I've posted needleplay photos twice on my Twitter now, so I suppose it's probably something I should talk about.
Needleplay remains quite a stigmatised activity in the kink community. While the broad majority of people are happy with some light bondage, ooh and aah at seeing someone suspended in rope, and will joyfully take part in a light spanking, needles seem to cross a boundary many are uncomfortable with. This is most evidenced in the dungeon I actually play in - we are sealed off in our own room, partially for hygiene reasons (more about that soon), but also so that no one will accidentally walk into it and freak out.
As someone who curls up and shrieks at the mere sight of the whip - a common sight around all areas of the dungeon - I pout at the unfairness, but also, I get it.
You are breaking a literal barrier with needles - the skin. And yes, blood (affectionately referred to as "the pretty red stuff" in the majority of the needle community) does sometimes come out (although not as often as you would think). While impact play has the chance to draw blood, it is plenty dependent on the tools you choose and the hardness of your play - those who bleed at a flogging, paddling, or whipping, are often regarded as very hard players, and it's generally not something you'd do accidentally. Breaking skin is inherent to needleplay, however, and it's why a lot of people get scared.
Your safety, as it always is with any BDSM activity, is at risk. We all take risks in our lives - crossing the road, leaving the house, getting out of bed; all these activities have an inherent risk of injury to them. But, the chances of me stepping wrong and breaking my foot while getting out of bed are pretty low, so I deem it an acceptable risk and go on with my day. With needleplay, the risk is slightly higher, but we learn how to mitigate risks and best ensure our safety. R.A.C.K (Risk Aware Consensual Kink) is a pretty common term in the community, and an ideology that definitely applies to this activity.
Number one - hygiene. My play partner and I attended a class ran by one of the top players in Australia before ever thinking about sticking stuff into each other. Being in a small group of people, with the player herself and her friends watching over us and catching any mistakes we might make, was invaluable and essential to picking up a new skill. No matter what you're thinking about doing with BDSM, if you haven't done it before - impact, rope, bondage, etc - I recommend going to a skillshare, as you educate yourself on the risks inherent to the activity (also ensuring your consent is informed) and you can help mitigate them and play safer.
We play at a dungeon and not my home partially for the exhibitionistic aspect of it, but also because the medical area is much cleaner and easy to sterilise than my bed is. We use a chlorine derived cleaner (Viraclean) to clean all our equipment, donning gloves and using chlorhexidine to sterilize our hands, and sterilize the skin before piercing. Our needles are sourced from reputable medical suppliers (though god knows what they think we're doing walking out with 400 hypodermic needles at a time), and are individually sealed, in sterile packaging, capped and sharp. We run nothing through the hypodermic needles - the joy we get out of needleplay is in the piercing of the skin itself.
Our order of set up looks something like this - wipe down leather medical table with Viraclean, place 3 large absorbent pads (blueys) over the table for me to lie on, remove equipment from bag, wipe down all equipment with Viraclean (including lids, dispensers, etc) place a disposable bowl on the table and wipe down with Viraclean, unscrew the lid of the sharps container, don gloves, use chlorhexidine to clean the gloves over our hands, put chlorhexidine on gauze and wipe down the area of piercing multiple times, remove needles from sterile packaging (often 20 at a time) and place in cleaned bowl (still capped), change gloves, check in, pick up first needle, uncap, and pierce.
It's often 15-20 minutes of set up alone for a scene but I've included the list to try and explain exactly how much we value our safety and how much we put hygiene above all else. I play as safe as I possibly can - and, to be honest, it's actually about as safe as spanking or flogging, once you do all this (and much safer than rope). Needles seem like a big scary thing, but the prep and set up makes it pretty normal and you fall into a ritual, of sorts. I've known people to fall asleep on the table.
Depending on the size and width of your needle (the gauge), it doesn't hurt that much. I use relatively thin needles and getting my blood drawn hurts more than these.
I do needleplay because the endorphin rush I get is unlike anything else. Feeling needles pierce through my skin - in and out, sitting just under the first few layers of skin - leaves me a giggling, floating mess on the table. My smile often makes my face ache, and my play partner checks in often, laughing at how happy I am. I suppose from the outside it does seem rather twisted, but all kink is often viewed like that to people who don't understand it. My brain is wired in a way that specific kinds of pain make me happy, and I'm known to laugh ("adorably psychotic", as one kinkster put it) upon receiving quite intense pain. Perhaps it's a crossed wire in there somewhere, perhaps my neural pathways got mixed up somewhere down the line, but this is one of the things that makes me happy like nothing else.
There's a kind of sacred release that I get from being pierced. Having the needle go in one side and out the other, rather than the pain being delivered by a flat smack like it would be in spanking, helps me process and release whatever is happening in that moment. When I'm on the table and a sharp is being pushed through my skin, I may swear and scream and cry, but it's also helping me let go of the tension of the week, of whatever might've happened in my life. In that moment, all that exists is me, my partner, and the needles. Some people have a beer to unwind, some people fuck. This is one of the ways I choose to relax after a long week - paradoxic though it seems - and it simply helps me process the event that have happened and to let it go, like exhaling a breath I've held onto for too long.
Needles - breaking the skin, crossing that sacred boundary, the sharp pinch as it pushes out the other side - is a pain I adore above all else. Yes, I'm delightfully messed up and perverted, but isn't that the best way to be? I never claimed to be anything but a hedonist, and if chasing pain is what brings me pleasure, then I'm glad I can share it with you.
(Note: I do not currently professionally bottom for needles. If desired, I can bring you through this journey myself, and pierce you, but we would need to have a long discussion first and sort out an appropriately easy to clean area to do it.)