Will my microneedling results not be as optimal if I spread the sessions out by a few months rather than 4-6 weeks apart?

Thank you for your question. You didn’t submit a photo, but you’re describing an issue with pores on the cheeks, and minor acne scars in the temple and chin. You’re asking if you can get optimal results if rather than 4-6 weeks apart, you spread out the treatments to every 5 months and maintain ongoing treatment.
I can share with you the way I explain to my patients the strategy of treatments such as microneedling based on foundational principles relevant to skin treatment. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Microneedling, lasers, and other non-surgical solutions are a significant part of my practice. I can understand why this question comes up because it is very important to envision what’s happening in your skin with these treatments.
Microneedling has become more and more popular after a very long period. It began in the mid-90s in dermatology, plastic surgery, cosmetic surgery with the magic of lasers. Lasers are excellent devices that have evolved, and are really wonderful tools. Interestingly, many of the greatest proponents for lasers have started to embrace microneedling for a lot of reasons we don’t necessarily have to go into. Understand that microneedling is also a tool like lasers, and can be adjusted depending on what you want to achieve. The principle is collagen induction therapy where you create very precise injuries at specific depths of the skin, and the skin responds to that injury. The skin responds with a best outcome by improving the quality of skin with the induction of collagen, repair of the skin, blood supply, etc.
We have to think of the mechanism of wound healing. The first phase is the inflammatory phase, then eventually goes into the proliferative phase where lot of collagen is produced, blood supply, and a lot of tissue remodeling begins right after that. A strategy of induction like that takes 4-6 weeks, depending on the level of aggressiveness, and is more likely to achieve better results than a strategy of treatment,then wait 5 months. In between, you’ve missed opportunities to build on previous treatments. I help people understand this with a comparison of going to the gym. If you want to build muscle, you stimulate muscle in a consistent way to get growth. If you just go to the gym every 5 months, you’re not going to get the same results as someone who goes to the gym more regularly. Obviously, there’s a big difference between muscle building and skin healing, but the concept is more understandable for people who have trouble envisioning what’s going on in the skin.
Customization is critically important, so you should have this discussion with your doctor about the expected outcomes. In our practice, if someone wants to improve pores, I don’t always use microneedling, but use a Q Switch laser. I can combine modalities such as Q Switch laser with microneedling for other complementary processes to accomplish an outcome.
Another principle of treating skin is I don’t always make assumptions, but treat, then observe the response, then counsel my patients on what the next step will be. There are a lot of ways to do these treatments to accomplish a goal, and all those approaches are based on an individual doctor’s experience with the modalities they’re most comfortable with.
Again, it’s very straightforward that you won’t get the same results if you do a treatment today, then wait 5 months from now for another treatment, as opposed to doing a treatment today, then another one in 6 weeks, and another one after that. Have this discussion with your doctor, and hopefully you’ll get a sense of what kind of outcome there will be. Also understand that skin does require maintenance. Even if you achieve a certain plateau of result, you may not have to come in as frequently, but it does makes sense to periodically come in for a particular treatment, or combination of treatments to maintain and maximize your appearance. I hope that was helpful, I wish you the best of luck, and thank you for your question.

The healing response is what determines the results from microneedling. We know that every person's healing response is not the same, but for most, it is fairly consistent and predictable. It begins with the inflammatory phase that lasts up to two weeks followed by the proliferative phase that lasts 4-6 additional weeks. This is then followed by the proliferation phase that may last up to a year. Accordingly, it stands to reason that the best results will be obtained while the patient's healing phase was in the proliferative part of the cycle. As you can see, recommending the treatment every 4-6 weeks  is scientifically sound. If you wait too long, the process will be unnecessarily delayed and the results will not be as good compared to being performed more frequently.
Dr. Knott