Scarring after microneedling - how can I treat this? (Photos)

Question

Hi! I got microneedling done with glycolic peel 6 months ago but have been left with tram tracks & pitting. It was done with a microneedling pen, 1.5 depth. I had open pores on my chin but normal skin under my chin (where the scarring occurred) before the treatment. My beautician suggested I use minimal ingredients for sensitive skin & a skin barrier cream but how could this erase the scarring? I read online that hypermobility, because of a less efficient type of collagen, could be more prone to scarring. Is there anything I can do to treat this scarring? It looks very unnatural in daylight with thin white/yellowish lines pulled taught over puckering red pitting/white bumps. My camera isn't fully able to pick it up unfortunately but I'll post photos for reference.

Anna Chacon, MD, FAAD · Answer

Tram-track lines and pitting after microneedling are uncommon but recognized complications, particularly when higher depths (e.g., 1.5 mm) are used on thinner areas like the chin. The linear pattern you describe typically reflects vertical needle tracks with uneven collagen remodeling, while the puckering suggests focal tethering or early atrophic scarring. Barrier creams alone will not reverse established scarring; they may calm inflammation but do not remodel collagen.

At six months out, the changes are likely mature enough to treat. Management is typically procedural and often multimodal:

- Fractional radiofrequency (RF) microneedling: Delivers controlled dermal heat to remodel collagen without ablating the surface. Particularly helpful for textural irregularities and safer in most skin types. A series of 3–4 sessions spaced 4–6 weeks apart is common.
- Fractional laser resurfacing (CO2 or erbium): Useful for persistent textural change and superficial tram-tracking. Requires downtime and careful parameter selection, especially in skin of color.
- Subcision: If there is clear tethering causing puckering, releasing fibrotic bands can significantly improve contour.
- Focal hyaluronic acid filler: Can soften isolated atrophic depressions, though it addresses volume rather than surface texture.
- Regarding hypermobility or collagen variants: while connective tissue differences can influence healing, most cases of this pattern are technique-related rather than genetic. A careful in-person assessment is important to determine whether the dominant issue is tethering, volume loss, or surface irregularity, as that guides therapy.

Realistically, meaningful improvement (often 50% or more) is achievable, but complete erasure is unlikely. Avoid further aggressive microneedling at high depths. Gentle skincare and strict photoprotection support procedural outcomes but will not independently correct established scars.

Scarring after microneedling - how can I treat this? (Photos)

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