Can microneedling acne scars cause keloid/hypertrophic scarring instead?

Question

Hi, I am looking to use a dermaroller on my face to get rid of pitted acne scars. My derma roller is 0.5mm in length. I was wondering, however, if microneedling my pitted scars - which is on the cheeks - will cause keloids or hypertrophic scarring? I'm Asian and have gotten one keloid on my leg from chicken pox when I was younger and one hypertrophic scar on my chest from acne. I have no raised scarring on my face, only pitted scars.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeff Rapaport, MD · Answer

In  my opinion, if you have a history of keloids it is always possible to develop additional keloids.  However, facial keloids are much less common than on the body. It's important for you to roll in three directions and not be extremely aggressive. I would recommend a microneedle roller .25 mm or  .35 mm.. Purchase a microneedle roller that can be boiled in hot water every 3 to 7 days. Keeping the microneedle roller clean is extremely important to prevent infection from its use.

William Rassman, MD (retired) · Answer

People who have a history of keloids run a small risk with microneedling that a keloid could form fromits use

Can microneedling acne scars cause keloid/hypertrophic scarring instead?

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Can microneedling acne scars cause keloid/hypertrophic scarring instead?

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