormones, health, trauma, and environment. It’s layered, alive, reactive—and it does not respond predictably to average settings.

Take microneedling. The guidance we’re given rarely distinguishes between epidermal and dermal work, let alone between the papillary and reticular dermis. Many templates offer depth ranges with no indication of suitability for different ethnicities, skin densities, or clinical goals.

They’re not wrong. They’re just too general to be meaningful.

As a practitioner, I use a handheld skin analysis machine as part of my consultations—because I want to be cautious. I can assess hydration, pigmentation, elasticity—even wrinkle depth.

But not skin thickness. And that’s the missing piece.

When it comes to skin depth, I’m still guessing.

The Cost of Guesswork

This isn’t just a clinical inconvenience. It’s a public health issue waiting to unfold.

If we go too shallow, the treatment may be ineffective. Clients are left chasing results.

If we go too deep, we risk scarring, post-inflammatory pigmentation, or unintended tissue disruption.

In sensitive areas—like around the eyes—we risk breaching what should never be breached.

And when we don’t know the depth of skin, we can’t make an informed decision about what we’re introducing into it.

That last point will be explored in future research proposals. But the principle is simple: you can't predict outcomes if you can't see what you’re working with.

What Would Better Look Like?

Imagine a tool—affordable, handheld, app-integrated—that quickly measures the epidermis and dermis thickness across six common zones:

• Forehead

• Cheeks

• Chin

• Nose

• Eyes

• Neck

You scan the area. The phone shows:

Forehead: Epidermis 0.08 mm / Dermis 1.30 mm

Suddenly, you know whether your setting is hitting the right target—or going beyond it.

It’s no longer guesswork. It’s evidence.

This isn’t science fiction. The technology exists in parts.

And while we’re here, if epidermal tissue, in part, is around 0.08 mm and many devices start at 0.25 mm... well, that’s another conversation. One we’ll be having soon.

Some high-end clinics and research centres can already access depth measurement analysers—but not at scale, not at price points that support wide adoption, and certainly not integrated into most practitioner workflows.

Yet this tool, if made accessible, could:

• Support safer treatment planning

• Improve consent and client understanding

• Strengthen clinical justification for every treatment

• Contribute to audit, quality assurance, and national regulation

• And offer restraint: telling us when not to proceed, or when to refer

So Why Don’t We Measure?

There are reasons, of course.

• It would cost money to develop.

• Some may feel it undermines current expertise.

• The industry has always worked like this.

• And some may not want their lack of precision exposed.

But good professionals have nothing to fear from better tools.
Measurement wouldn’t remove artistry—it would support it.

It would offer reassurance to clients, and protection to practitioners.
And it would give regulators a benchmark that actually reflects the skin—not just the treatment.

We need to get there. Because right now, we’re still treating an organ without seeing the full picture.

What Comes Next?

This is the first in a series of proposals from The Skin Well™, exploring where our industry might benefit from better data, better tools, and ultimately better outcomes.

The systemic implications of products penetrating beyond the skin’s barrier—the glides, actives, and delivery methods used in some microneedling settings—will be addressed in future research proposals.

These are questions that need asking, and this campaign is here to ask them.

But we start here.

You cannot regulate what you cannot measure. You can not even licence it responsibly.
And you cannot protect what you cannot see.

Let’s Ask a Better Question

This campaign isn’t about tearing anything down. It’s about asking better questions—and supporting the professionals who want better answers.

So here’s the first one:

Do we know how deep we’re going?

Because if we don’t, maybe it’s time we did.