Microneedling Acne Scars

Microneedling is a broad term to describe the use of small needles to injure the layers of skin. This ‘micro injury’ of skin results in remodelling of the lower dermis. This can increase collagen resulting in improvement of some forms of acne scarring.

Microneedles can be delivered in 4 ways. The simplest is a roller mechanism consisting of 128-256 plus needles (depth varies between 0.1 to 2+ mm). These can be purchased online from eBay or Amazon for about $3 to $8 USD.

The second way of needling involves stamping or ‘derma stamp’. This provides vertical entry of needles in a stamping mode. Stamping is safer, but it is limited in the capability of treating angular areas such as the nose.

Thirdly microneedles can be delivered with a pen, called Dermapen, or Skin Pen. This is the most common mode of delivery as it is motor driven.

The fourth variation of microneedling is called energy microneedling or RFM; radiofrequency microneedling. This involves the use of insulated or non insulated bipolar needles. RFM has the advantage of providing heat. This results in more collagen remodelling. Devices such as Infini, Genius, Intracel, Vivace, Morpheus 8, Secret & Intensif are examples of RFM.

Early & superficial acne scars may improve with microneedling. This method is best for atrophic acne scars of the boxcar variety. It provides a general improvement of skin texture.

Microneedling is not effective for ice-pick scars as well as high volume atrophic acne scars. For this pattern of acne scarring, procedures such as subcision, punch excision, TCA Paint-CROSS & lasers provide better results.

This is concentrated platelet cells from blood. It involves taking your own blood, processing it, spinning it to give platelet cells (clotting cells) and then reinjecting or applying back to your skin scars after the area has been micro needled. The micro wounds left following needling allows the goodness of concentrated platelets & growth factors to enter your deeper layers of skin, stimulating collagen production.

 I do believe it has extremely marginal improvements when it comes to healing times, but little or no advantage when it comes to overall outcome. I do not routinely use PRP in the context of acne scar management as I believe that there are far superior ways to improve volume changes, including fat transfer & dermal fillers.

Yes. Microneedling can be a good non-targeted way to address acne scars. Mild to moderate early acne scars can improve with this treatment. It is the microneedling part that works, the PRP gives marginal improvements..

Microneedling has been shown to improve scarring by collagen remodelling in the deeper layers of skin. It can also release growth factors known as cytokines from the upper layers of skin (epidermis). A third mechanism is creating an electrical potential between the cells, leading to cell migration. There is no evidence that super deep treatments work better, however the deeper one goes, the riskier the treatment (scars, bleeding, bruising, infection). A sensible depth is 0.25 to 1.0 mm conducted with traction & counter traction. Performed correctly, a Derma roller or stamp can be just as effective. This can be done at home if you are careful.

Most dermatologists would agree, if sensible selection of depths with good technique, the risks of scarring is remote. A sensible at home depth is 0.25 maximum. Stamping is safer than rolling. Perform every 3-6 weeks, 6 to 8 passes depending on the number of needles.

Leading dermatologists & plastic surgeons would agree that platelet rich plasma does not contribute to the improvement of correction of moderate to severe atrophic acne scars. PRP can not correct meaningful volume loss.

I do believe it gives marginal improvement in healing times. There are many conflicting studies demonstrating the efficacy & in some cases the effectiveness of PRP. Base your decision on the interpretation of the data. If you would like to upsize your treatment & would like me to add PRP, just let me know.