No effects of microneedling even after a month -- what should I do? (Photos)

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Microneedling done at a medical office, like a board certified dermatologist, the needles are able to reach a depth up to 3mm on the fatty tissues of the skin.  Outcomes can differ depending on protocols being used, the technicians training and also patients can all respond different.  I have seen my patients have the best outcome after a series of 3 treatments, once every 3-4 weeks.  Combining the treatments with peels outcomes have been even more positive with reducing acne scars.  Definitely you should see more improvement with each treatment.  Once again, I recommend receiving treatments at the office of a board certified dermatologist or plastic surgeon.

This is a very important question! In order for you microneedling treatments to be most effective, I recommend that treatments are spaced 3-4 weeks apart and that you have at least a series of 3-6 treatments. You should start to see visible changes over the course of several weeks. I do recommend that you consult your board-certified dermatologist to confirm the number of treatments that will work best for you, as well as start an at-home skincare regimen to compliment your results from the microneedling.

RFMN is best done in a package of 3-4 treatments done 1 month apart. I would not expect you to see any difference 1 month after your 1st treatment. It takes at least 6-8 weeks to start seeing results. Usually between treatment #2 and 3 is when I tell my patients to expect to see improvement. You will also continue to see improvement for 3 months post your last treatment. The type of scarring you have is hard to see in the pictures but if they are ice pick like then RFMN is not the best option. Subcision or spot treatment with TCA is an option, but I would consult a Dermatologist to perform these treatments. Darker skin types can hyperpigment with TCA if not done correctly.

Micro needling is a good overall treatment for acne scars, it is by no means a targeted form of acne scar treatment. I can not see clearly, you may possibly have ice pick scars on the right cheek, and a deep box car scar on the left cheek. Micro needling can help non tethered, mildly atrophic scars. Adding energy such as RF makes this treatment more effective. Insulated RF energy with fourth generation devices such as Infini RF or Intracel is even better, however the best results you will get is via manual scar revision by a specialist, This means each scar type is matched with a treatment type, this gives a very accurate method of treating acne scars. Acne scar revision comprises of specialised procedures. For the best results, one should target the acne scar type with ideal treatments METHODS. Using one device is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help.

 

As an example deep ice pick scars, and narrow box car scars are best treated with TCA CROSS. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat grafts, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations.

 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combination that give you best results, and everyone is unique! It is never about the device, its about the specialist behind the equipment that will deliver the best outcomes. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.