Are chemical peels better than microneedling when used for scarring?

Question

I am seeking advice on what type of procedure is best for my situation. I am a 29 year old female of african american / mexican descent. I have been acne prone for years and have recently done microneedling for scarring treatment. This session broke me out badly and I have been recovering. I would like to know if chemical peels are a better option? especially for someone who still experiences break outs here and there.

Nelson Lee Novick, MD · Answer

Just as the original breakouts of acne led to normal tissue destruction and ultimately scars, acne outbreaks during treatment to improve the scars may interfere with and impede the progress of treatment. I therefore typically recommend definitive scar treatments in patients who have ceased have breakouts or at least who have had them suppressed for a sufficient time with appropriate treatments. As far as appropriate treatment of the scars, this would depend upon many factors not specified in the question, such as what kind of scars, how deep, how wide, location, to name just a few. What i can say is that a series of superficial peels and microneedling are best reserved for only the most minimal shallow scars and are unlikely to be particularly helpful in treating deeper scars, such as boxcar, rolling and ice pick scars. Superficial peels can help for treating acne breakouts , however, and are generally quite safe for use in skin of color. You would be wise to make sure that you consult a board certified cosmetic dermatologist who can both help you to treat the acne and afterward the scars. Hope this helps. Best of luck.

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
hRealself100 Surgeon

Nadir Qazi, DO · Answer

We understand that dealing with acne-prone skin can be challenging, and we are here to help you make an informed decision about your skincare options.
Regarding your question about chemical peels and microneedling, both treatments can be effective for reducing the appearance of scarring caused by acne. However, the best treatment option for you will depend on your individual skin type, concerns, and medical history.
Chemical peels work by using a chemical solution to exfoliate the top layers of your skin, promoting skin cell turnover and revealing smoother, more even-toned skin. This can be particularly helpful for reducing the appearance of acne scars.
Microneedling, on the other hand, involves using a small device to create tiny punctures in your skin, stimulating collagen production and promoting skin regeneration. This can help to reduce the appearance of scars and improve overall skin texture.
While both treatments can be effective, it is essential to note that some people may experience adverse reactions to either treatment, particularly if they have sensitive skin or are prone to breakouts. In your case, since you experienced a breakout after microneedling, a chemical peel may be a better option.
However, it is essential to consult with a dermatologist or skincare professional to determine the best course of action for your specific concerns. They can evaluate your skin type and medical history and recommend the best treatment option for you.
In addition to chemical peels, there are several other treatments that can help minimize the appearance of acne scars, including laser therapy and topical medications. With the right combination of treatments and skincare practices, you can help your skin heal and minimize the appearance of scarring caused by acne.
Overall, it is important to take a personalized approach to scarring treatment and work closely with a skincare professional to determine the best treatment options for your individual needs.
We hope this information has been helpful to you, and we wish you the best of luck in your skincare journey.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions. There is likely no better treatment than erbium laser skin resurfacing for your skin issues. Chemical peels treat the skin equally all over the face, whereas a laser can pinpoint and treat specific areas differently. With all these treatments, care must be given due to the risk of pigmentary changes. Have a consultation with an experienced oculofacial surgeon who uses the erbium laser.
Good luck!

Nima Shemirani, MD · Answer

Hi @MissTatooine. I would considering doing microneeding in conjunction with a chemical peel ( a few weeks later) for optimal results. In my experience, microneedling with radiofrequency (Morpheus 8, Potenza) works great for acne scars. The benefit of radiofrequency microneedling is that it can be performed with active acne. Regular microneedling is not recommended with active acne. However, purging after a microneedling session is normal.

Are chemical peels better than microneedling when used for scarring?

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Are chemical peels better than microneedling when used for scarring?

Answers (6)

Answer: Best treatment for skin issues on skin of color

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