Would microneedling help minimize the appearance of pitted acne scars on the cheeks? (photos)

Hi there! Thank you for your question regarding acne scars and possible treatment options. I would suggest microneedling for acne scars, once you no longer have any active acne. Microneedling on active acne can cause more breakouts, as it will spread the bacteria. For microneedling, I suggest 3 treatments, 4-6 weeks apart.

In some cases, Morpheus 8 can be used on patients who have minimal active acne spots. Morpheus8 is microneedling PLUS radiofrequency (heat) that will actually kill the bacteria. For Morpheus8, I also suggest 3 treatments 4-6 weeks apart. I hope this helps!

Acne scar treatments require precision and attention to detail. There are several types of acne scars, including atrophic, hypertrophic, PIH hyperpigmented, and hypopigmented scars. Depending on the types of scars you have, our office can recommend a Hidef treatment protocol that can recontour existing scars and reduce complexion irregularities. The results are simply life-changing.

As a general rule, we recommend fillers, subcision, acne surgery, RF ablation, and laser ablation to help with atrophic scars. Hypertrophic and keloid acne scars require pulsed dye laser and IIT SC. PIH scars require chemical peels, Melarase creams (AM and PM) and laser.
If you have ice-pick scars, we recommend RF ablation and TCA Cross.
Best,
Dr. Karamanoukian
Realself100 Surgeon

"​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. 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, Skinfinity, Morpheus, PiXel8, 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. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Subcision, which I have been performing since 1995, is a simple, relatively inexpensive procedure for elevating and smoothing all kinds of depressed scars, particularly the rolling scars seen in the photos. It has a several decades long proven record of safety and efficacy and engenders little to no significant downtime. I have been performing microneedling for well over twenty years and do not find it particularly useful as a monotherapy for acne scars. However, it can be especially useful as a final "polishing" step following elevating the depression. Professionally performed manual Dermastamp microneedling (no need for the extra expense and risks of added RF) can be used to better blend in both color and texture the treated area with the surrounding normal tissue. You would be wise to consult with an experienced, board certified cosmetic dermatologist who can help to clear up your current outbreak and subsequently initiate appropriate scar therapies. Best of luck.

Hello, yes micro needling for this type of scar tissue can be a great option. Typically 3-6 treatments would be needed to see improvement of the dermal tissue. These can be done one month apart with seeing improvement after each session. Microneedling works to remodel tissue and also improve skin texture and tone.

A series of microneedling could help blend. More effective may be TCA or CO2 laser. The nice thing about microneedling is little downtime and lower cost so certainly reasonable to try first.