Is Microneedling the best treatment for a Hypertrophic/Atrophic Facial Scar? Recommendations? (Photos)

I was injured in 2/2014 that required stitches inside and outside of my mouth. I was left with a 2 inch scar, 1 inch hypertrophic underneath my lip, 1 inch atrophic extended to left side of my face with hyperpigmentation. After using silicone gel sheets and scar gel, I'm considering Microneedling treatment with the Eclipse Micropen. Would this be the best treatment for my scar, or any recommendations? Thank you!

Doctor Answers 2


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There are three separate issues as it pertains to your unfortunate injury scar.

1. hypertrophic scar - a simple and classic approach is intralesional kenalog injection but this can result in hypopigmentation and atrophy in some cases. The approach I would recommend is to treat the hypertrophic scar with 585 nm -pulse dye laser with lower energies, shorter pulse durations, and intervals of at least six weeks between treatments (we routinely use 4.5 to 5.0 J/cm2 fluence with small spot size). 

2. atrophied portion of the scar, which I would treat with dermal filler to raise the base of the scar to the level of the skin as best as possible (sometimes scar tissue is hard and non-cooperative). I typically use Restylane Silk for this because I like the softer, less-viscous gel. The microneedling will help blend the edges of scar as well as help with problem #3 which is the hyperpigmentation.

3. hyperpigmentation - treatment with brightening agents such as Tri-luma, in addition to a product with Kojic acid might be helpful combined with microneedling. Keep in mind that Tri-luma contains hydroquinone which needs to be used intermittently to prevent potential side effects. 

Best of luck with treatment!   

Fresno Dermatologist


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Microneedling with PRP would give very good results, especially in the hypertrophic area.  If there is some pigmentation issues, would need to consider IPL or laser treatments as well.

The atrophic portion could also benefit from fillers, at least in the short term if you want immediate results.

Good luck to you,

Dr. Powell

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