Microneedling was introduced in the 1990s to treat wrinkles and fine lines. It was later discovered to help improve acne scars. Microneedling is one of many treatment options available for acne scars. The type and severity of the acne scarring dictate the best treatment options. Read on to learn the effectiveness of microneedling, how it compares to laser treatments, and what are the risks.
There are two types of acne scars: atrophic (ice pick, rolling, and box car scars) and hypertrophic scars.
Microneedling (collagen induction therapy) is performed with a device that has numerous tiny needles that puncture the skin, causing micro-injuries resulting in the stimulation of new collagen.
It can take 4–6 monthly microneedling sessions to see improvement in atrophic post-acne scars.
Several side effects and risks are associated with microneedling, such as infection, scarring, bleeding, and bruising, which can be lessened by strict adherence to pre- and post-op instructions.
What are acne scars?
Acne scars are caused by inflammation and trauma from acne breakouts, trauma caused by picking or squeezing the acne lesions, and infection caused by picking at acne lesions. The scars can be superficial, deep, or moderate, depending on the inflammation's depth. There are two basic types of acne scars: atrophic and hypertrophic.
- Atrophic acne scars can be ice pick, rolling, or box car scars. Ice pick scars are thin, deep scars. Rolling and box car scars are wider with sloped or sharp edges.
- Hypertrophic scars are thick and lumpy.
What acne scars are hardest to treat?
Ice-pick scars are typically the result of cystic acne caused by inflammation deep inside the pore. These scars are the hardest to treat because they are the most severe. Ice-pick scars are deeper than boxcar or rolling scars, making them challenging to treat. Their narrow appearance also makes them difficult to treat.
Does moderate acne cause scarring?
Yes, moderate acne can cause scarring in many cases. The risk of scarring increases if acne is not cared for properly. Avoid picking or squeezing at acne, especially acne cysts. This will worsen the acne and scarring and increase the infection risk. Also, it will take longer for the acne to resolve. Proper treatment with prescription medications can decrease the scarring risk.
Does microneedling work for acne scars?
Yes, microneedling can help improve the appearance of acne scars. Microneedling, also known as collagen induction therapy, involves creating micro-injuries to the skin with numerous tiny needles that stimulate the production of new and remodeled collagen. This new collagen leads to improvement in skin texture and scar tissue.
Microneedling works best on atrophic scars, especially rolling and boxcar acne scars. Only minimal improvement is achieved in ice pick scars. It is best to avoid microneedling for hypertrophic and keloid scars, as they could worsen.
Microneedling has other skin benefits. It can even skin tone, giving you a brighter complexion and helping fade discoloration associated with acne scars. It can also improve the appearance of fine lines and wrinkles.
What does a microneedling session look like?
After cleansing and numbing the skin, an electronic microneedling device with numerous tiny needles is used to treat the area with acne scars. Some opt to treat their entire face to reap the rejuvenation benefits in unaffected areas of the face. The average microneedling session takes about 30 minutes. You will notice mild, pinpoint bleeding that resolves quickly before you leave your appointment. Immediately after the session, your skin will appear red and swollen, which lasts a couple of days. You may also experience dryness and peeling that lasts a few days after the microneedling procedure. Some experience mild discomfort or soreness, and possibly itching.
Some opt for applying PRP (platelet-rich plasma) or PRF (platelet-rich fibrin) after the microneedling session. PRP and PRF contain growth factors extracted from the blood's plasma. These growth factors are used to speed the healing and treatment of scars.
Some apply special serums after the microneedling session. These serums may contain antioxidants, Botox, dermal fillers, and hyaluronic acid. Applying these serums immediately after microneedling will enhance the penetration of these ingredients, leading to better and faster results.
How many microneedling sessions do you need for acne scars?
