5 days since I did my 4th microneedling. No improvement on my acne scarring and there is hyperpigmentation. Is this normal?

Question

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Prashant Murugkar, MD · Answer

hi there is generally no hyperpigmentation after dermaroller treatment, so sorry to hear you have had this problem. It is quite likely that what you are seeing is a temporary brown discolouration of the skin that will flake off in a few days. By the way your problem seems to be more solvable with cross TCA and Subscision with or without Nano Fat or PRP

Maha S. Shakir, MD, FACS · Answer

Thank you for the question. When treating acne scars using microneedling, usually that’s need several sessions to see results and at least 4 weeks post each session to see results. Darkening of the treated area is secondary to PIH. This can improve with time and hydroquinone. Good luck. 
Lake Oswego Vein and Aesthetic-LOVA

Steven F. Weiner, MD · Answer

You affirm my belief that microneedling gives only minor improvements to acne scarring. PIH is rare after this procedure but occurs. It can be treated with retin a and hydroquinone. I feel that you would benefit from TCA Cross for all the ice pick scarring, and possibly RFM. Please see an acne scar specialist. PRP might improve healing as well. I also use subcision on most of my acne scar patients.

Laura Riehm, MD · Answer

Thanks for your question and posting a picture.  I'm sorry that you aren't seeing the results you anticipated.  Microneedling results are often over-promised and not predictable.  I don't understand how scuffing up the surface of the skin will help with scar tissue below the surface.  Unfortunately, post inflammatory hyperpigmentation is a frequent complication of microneedling.  I would suggest contacting an acne scar expert.  Best of luck

5 days since I did my 4th microneedling. No improvement on my acne scarring and there is hyperpigmentation. Is this normal?

Answers (5)

Answer: Microneedling hasn't improved my acne scarring after 4 treatments, and I have PIH

Answer: Microneedling hasn't improved my acne scarring after 4 treatments, and I have PIH

Answer: We Don't Recommend Microneedling

Answer: We Don't Recommend Microneedling

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Everything you need to know about Microneedling

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5 days since I did my 4th microneedling. No improvement on my acne scarring and there is hyperpigmentation. Is this normal?

Answers (5)

Answer: Microneedling hasn't improved my acne scarring after 4 treatments, and I have PIH

Answer: Microneedling hasn't improved my acne scarring after 4 treatments, and I have PIH

Answer: We Don't Recommend Microneedling

Answer: We Don't Recommend Microneedling

Browse related questions

Recommended reading

Everything you need to know about Microneedling

Our mission is to create a world where every investment in modern beauty is Worth It.