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 an entry level treatment for acne scars. The most frequently used devices include Dermapen, Dermarollers & Skin Pen. It is best used for mild acne scarring as it provides a general improvement for most types of superficial scars. This procedure can be done in office or as a DIY home procedure, providing needle lengths are conservative & methodology sound. 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
- This can remodel scars & create a modest increase in collagen
- Microneedling is an entry level treatment for shallow acne scars
- Dermapen, Dermastampers, Dermarollers & Skin Pens are the most popular devices
- 4-6 treatments are performed, 3-6 weeks apart for best results
- RF microneedling is more effective as it employs controlled heating
- At home DIY microneedling is a safe option, read more to understand
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 types of acne scars respond to microneedling?
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.
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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Is microneedling PRP a safe treatment?
Yes, if conducted appropriately. In office microneedling is considered an ‘entry level’ treatment for acne scars. It provides global improvement of shallow scars.
3-4 sessions are required for optional outcomes.
PRP can be classed as autologous transfer of material- this means that side effects such as allergies & bloodborne infections are not encountered.
When do I use microneedling for acne scars?
I 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 (RF microneedling).
If you would like the Clinic to perform straight up microneedling for your scars, book an appointment with our dermal therapist in Brisbane or Sydney.
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.
RF microneedling produces much better results compared to normal microneedling. The devices that we employ include-
- Inifni RF:replaced
- Genius RFM: current
- Potenza RFM: current
- Morpheus8 RF: replaced
- Profound RF: current, but hardly used
- Matrix-eMatrix RF; current but hardly used
- Secret RFM (Sydney): current
How to treat ACNE SCARS on a budget?
At home: Use the Banish microneedling system together with their products. This program is an affordable method to reduce superficial acne scars. The microneedle of choice is a dermastamper. It provides a safe, at home alternative to microneedling.
In clinic procedures: For better results, book an appointment with my nurses at Cutis Dermatology in Brisbane or DVP in Sydney. They will provide cost-effective solutions for mild to moderate acne scars.
Why is control of your acne paramount in getting results?
Placing your acne in remission is important during any form of scar revision, including microneedling.
Active acne, no matter how mild, will not allow your body to remodel scars & boost collagen efficiently. Your immune system’s efforts are concentrated on fighting the pimple (via inflammation) & not on building new collagen.
If you are struggling with acne, see a medical dermatologist for treatment. They will discuss (negotiate) acne treatments that you are comfortable with.
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.
How to get an appointment to see if microneedling is the correct treatment for your acne scars?
For Brisbane patents; book a consultation with our nurses at Cutis Dermatology.
For Sydney patients: book an appointment with Louise, my dermal therapist at Dr Van Park’s practice in the Eastern Suburbs.
In Sydney I offer the current acne scar revision treatments-
- RF microneedling
- Limited subcision
- Dermal fillers for acne scars
- Collagen stimulating injectables
- Rejuran S for acne scars
- TCA Paint
*Ablative lasers & in theatre subcision will be offered in 2024 in a private hospital in the Eastern Suburbs of Sydney.
Is microneedling a good treatment for enlarged pores?
Though it can improve the size of pores (in conjunction with acne scarring), I do not employ microneedling for this purpose, simply because there are far more effective solutions to reduce the size of your pores. They include-
- Pico lasers, especially Picosure Pro (better than Picoway)in darker skin types.
- Fraxel or LaseMD fractional lasers in lighter skin types.
Microneedling Acne Scars 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, namely acne scars on the forehead. This is when I employ manual microneedling to break up focal areas of fibrosis.
Microneedling (even RF microneedling) is designed as an overall or general method for scar revision, it is not targeted. What this means is that some scars will respond better to others. Better response can be seen in shallow atrophic scars such as boxcar scars, saucer scars & low volume atrophic scars.
Provided it is correctly performed correctly, it is a safe & marginally effective at home treatment. You can use derma rollers from eBay (limit needle length to 0.25 mm), or stamping devices (Banish Acne range). 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. Limiting your depth of needles provides safety, hence why I do not recommend DIY microneedling with DermPens (as these devices can reach deeper).
A super quick guide to DIY (safe) microneedling at home is as follows:
- Ensure your acne is under control (complete remission or showing a marked trend of reduction over the past few months). This the biggest mistake patients make in over 80% of cases. If you still have background inflammation, your skin’s immune system is not functioning at its maximum potential.
- Start with a stamper, 0.1 to 0.2 mm in depth, Banish make good ones. If you are on a budget, search eBay or Amazon.
- Stamp as directed, every 5 to 14 days. You can use adjunctive retinol, vitamin C & other skin care active as tolerated.
- If your results are slow, revisit point number one (control your acne).
DIY mironeedling is an entry level treatment for only mild to superficial acne scars, providing your inflammation is controlled with a downward trend in acne activity, this treatment can be effective. For deeper scars, consult a dermatologist for other treatment options.
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