It can take 4–6 sessions to improve your acne scars, depending on the depth, severity, or extensiveness of the scarring. The more severe, the more sessions it will take. The sessions are usually performed monthly to allow the skin to heal fully. Deep scars will require deeper microneedling, which needs more downtime and could result in more possible side effects. These deeper treatments may need to be spaced out every 6–8 weeks for recovery.
Maintenance microneedling sessions can be performed periodically to retain skin improvement. If you have an acne breakout in the future, you will need to have more microneedling sessions. It's best to treat scars after your acne is under control and aren't experiencing breakouts.
Can you do microneedling for acne scars at home?
Yes, there are at-home dermarollers for microneedling. Because the needles on these at-home devices will not penetrate as deeply as the professional ones, you will not get the same results as a professional treatment. Also, without proper training, you can cause permanent scarring by doing it yourself. Since there is no way to sterilize your at-home device properly, you are at risk for developing an infection that could require hospitalization or long-term intravenous antibiotics and lead to permanent scarring.
Microneedling vs. laser for acne scars: Which one is better?
Microneedling and laser are good treatment options for acne scars. The choice depends on the type of scar, downtime, side effects, and skin type. Microneedling may be better for darker skin types and those who can't have a long downtime or are concerned about laser risks. Laser treatments may give faster and better results for some but require more downtime and have more risks. Some lasers may not be used on darker skin types because of depigmentation risks.
Another important consideration is budget. Microneedling is typically less expensive than laser treatments. The costs of microneedling can make it more attractive for those on a budget. However, more microneedling treatments may be needed to improve scarring, making it more time intensive.
Does microneedling for acne scars have side effects?
Yes, microneedling, like any procedure, has associated risks and side effects. Some are minor, and others are severe. The potential side effects and risks can be lessened by strictly following your doctor's pre- and post-op guidelines. These side effects include:
- Allergic reaction
Who should not have microneedling?
Some patients are not good candidates for microneedling. Patients with certain medical conditions or on certain medications are at increased risk for side effects. It is best to discuss this with your dermatologist to see if microneedling is right for you. These medical conditions include:
- Bleeding disorders
- Active infection
- Skin conditions (eczema or psoriasis)
- Problems with wound healing
- Medications (blood thinners or immunosuppressants)
Acne scars can cause significant physical and psychological distress. Good acne treatments instituted early and proper acne care may prevent acne scars. If unpreventable, treatments are available to help fade acne scars, such as microneedling.
The lower cost of microneedling compared to laser make it an attractive treatment option for acne scars. Microneedling can be a safe and effective treatment when performed by a properly trained professional.
Can acne scars be treated 100%?
No, acne scars cannot be treated completely. Patients with superficial scars may see complete resolution of their acne scars. However, those with severe, deeper scars, especially ice-pick scars and extensive scarring, will not have complete resolution. Those with extensive scarring may see enough improvement to be satisfied.
How do dermatologists fade acne scars?
Treatment options for atrophic scars include topicals (retinoids, sunscreen, and hydroxy acids), chemical peels, radiofrequency, dermal fillers, dermabrasion, light treatments, surgery, Botox, and microdermabrasion. Hypertrophic scars may benefit from intralesional injections of steroids or fluorouracil, radiation, and cryotherapy.
How long does it take for acne scars to fade with microneedling?
The severity of the acne scarring will determine how many treatments are needed. The more severe the scars, the more treatments needed. It may take 6–12 months to see the full collagen-inducing effects of the treatments because it takes time for collagen remodeling. Some may begin to see results after the first treatment.
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- Indian Dermatology Online Journal. Microneedling: Advances and widening horizons.
- Dermatology Research and Practice. Acne scars: pathogenesis, classification, and treatment.
- Indian Dermatology Online Journal. A Randomized Study to Evaluate the Efficacy of Fractional CO2 Laser, Microneedling, and Platelet Rich Plasma in Post-Acne Scarring.
- Pakistani Armed Forces Medical Journal. Microneedling versus carbon dioxide fractional laser in management of acne scars.