I recently had dermapen microneedling done 3 weeks ago and have regretted it since. Permanent puncture scarring?

Hello,Thank you for your question and photos. It is hard to tell without seeing a before picture. The picture you are showing looks similar to acne scarring. Dermapen, if performed correctly should heal acne scarring from the base up, diminishing the appearance of scarring holes. However, this is not completed with just one treatment, it usually takes a minimum of three treatments and can be combined with PRP. I would suggest going back to the provider and seeing what they suggest. Best of luck to you.

This is a complex question that has to be addressed. Here are my thoughts on this common situation.1. Idiosyncratic scars can occur with ANY treatment - this includes lasers and skin needling. 2. Erbium spot size from Sciton Profractional is large. One in eighty patients can and will develop grids. In most cases they will settle down with time. 3. The fact that you had prolonged grids with large spot erbium is a warning sign. 4. I do agree that before photos are needed to ascertain the degree of idiosyncratic 'scars'. Objective measurements are ALWAYS needed- hence why specialist always take before photos as well as a running time line.5. Treatment is straight forward if this occurs. Time will help 80% of patients, time line is 6 months. If things do not settle, small beam lasers such as NA lasers 1927, 1550 , 1540 can all help. 6. Microneedling can be an effective treatment for many conditions, however it should NOT be used as a sole treatment modality - if you have a hammer, everything looks like a nail. Microneedling has come a long way over the past few years and can help skin via several methods. Firstly it releases cytokines and growth factors in the epidermis and dermis- the top and bottom layers of your skin. This in turn remodels scars and the dermal layer of the skin. Additionally needles can break up scars themselves. This leads to new collagen formation, and in practice can provide limited skin rejuvenation. 



Microneedling is both user dependent and method driven. Simple needles can be used, growth factors can be added after the procedure, including PRP, or controlled heating during the procedure. This controlled heating is delivered via RF, and is called RF microneedling. RF can then be delivered via insulated or insulated needles. Even the energy level, depths, density, pulse duration and so many other variables can be controlled. This together with the added benefits of growth factor infusion makes this one of the most complex procedures in procedural dermatology. I use everything from Dermapen, though to newer generation insulated and non-insulated devices including INFINI micro-needling radiofrequency, Intensif and others. Newer generation devices can provide an added advantage in some, but not all patients. In my practice, I combine microneedling with many different forms of energy devices, depending on the expectations of the patient. Tailored microneedling combination will always give the best results. 



Like most procedures, its 80% skill level of the specialist and 20% dependent on the brand of the energy device- microneedling system. All the best, Dr Davin Lim. Brisbane. Australia. Realself Advisory Board Member