Deep acne scar in between eyes - will Microneedling help flatten it? (photos)

Question

Hello, I have a deep acne scar inbetween my eyes since I’ve touched what seemed to be a kyst in November. Borders of the scars are not flat, skin feels a bit hard underneath. I’m so self conscious I can’t stop touching it. I can’t look at people in the eye anymore cause to me this is all we can see. Do you think microneedling could help me flatten it ?

Jason Emer, MD · Answer

Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. Generally speaking, we often use:

- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, PiXel8, Morpheus, Skinfinity, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.
- All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time.

For darker skin types, it is important to avoid strong lasers such as CO2/Erbium and Fraxel as they can cause hyperpigmentation. Instead, scars in darker skin types can be improved with a combination of microneedling RF (Fractora, Intensif, Infini), Aerolase or Laser Genesis, microneedling with PRP, skin lightening, peels like Cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, and a proper skin care protocol (hydroquinone, vitamin c, kojic acid, azelaic acid, retinol)​. Sun protection is essential. I recommend getting a formal evaluation with a board-certified cosmetic dermatologist and acne scarring expert. Best, Dr. Emer​

Raffy Karamanoukian, MD, FACS · Answer

Acne scars are usually characterized within the subtypes of atrophic, hypertrophic, pigmented, or inflammatory. These subtypes of acne scars can be visually discerning in ambient light and can cause significant cosmetic concerns. Indented and atrophic scars require a combination approach to stimulate collagen and elastin, thereby smoothing contour and uneven skin. These are usually combined with lasers and depigmentation protocols to reduce inflammatory hyperpigmentation (Melarase AM and Melarase PM). Our Hidef protocols for acne scars include fillers such as Sculptra, Juvederm, Radiesse, and Restylane to improve deep acne scars; Vascular lasers to reduce inflammation and post-inflammatory redness and erythema; Fractional lasers to smooth contour and collagen; and Fractional RF to stimulate production of collagen within atrophic scars. Textural improvement and superficial scarring can be improved with Cosmelan peels, TCA Cross for ice-pick scars, deep chemical peels, and fractional CO2. We offer a personalized approach to your combination of scars and a formal evaluation with consultation is recommended to help you achieve your final results. Our plastic surgery office offers subcision and combination TCA Cross to help reduce deeply pitted scars. In terms of pigmentation and skin resonance, we recommend daily use of Melarase AM and Melarase PM coupled with Retinoid creams to achieve brilliant skin.

Best,
Dr. Raffy Karamanoukian
Realself100 Surgeon

Best, 
Dr. Raffy Karamanoukian
Realself100 Surgeon

Jennifer Scaljon, MD · Answer

Microneedling combined with Subcision will help that particular scar. Scars can be tethered down under the skin, and using a small needle to cut through that tissue will help release the tension on the scar. I think you will see good results from both procedures, combined.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Microneedling could help diminish your scar. You may also pair it with PRP for better healing and results. It may take multiple treatments and the skin may never be completely smooth again but you will see an improvement over time. We hope this information is useful and wish you the best of luck with your skincare concerns!

Deep acne scar in between eyes - will Microneedling help flatten it? (photos)

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