At A Glance Microneedling Acne Scars
- Best Results4-6 sessions
- Treatment Recovery1-3+ days
- Procedure Time10-30 minutes
- Skin SpecialistNurse, therapist, dermatologist
- Duration of ResultsVariable
- AnaestheticNumbing cream/gel
- Back to Work1-2 days
Microneedling Acne Scars
Microneedling is a favourite treatment offered by many cosmetic clinics as an option for acne scars. The most frequently used devices include Dermapen & Skin Pen. Microneedling can be combined with PRP or platelet rich plasma.
FactsFacts on Microneedling Acne Scars
- This treatment involves the use of tiny needles to break the surface of skin
- MIcroneedles provides controlled injury & miniature channels
- Dermapen & Skin Pens are the most popular devices
- 4-6 treatments are performed, 2-4 weeks apart for best results
- PRP is frequently combined with microneedling
What is microneedling?
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.
|Type||Derma Roller||Derma Pen||Derma Stamp||RF microneedling|
|Mechanism||Rolling||Vertical needles, motor driven||Stamping|
|Vertical insulated vs non-insulated needles|
|Pros||Cheap||Fast||Cheap, safe||More collagen remodelling|
|Cons||Needle entry not vertically orientated||Dragging or poor technique can induce scars||Difficult to treat|
Areas such as the nose, eyelids
What is PRP?
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.
Is microneedling PRP a good treatment for acne scars?
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.
Does PRP actually contribute to scar remodelling?
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.
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What types of acne scars can respond to microneedling?
Microneedling can improve mild & early scars & some cases of red scars. Though we do perform microneedling there are far better (& often more cost effective) treatments. As a guide, microneedling can improve shallow boxcar scars, pick scars, very mild atrophic scars as well as enlarged pores.
Is microneedling PRP a safe treatment?
Yes, if conducted appropriately. Device selection is important. A strong high Hz motor is required to facilitate gliding & not dragging. Technique is critical to prevent idiosyncratic scars- most frequently seen if needles are ‘dragged.’
PRP can be classed as autologous transfer of material- this means that side effects such as allergies & blood borne infections are not encountered.
What is the difference between microneedling & Radiofrequency Microneedling?
Microneedling can be classed as ‘cold steel’ needling whilst radiofrequency microneedling (RFM) is classed as energy based microneedling. Energy based RFM produces controlled heat. Heat denatures collagen, & stimulates new formation. Normal microneedling does not generate heat.
When do I use microneedling for acne scars?
I use microneedling to treat raised scars including hypertrophic & keloid acne scars. In this setting I do not want heating, but I want channels in the scars for topicals to penetrate into the deeper layers of the scar.
I also perform manual microneedling (often with saline) for forehead scars. I do not use Dermapen or Skinpen for atrophic scars, purely because other treatments work better.
If you would like the Clinic to perform straight up microneedling for your scars, book an appointment with our dermal therapist.
What are other scar treatments that specialists perform?
At Clinic Cutis my team & we employ over 40 types of lasers & EBD or energy based devices from powerful CO2 lasers to gentle Tixel, Fraxel, Clear & Brilliant, & LaseMD Ultra fractional laser systems. RF microneedling is delivered by the newest Genius RF (replaces Infini RF). Nano RF system is by Candela – called the eMatrix.
Microneedling & PRP combined: Davin’s Viewpoint
I still employ microneedling in the day and age of lasers & RFM (radiofrequency microneedling). The latter provides controlled heating with microneedling and hence it generates more collagen remodelling, especially in the context of scar revision. Lasers are much more precise, especially ‘small dot’ lasers such as Fraxel, LaseMD, Clear & Brilliant & eCO2. I prefer these treatments over microneedling – RFM when the ‘target’ or problem is small (eg pores). My preference for microneedling only is in the treatment of some types of scars, hypertrophic & sensitive keloid scars are examples. This is when I want punctate entry wounds without ‘char’ so I can deliver drugs into the deeper layers of skin.
Provided it is correctly performed, I don’t agree with the illustrations of ‘tearing’ the skin with derma rollers, once again this is in the context of depth of needles & technique. Using 0.1 to 0.25mm with adequate counter traction is a safe DIY, dragging microneedles can also result in idiosyncratic & iatrogenic scars. Possibly derma stamping is safer esp if longer needles.
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