Why is there a 1mm microneedling depth regulation for estheticians?

Estheticians do not have the extensive training that a board-certified doctor does. I suggest you only see a board certified dermatologist who is an expert in acne scarring treatments, because it requires a combination approach to get the most improvement. For the best results, one should target the acne scar type. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision. Subcision for depressed tethered scars. Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring. Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision. All lasers are combined with microneedling and PRP to get even better results and improve healing times. The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician. It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome. Scars cannot be cured and will need life-long treatments to maintain and build on the results. Best, Dr. Emer.

As above, anatomy is vitally important. I have seen some disasters when non board certified doctors hit vital nerves with ridiculous depth miconeedling 5 mm for example. Having your nerve repaired by a plastic surgeon or having permanent neuropraxia is not good! This is why the regulation exist. When microneedling the depth should always change. Using RF microneedling I vary my depth depending on the areas treated. IMO even 1 mm on the forehead is too deep, I personally go to 0.5 mm. Touch your skin and feel bone? Your buffer from skin to muscle is 0.5 mm at most. 


Acne scar revision comprises of many specialised procedures. For the best results, one should target the acne scar type with appropriate treatments METHODS. Using one or two devices is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Remember, scar revision is a medical procedure that is technical to perform. It is not dependent on the clinic, branch, machine, or laser but by the skill of your dermatologist of plastic surgeon. 



Take for example deep ice pick scars, and narrow box car scars. These are best treated with TCA CROSS and focused angled Co2 fractional laser in low density. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat graft, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations. 



In the vast majority of patients, different patterns of acne scars will be present. Monomorphic acne scarring (scars of the safe subtype) are extremely rare. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combinations that yields the best results. It is never about the device, it is about the specialist behind the equipment that will deliver the best outcomes. 

Global leaders in acne scar revision will always use manual methods to revise scars, and employ lasers and energy devices as instruments to assist. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.