Long-term microneedling results for acne scars and shallow fine lines?

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

There is no published evidence supporting the long-term safety or efficacy of monthly microneedling sessions for years, but current studies show that most improvement in acne scars and fine lines occurs within the first 4–6 sessions, spaced 4–8 weeks apart, with diminishing returns after additional treatments.

Typical Protocols: Most clinical studies use 2–6 sessions, spaced 4–8 weeks apart, and report moderate improvement in acne scars and fine lines. For example, one study found that four sessions (one per month) led to significant improvement in acne scars, with 85% of patients seeing some reduction and no reported worsening. Another study using six sessions at two-week intervals also showed noticeable improvement in scars and skin texture.

Diminishing Returns: After 4–6 sessions, further improvement tends to plateau, and additional sessions may yield only minimal further benefit.

Long-Term/Repeated Use: There are no published studies or safety data on patients undergoing monthly microneedling for years. The longest follow-up in the literature is typically 3–6 months after the last session. No studies have evaluated the effects or risks of indefinite, ongoing monthly microneedling.

Safety: Short-term studies report that microneedling is generally safe with minimal downtime and low risk of adverse effects when performed at appropriate intervals. However, the long-term effects of repeated, frequent microneedling over years are unknown.


In summary: While you can safely undergo several more sessions (up to 6–8 total) with at least 28 days between treatments, there is no evidence to support or refute the safety or benefit of continuing monthly microneedling for years. Most improvement is seen within the first several sessions, and ongoing monthly treatments for years have not been studied or recommended in the medical literature