My scarring widened after microneedling for boxcars in the temple area, should I have another treatment? (Photos)

this type of scarring requires fillers, microneedling, and lasers in combination. Please see an expert Best, Dr. Emer.

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
Realself100 Surgeon

Hello! Thank you for your question, and for sharing your photographs. In my opinion, 1mm depth microneedling will get you exactly nowhere with scars. You need at least 2.5mm of depth, and I personally like to stamp as deep as 3mm on individual scars themselves. This does results in a bit more downtime - but in my experience if you do not get down to the bottom of the scar tissue with the needles, you will not see a full response. Also - adding something like PRP could also help induce a healing response - but only if it is delivered deep enough in the tissue to work. I hope this helps, and good luck!

Hello and thank you for your question. If you really want the best results I would recommend microneedling with PRP, not a dermaroller or dermastamp. Micro needling creates microscopic pinpoint “wounds”. The body responds by creating new elastin and collagen. The skin then heals smooth. Microneedling is done by a medical professional with a device that your provider controls the depth and the speed. The provider is able to go deeper to repair the scarring. We treat many patients with acne scars and we achieve excellent results.

Best treated with a combination of INFINI RF micro needling and PRP, aim for 3 sessions followed by filler and subcision, this will give great and predictable results for acne scars in this area. regards, Dr Davin Lim