Why do my acne scars look worse after Microneedling? (Photos)

Question

I do not have active acne anymore, however, I did have scars. I have had three sessions of Microneedling done to help with my acne scars, and I have three more sessions left. She was using the dermapen. My skin looks worse now - I never had dents in my skin, and now I have dents and the scars look much darker. I was taking a 4-week break between each session. The first two pictures are how I looked right before Microneedling, the pictures following are after the sessions. Is this normal?

Jason Emer, MD · Answer

Unfortunately microneedling alone will not give you the improvement you're looking for; acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. - Subcision for depressed, tethered scars. - Vascular lasers like Yellow laser, Aerolase, excel V, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, Intensif microneedling RF) for textural issues and superficial scarring. - TCA CROSS and punch excision for deep ice pick scars and narrow box car scars. 
All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

Evangeline Specht, MD · Answer

Micro needling can be performed with many different devices and several different topicals including PRP. Success with MCN is truly based on what you are trying to fix. Depth of needling is very important because your collagen and elastin are formed in your dermis and if your needles are not getting to that depth you are not maximally stimulating their formation. Acne scarring needs deeper needling to >2mm. 
MCN RF would probably be a better treatment for your acne scars as the RF can go deeper than the needles to soften and eliminate the deeper scars. Downtime is much the same as the Dermapen but a more aggressive treatment form.

Mitchell Schwartz, MD - Account Suspended · Answer

The treatment of acne scarring with microneedling is much more effecting when combined with application of human growth-factor serum during the treatment. In my office, we use the ProCell Therapies system which combines motorized micro-needling with concentrated growth factor serums made from human bone marrow stem cells and are seeing excellent results in the treatment of
acne scars. Because these particular stem cells are much more involved in wound healing than any other stem cells in the body, they are the ideal source for the growth-factors which are the messengers that very effectively stimulate formation of new collagen in the skin.
ProCell Therapies is also approved by Health Canada for use in your country, which I do not believe is true for Dermapen.

Why do my acne scars look worse after Microneedling? (Photos)

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Why do my acne scars look worse after Microneedling? (Photos)

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