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Can You Use HSA & FSA for Microneedling?

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Microneedling has gone from a niche dermatology procedure to one of the most talked-about skin treatments in the U.S. Walk into any med spa or clinic today, and chances are you’ll hear someone asking about its ability to smooth scars, soften wrinkles, or give skin a healthier glow. 

With that growing popularity, another question keeps coming up: can you use HSA for microneedling? Can you use FSA?

It’s a smart question, especially when you consider the results people are seeing. In one clinical study, 93.8% of patients noticed visible wrinkle improvement after 30 days, and 87.5% said they were satisfied with their treatment. 

Those kinds of outcomes are exciting, but they also leave most patients wondering whether the microneedling cost can be offset with funds they’ve already set aside for healthcare.

In this article, we’ll explore how HSA and FSA coverage works, when microneedling might count as a qualified expense, and what your options are if it doesn’t.

Can You Use HSA for Microneedling?

The short answer: it depends. You can use your Health Savings Account (HSA) for microneedling, but only if it’s considered medically necessary under Internal Revenue Service (IRS) guidelines. 

The IRS allows HSA funds to be used for the diagnosis, cure, mitigation, treatment, or prevention of a disease. That means the procedure needs to serve a medical purpose, not just a cosmetic one.

Using your HSA can save you money, since the dollars you spend are tax-free. But it’s important to remember that using HSA funds for non-qualified expenses can result in tax penalties, so you’ll want to confirm eligibility before booking your treatment.

When Microneedling May Qualify as an HSA Expense

Microneedling can sometimes be reimbursed with HSA funds if it’s part of a medical treatment plan. Examples include:

  • Acne scarring: When scars are persistent and affect your skin’s function or appearance, a dermatologist may classify microneedling treatment as medically necessary.
  • Traumatic or surgical scars: In cases where microneedling helps restore skin after injury or surgery.
  • Stretch marks (striae): While often considered cosmetic, stretch marks linked to certain conditions or rapid changes may be eligible if documented by a provider.

In each scenario, a doctor’s recommendation and a Letter of Medical Necessity are critical to prove that treatment is more than just cosmetic.

When Microneedling Is Not HSA-Eligible

On the other hand, HSA funds generally cannot be used for:

  • Reducing wrinkles or fine lines.
  • Evening out skin tone.
  • Minimizing pores.
  • General skin rejuvenation or “preventive” cosmetic care.

These situations fall under cosmetic procedures, which the IRS does not consider eligible medical expenses. If HSA funds are used here, you could face tax penalties in addition to paying back the expense.

Can You Use FSA for Microneedling?

The rules for FSAs (Flexible Spending Accounts) are very similar to HSAs: microneedling is typically not covered if it’s only cosmetic, but it may qualify if performed for medical reasons. 

Like HSAs, FSAs require documentation such as a Letter of Medical Necessity to justify reimbursement.

The difference is how FSAs work:

  • “Use it or lose it” policy: Unlike HSAs, most FSAs don’t allow you to roll over unused funds year to year. If you don’t spend the balance before your plan’s deadline, you forfeit it.
  • Employer-sponsored accounts: FSAs are only available through participating employers, while HSAs are tied to high-deductible health plans.

If you’re considering microneedling and want to use your FSA, you’ll need to confirm eligibility with your plan administrator before scheduling. 

Cosmetic treatments like wrinkle reduction won’t be approved, but medically necessary procedures, such as treating acne scars, may be reimbursable.

HSA and FSA Eligibility Rules for Microneedling

When paying for microneedling with your HSA or FSA, the deciding factor is whether the procedure is considered cosmetic or medically necessary. The IRS sets the criteria for what qualifies, and your plan administrator applies those rules to your claim.

The IRS Guidelines

According to IRS Publication 502, you can only use tax-advantaged accounts like HSAs and FSAs for medical expenses that are meant to “diagnose, cure, mitigate, treat, or prevent” a condition or disease. 

Treatments that are purely cosmetic, meaning they’re done to improve appearance but don’t address a medical issue, are specifically excluded.

