Treatment of hypopigmented acne scarring using microneedling, or other less resource intensive modalities than frac laser?

Question

I have diffuse macular hypopigmented scarring of my face from acne; no raised, depressed, or hyperpigmented tissue. Would microneedling (eg dermarolling, dermastemping, etc.) be worth trying? If so, what needle depth, treatment frequency & duration? Should vitamin C application be incorporated (w/ or without microneedling)? Is there a role for UV light exposure at some point in the therapeutic course? What other therapeutic options exist short of fractionated laser tx? Thank you in advance!

Nelson Lee Novick, MD · Answer

Loss of pigment, or hypopigmentation, from any cause, including the kind that can arise following the resolution of acne, tends to be notoriously difficult to treat with any current modality. Parenthetically, the same can be said of Ivory white scars, as well other types of loss of pigmentation problem that may result from prior injury or treatments, such as infections, trauma, scalpel surgery, lasers and chemical peels that damage the pigment producing layer of our skin.For well over a decade,  have had a gratifying measure of success with repigmentation, regardless of the prior cause of the pigment loss, using a combination of medical microneedling followed immediately by the application of tyrosine cream. Tyrosine is the naturally occurring amino acid that plays a crucial role in melanin production in our skin. (It is this process that  we try to suppress with agents like hydroquinone when treating overpigmentation or HYPERpigmentation). Successful treatment of hypopigmentation with the above approach usually requires a series of generally three to four (sometimes more) treatments spaced at four to six week intervals.

Brian S. Biesman, MD · Answer

You have asked in excellent question but it is one which would be best opposed to someone who is examining you in person and who also has experience in the treatment of acne scarring.  There are multiple different approaches that can be used to improve the appearance of acne scars.  The approach which is best for you can only be determined after learning your objectives, consideration of risks and benefits, and determining whether your expectations re likely to be met by any given treatment.

Jason Emer, MD · Answer

This is best treated with fractional nonablative lasers such as fraxel or clear and brilliant.  In the right hands they are very safe and can give amazing results.  Sometimes hypopigmentation cannot be reversed or can be made worse and so finding an expert to treat you is essential.  Best, Dr. Emer.

Jeff Rapaport, MD · Answer

In my opinion, microneedling would help although fractionated erbium produces the best result. You can buy a roller. Anything longer than .5 mm is dangerous outside of professional use.The extrac laser is great at repigmentation. It should not be expensive if you shop around.A combination of multiple modalities is preferred. Good luck

Treatment of hypopigmented acne scarring using microneedling, or other less resource intensive modalities than frac laser?

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Answer: Hypopigmented acne scars?

Answer: Hypopigmented acne scars?

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Everything you need to know about Microneedling

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Treatment of hypopigmented acne scarring using microneedling, or other less resource intensive modalities than frac laser?

Answers (4)

Answer: Hypopigmented acne scars?

Answer: Hypopigmented acne scars?

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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.