How can I improve the look of scars from piercing needles? (Photos)

Thank you for sharing your photos—scarring from piercing needles is more common than people realize, especially when the skin heals unevenly or develops a bit of tethering. What you’re describing looks like a combination of small, pinpoint scars and the surrounding skin forming mild folds or indentations due to how the tissue healed.

There are a few approaches that can significantly improve the appearance:

1. Microneedling or RF microneedling
These treatments help break up the tight scar tissue beneath the surface and stimulate new collagen. Over a series of sessions, the skin texture can become smoother and the small folds can soften noticeably.

2. Fractional laser resurfacing
A gentle fractional laser can help resurface the skin, reducing the visibility of the small scars and evening out the texture. This is especially helpful when the scars are shallow but still visible.

3. Subcision for deeper tethering
If there is a small “pull” under the skin where the scar is attached more firmly, a minor subcision (using a tiny needle to release that tether) can help the skin lift and smooth out. This is usually combined with other treatments for the best result.

4. Silicone gel or silicone sheeting
For ongoing redness or raised edges, silicone can help flatten and fade scars over time. It’s a simple, at‑home approach that supports long‑term improvement.

5. Soft, precise filler (only if needed)
In cases where the scar leaves a small indentation that doesn’t respond to other methods, a tiny amount of hyaluronic acid filler can help lift the area so the fold is less noticeable. It’s subtle but effective when used conservatively.

Overall, the best results usually come from a combination of collagen stimulation and scar release, rather than trying to erase the scar in a single step. With the right approach, those small needle marks and the folds they create can be softened significantly, giving the area a smoother, more even appearance.

I have had great success in closing unwanted piercing holes in lips and belly-buttons using TCA CROSS, a technique well-recognized for its success in treating ice pick scars and very dilated pores. Typically one to three treatment sessions are needed to completely seal close the piercing hole.
A couple of microdroplets of Botox injected on each side of the upper and lower lips an be used to diminish the accordion folding seen in the photos. You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. 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 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 scars and indented 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 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