Are results of microneedling on acne scars not permanent? Why are maintenance sessions recommended? (Photo)

Question

I have undergone 8 sessions of vivache RF microneedling.Am quite satisfied with the results but am skeptical on the recommendation of going for maintenance sessions.Will the scars surface back? Is it just a temporary filling in ?

Jason Emer, MD · Answer

OF COURSE you should be doing maintenance, you should do this every 2 months and derma rolling weekly. peels like cosmelan and enlighten between.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly from emeragecosmetics.com) should be started now.  visit emeragecosmetics.com where we ship medical grade skincare all over the world AND do free virtual skincare consults daily.

if you have post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream. see emeragecosmetics.com where we do free skincare consults daily and can send you peels and skincare. proceeds go to help BLM and LGBTQ+ non for profit organizations.

Acne scar treatment needs a combination approach for improvement.  For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we already pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer.

Susan Fox, DO, RPVI · Answer

Hello, congratulations on your great results! Vivace does not fill in scarring, it works by rebuilding collagen in the skin.  Maintenance sessions are ideal to keep the collagen stimulated but does not mean that your results are temporary.  Skincare is always an ongoing thing.  Think of it like dieting and working out, once you reach your goal you can probably be less strict about your work outs and your diet but if you stop completely you will start to gain weight. Hope this helps.

Sonam Yadav, MBBS, MSc - Account Suspended · Answer

MNRF improves scars by building better collagen and thus resurfacing skin. As we age we do lose collagen every year, thus skin would sag and scars may become more obvious again. Even after excellent results of treatments, some scars may remain. As aging is inevitable, maintenance treatments that build new collagen help maintain the results. It would also be important to prevent relapse of acne.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Those are great results with mono therapy. Results are permanent however age related volume loss will reduce the support for the overlying scars over time. The ideal treatment for acne scars will depend on the morphology of individual scars. For example, rolling scars are best treated with subcision, atrophic scars with fillers, pick-ice pick scars with TCA or Phenol CROSS/ Paint, box-scar scars with fractional laser/ modified TCA/ phenol chemical peels, hypertrophic scars with steroid injections/modulated fractional delivery.

Energy devices such as lasers, microneedling RF and bipolar radiofrequency are other methods to treat ‘general’ scar types. For example devices can improve rolling-tethered scars as well as ‘deep - superficial scars’ such as broad ice-pick scars and broad box-car scars. Devices should be viewed as a method of scar revision, and rarely as a sole modality. Exceptions do apply- for example in patients with predominantly shallow/broad box-car scars and or superficial pits.

Another factor that will determine the ideal combination of treatment is the skin type of patients. Skin typing used to determine the ‘skin colour’ of patients. Darker skin patients will require modifications to treatment parameters. This includes a lower percentage of chemical peels, conservative protocols for lasers and energy devices and in some cases pre and post treatment of skin to reduce but not eliminate the chances of PIH- post inflammatory hyperpigmentation- skin darkening.

The very first step in scar revision is to accurately determine the subset of scars you have. This is best done with a real time examination. Factors such as animation (rather than static photographs) are frequently used to determine the amount of ‘deep scarring’ /anchored scars or tethering. Palpation or touch is also extremely important to determine the presence of dermal and subdermal fibrosis. Scars that have altered ‘texture’ either hard or soft (atrophy) are more challenging to treat compared to scars with ‘normal’ texture. In some cases the use of angled lighting can be employed to accurately map scar types.

My answers given in the context of this question is a general plan given the limited information. For an accurate guide, one has to take into consideration factors such as animation, touch, feel, real time examination and most importantly subjective measures, namely patient expectations. A real time consult with a procedural dermatologist or plastic surgeon is required for the best accuracy- diagnosis.

All the best, Dr Davin S. Lim, Dermatologist. Brisbane. Australia.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Yes you definitely want a maintenance schedule.  Keeps your collagen stimulated and will keep and maintain tone and texture.

Best of luck....

Are results of microneedling on acne scars not permanent? Why are maintenance sessions recommended? (Photo)

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