Is microneedling safe to do on a failed excision for a chicken pox scar? (Photo)

Microneedling will not give much improvement alone. Chicken pox scars need a combination approach of fillers, lasers, and subcision. See an expert. Best, Dr. Emer

Microneedling can help blend the edges of the scar and restore some collagen in that area. It should not make the area worse. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Chicken pox scars can be difficult to treat but in this case it appears that a surgical scar is what you want to treat. I think microneedling may help although a fractional nonablative laser (such as Fraxel or ResurFX) or a fractional CO2 laser (CO2RE) will almost certainly help more. 

Yes, it may help induce some collagen. Chick pox scars however are notoriously atrophic, academically you MAY get 20%-30% improvement in your scars. I personally think the time, effort and money for many sessions of microneedling may not yield the result you are after. You will have to talk about the procedure with your dermatologist or plastic surgeon to ensure your understand the end goals based upon probability of YOUR scar. As mentioned, for pox scarring inflammation early on is more and histology reflects this. 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