Micro-needling for Old, Burn Scars?

Question

I have 40-year-old burn scars on legs, bottom and inner thigh area on one leg I also have old skin graft scars. What do you think about Micro-needling? I have already spent thousands on Laser treatments with little improvement. Do you think skin expansion is my only option?

Hooman Khorasani, MD · Answer

I am sorry to hear about your burn scars.  Microneedling can stimulate collagen regeneration and when combined with PRP it can improve scars in a variety of skin types.  This includes acne scars, chickenpox scars, surgical scars and burn scars. Lasers can also improve burn scars.  Pulsed dye lasers can help improve scar redness.  Fractionated ablative and non-ablative lasers can help improve scar texture. May I ask what lasers you have used?

Robert W. Sheffield, MD · Answer

Thanks for your question! You have mentioned that youhave already undergone through several laser type treatments and have seen verylittle improvement. With this case at hand, I believe that microneedling willbe able to produce better results. You see, for burn scars to heal, pigmentmust be brought back and for this to happen, there should be follicle tracesleft in the scarred part of the body. These follicle traces contain themelanocytes that would be producing the pigment needed. Microneedling wouldstill need the aid of melanocytes to work out the healing process of the scars.
I would highly recommend consulting a board certifiedmedical professional to help you out in selecting the best burn scar treatmentoption for your case. Your doctor will help you by evaluating your case as wellas trimming down the options that will give you the best results.

Margaret Weiss, MD · Answer

This is such a difficult problem, and scars like this usually bring back old memories of the painful injury which can make it a constant reminder.  For a treatment to bring back pigment, there needs to be a remnant of follicles in the scarred area--the follicle is where there would still be melanocytes, or cells capable of producing pigment.  
If many types of lasers haven't helped, then it is unfortunately unlikely that micro-needling would help, as there probably aren't any follicles left in the scarred area. One could consider medical type tattooing, to try to match the surrounding skin, although that is hard to match.  Trying to protect from sun/bleach the surrounding skin may help a bit.  This is very hard and sometimes just not responsive to treatment.

Micro-needling for Old, Burn Scars?

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