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Microneedling before application is used in some protocols to improve penetration, though this is based on mechanistic reasoning more than direct comparative RCT data

10.1016/j.actbio.2017.08.032 54 SnedekerJ

Observational Adverse Events and Severe Toxicities Conversely, the unregulated, experimental nature of this digital ecosystem has brought significant, highly concerning adverse effects to light, severely underscoring the dangers of self-administering experimental systemic therapeutics

In addition, subjects in whom serum IGF-1 levels had not been measured while in resting positions (n = 60) were also excluded

doi: 10.1080/14764170701704668