That means if microneedling is performed to reduce wrinkles, even out skin tone, or generally refresh your complexion, it won’t qualify. But if your provider documents that it’s being used to treat a medical concern, there’s a chance you could use your HSA or FSA.

Documentation Requirements For HSA or FSA Reimbursement

To get reimbursed for microneedling through an HSA or FSA, you’ll usually need:

  • A Letter of Medical Necessity (LMN): This is a statement from your doctor explaining why microneedling is needed to treat a specific condition.
  • Detailed receipts or invoices: These should include the provider’s name, the date of service, and a clear description of the procedure.
  • Plan administrator approval: Each HSA or FSA provider may have slightly different documentation requirements, so it’s best to confirm before your appointment.

Without proper documentation, there’s a good chance your claim will be denied. 

Alternatives if HSA or FSA Won’t Cover Microneedling

Even if your HSA or FSA won’t cover microneedling, you still have options to make the treatment more affordable. Many practices understand that cosmetic procedures can be a financial commitment and provide flexible ways to pay.

Using Payment Plans or Financing Options

Some microneedling clinics offer in-house payment plans that let you spread out the cost of microneedling. This way, you can invest in your skin health over time without the stress of a large upfront payment.

Others may partner with third-party financing companies that provide low-interest or promotional financing for medical and cosmetic treatments.

Additionally, you can check whether your provider offers membership programs or package deals, for example, buying multiple sessions at once at a discounted rate. Since microneedling often works best in a series, these packages can provide both convenience and savings.

HSA, FSA, and Microneedling: The Bottom Line

So, can you use your HSA or FSA for microneedling? The answer ultimately depends on the purpose. If you’re pursuing microneedling for cosmetic reasons, like reducing fine lines, evening out skin tone, or achieving a smoother complexion, it’s usually not covered. 

But in cases where microneedling is medically necessary, such as treating acne scars or certain types of scarring, you may be able to use HSA or FSA funds with the proper documentation.

Because rules can vary, it’s always best to seek consultation with both your healthcare provider and your plan administrator before scheduling your microneedling treatment. That way, you’ll know what to expect and can avoid surprise costs.

At InjectCo, we help patients explore safe, effective treatment options while keeping budget considerations in mind. Schedule a free virtual consultation today to learn more about microneedling, payment options, and whether this treatment is the right fit for your skin goals.

Frequently Asked Questions

Can I use my health savings account (HSA) for microneedling?

You can only use your HSA for microneedling if it’s considered medically necessary. Cosmetic procedures, like wrinkle reduction or general skin rejuvenation, usually don’t qualify.

When is microneedling considered a medical necessity?

Microneedling may be medically necessary if it’s recommended by a licensed provider to treat conditions such as acne scars or traumatic scars. In these cases, documentation from your doctor is often required.

What counts as eligible expenses for HSA or FSA reimbursement?

Qualified medical expenses must mitigate, treat, diagnose, or prevent a medical condition. Cosmetic-only treatments, like microneedling for smoother skin, are not included.

Can I use HSA funds for cosmetic microneedling?

No. HSA funds can’t be used for purely cosmetic treatments. To qualify, you need proof that the treatment addresses a specific medical condition.

Do I need a Letter of Medical Necessity for microneedling?

Yes, most HSA or FSA providers will require a Letter of Medical Necessity from your doctor to approve reimbursement. This letter explains why the procedure is medically needed.

Is RF microneedling covered by HSA or FSA?

RF microneedling, which uses radiofrequency energy to target deeper layers of skin, is generally not covered unless it’s prescribed for a medical reason, such as scar treatment, with proper documentation.

What should I do before booking an appointment today for microneedling?

Before scheduling, check with both your provider and your HSA/FSA administrator to confirm if your treatment could be eligible. This helps avoid denied claims later.

Written By:
Dr. Adrian Cole, MD


Dr. Adrian Cole, MD, is a Medical Advisor with over a decade of experience in medical aesthetics and wellness. He provides clinical guidance on patient safety, treatment planning, and evidence-based protocols across a broad range of services, including injectables, skin health, and medical weight management. With extensive experience training healthcare providers, Dr. Cole plays a key role in shaping best practices and supporting safe, results-driven care within modern aesthetic and wellness clinics.

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