Is it more effective to treat scars when they're recent? (Photo)

Hello, I recently got the chance of being able to try out a scar-reducing procedure with a microneedling device known as the Dermapen. In general, though, is scar treatment more effective when the scars being treated are more fresh, so to speak, (e.g., 1 to 3 months) compared to treating them when they've aged (3+ months)? Would anyone know if the Dermapen would be more effective with scars that are recent compared to older scars?

Doctor Answers 5

Microneedling is a controlled injury, so you don't want to do it early in the healing process - you want to prevent scars early

Thank you for your question. You’re asking about timing of when is it best to treat a scar at less than 3 months, or greater than 3 months. You state you recently started doing Dermapen treatments for scars, and you submitted two very good photos to help describe your situation.

First a little about my background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice for over 20 years in Manhattan and Long Island.  We do a lot of treatment for acne scars and active acne. I was an early adopter of the Dermapen so I have a lot of experience with this device, so I’ll help you first in understanding the treatments of scars and wound healing. This will give you a better understanding of the ideas and different ways we treat tissue early or later in the wound healing process.

Dermapen is a microneedling device, and one of many in the category of devices with multiple clusters of needles that enter the skin. It can be adjusted for depth, and rate and frequency it penetrates the skin. Different depths, different levels, and different rates are adjusted to treat different issues.

Early in the healing process, it’s not likely derma needling would be optimal. Early in the healing process, you want to prevent an undesirable scar from forming. Early in the healing process, we often use a regenerative medicine technology such as platelet-rich plasma (PRP). Platelet-rich plasma (PRP) is derived from your own blood, and it’s a concentration of the growth factors and wound healing factors necessary when you have a cut. We have found that helping people who recently had an inflammatory issue, recently healing, or early signs of scarring, platelet-rich plasma (PRP) has a role, but it’s one part of the equation. There is also a role for steroids, be it topical or injectable. There’s also a role for other modalities such as silicone topical sheets.

Dermapen, or microneedling, is a very versatile tool, but it’s not the only tool available to help someone like yourself dealing with inflammation and wound healing issues. We spend a lot of time in our practice because we are also very innovative with the use of platelet-rich plasma (PRP) and Acellular matrix. Acellular matrix can help enhance wound healing, so we use if often to rehabilitate skin, improve skin quality, and to restore volume with a different strategy. Clearly, you’ve already found someone to help you with scarring, but I think you need a good conversation about the broad strategy for your treatment, and other modalities may potentially play a role.

There are also lasers, and we have a laser in our practice to treat active acne. It might have a value if for any reason you are not responding, or not tolerating topical or oral treatments, or it can fit in with a strategy with those treatments. There are almost infinite variables that can play a role in how a doctor strategizes your type of treatment based on your conditions,  the outcomes, and how you respond to these different treatments.

I think you’re asking a very good question, and the general feeling in the medical world is if the wound is more recent, it is easier to work with before it becomes scar tissue. Scar tissue is more solid and requires more intervention. In the earlier phases of wound healing, you could make a lot of impact. Wound healing basically has four phases: there’s a hemostatic phase which is  initial healing and stopping bleeding; the inflammatory phase; the proliferative phase where the body is generating collagen, blood supply, etc.; then there’s a remodeling phase. We have different strategies to help people throughout those different phases of wound healing. Microneedling and Dermapen has its place in different phases, but learn more about your other options so you can possibly incorporate them, and so discuss this with your own doctor.  I hope that was helpful, I wish you the best of luck, and thank you for your question.

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New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

Scars on Face/Body -- Lasers (Fraxel, Co2, Erbium), TCA Cross, Microneedling/PRP, Subcision, Fillers, Tattooing, Surgery

It
is always easier to treat a new scar, because the skin is still soft
and responsive. Older scars may take more treatments and may not
resolve as well. I use a combination of therapies rather than relying
on just one, for best results. Please see an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Treating scars - early vs late

It is much more effective to treat scars early vs late. Dermapen is only one way to treat scars. Numerous studies have shown the VBeam to help with scars, particularly surgical scars, when treated just after the sutures are removed. Keep in mind that all scars aren't the same and treatment needs to be individualized. I also treat scars with the Infini, Fraxel 1550, and topicals.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

New Acne Scars

It is much better to start treatmemt on your acne scars right away. You will need a combination of lasers to treat these scars. I like microneedling but not for this type of scars. Please consult an expert in acne scar treatments for the best cosmetic results. Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 79 reviews

Treating acne scar early versus later

I think the approach is entirely different. If it is red and inflammed the treatment is approach towards the active acne. This would be antibiotics and topical treatments. Once this is settled then you can treat the scars that are left. Then the approach is a multilayered approach most of the time except when the scars are superficial.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.