Would the microneedle procedure work for my acne scars? How much treatment do I need for the type of scars I have? (Photo)

Doctor Answers 6

Subcision Combined With Microneedling Can Work Well For Acne Scarring

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I have been performing fractional microneedling resurfacing for acne scars (as well as for other purposes) for over fifteen years. Microneedling, which works by creating numerous microscopic wounds in the skin, which in turn promote new collagen synthesis, works best for improving the surface texture and tone of scars and other skin problems. It is a simple and relatively inexpensive technique that usually requires a series of two to four treatments, spaced at six week intervals, to achieve maximal improvement. 

Unfortunately, to date, the results of expensive laser treatments, including fraxels and IPL, for the treatment of acne scarring have been variable and unpredictable and appear to be a whole lot more device manufacturer supported marketing hype than hard science. 

Subcision is a technique used for deeper, depressed scars, such as appear to be the case here. A cutting needle is inserted, under local anesthesia, under each depression to break up the abnormal tethering scar bonds below the surface. This allows the base of the scar to "float" upwards to become flush with the surface. Meanwhile the blood and tissue fluid that accumulate below to fill the newly created space spurs wound healing and hence new collagen synthesis--a process that results in permanent improvement of the scar. Two four treatment sessions are also required for subcision in order to achieve maximal correction.

I typically inject a volumizing filler at the time of treatment for two reasons. For one, the volumizers provides immediate visible improvement. For another, the presence of the volumizing filler further stimulates new collagen formation.

Consultation with a board certified aesthetic physician with extensive experience and expertise in the treatment of acne scarring is strongly urged.

New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Monthly regimen of microneedling, subscision, and peels is an easy solution.

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Microneedling would help improve the scars. I would also suggest you look into subscision to help raise the some of the scar tissue. This will help decrease the depth of some of the scarring. Additionally you should consider a monthly chemical peel regimen to help with the overall texture and discoloration. Using a combination of microneedling, subscision, and chemical peels monthly is a great regimen to help with acne scars. Peel wise - I would go with the Vitalize Peel by SkinMedica.

Bernard Raskin, MD
Valencia Dermatologic Surgeon

Microneedling for Acne Scars

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Micro needling significantly improves the absorption and efficacy of all topical skin care products. It stimulates blood circulation and collagen production by over 1,000%. You can consider having micro needling treatment as it works well on scars and wrinkles. You will likely need at least 5 sessions of microneedling. You may also need filler injections to fill in any remaining pits.

Hardik Soni, MD (not currently practicing)
Summit Emergency Medicine Physician

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Scars and microneedling.

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You will likely need at least 5 sessions of microneedling. You may also need filler injections to fill in any remaining pits. 

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Microneedling and Other Acne Scar Techniques

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A variety of treatment approaches are available for acne scarring and most often more than one approach is required for the best result in my experience. In your case, microneedling may help but you will need other approaches as well for best results. Picking the best one or combination of treatments depend on the type and extent of scarring, whether the acne is active, color, and size and your skin type. Treatments include undermining ("subcission") depressed scars, excision and closure for large depressed scars, various lasers (CO2, Erbium, Yag, Alexandrite), dermabrasion (not microdermabrasion), Needling (e.g. Dermaroller), RadioFrequency ("RF" devices), and Chemical Peels. For those of darker complexion use of fractionated lasers, RF, subcision or needling tend not to alter your skin color. Many of these treatments are not recommende in the first year or more following Accutane treatment. More than one treatment or a combination of treatments are often necessary for best results. It is most important to see a plastic surgeon or other physician well versed in all of these methodologies and to guide you regarding realistic expectations with each of these options. He/she will guide you to the best approach tailored to your needs.

Microneedling for Acne Scars

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Hi Neya.  Most practices that offer microneedling do not use fractional laser resurfacing.  Microneedling is a poor replacement for fractional resurfacing because it does not remove scar tissue, but rather it forces tiny openings in the skin that heal up with the same contour.

Fractional laser resurfacing is what you need for acne scars and you are probably going to need 2-3 visits to achieve good results.  A deep resurfacing would also be required on the cheeks, on the order of 500-1000 microns deep.  Anything superficial will not benefit you.

When fractional laser resurfacing is performed, the laser light strikes the skin, creating heat and vaporizing the skin tissue in a column like shape.  The method drills tiny holes in the skin and at each penetration, scar tissue is removed and replaced by new collagen.  This method is altogether different than a microneedling procedure because in microneedling, no scar tissue is removed.  

To see examples of Signal Hill, CA patients that have had fractional laser resurfacing for acne scars, click on the link below.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.