A Detailed Guide to Microneedling for Acne Scars
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Table of Contents
What Causes Acne Scars and Which Ones Can Microneedling Help?
How Does Microneedling Smooth and Soften Scars?
Different Types of Microneedling for Acne Scarring
What Should I Expect During a Professional Microneedling Treatment?
How Long is the Downtime and Recovery with Microneedling?
How Many Microneedling Sessions Are Needed to Improve Acne Scars?
How Much Does Professional Microneedling Cost on Average?
Why is this an important topic?
Microneedling is an increasingly popular minimally invasive treatment for reducing the appearance of acne scarring. But how effective is it really? And is it right for your skin? Here, we dive into everything you need to know about using microneedling to improve different types of acne scars, what to expect during and after the procedure, and how to get the best results according to dermatologists and cosmetic laser experts.
What Causes Acne Scars and Which Ones Can Microneedling Help?
Acne scars develop when severe acne damages the deeper skin layers. However, once scarring has already taken place after severe acne, microneedling can be a reasonable option. Certain types of scars respond better to microneedling than others:
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Atrophic scars - Indented scars caused by loss of collagen and fat. Includes rolling, boxcar, and icepick scars. Microneedling excels at improving these by stimulating collagen rebuilding.
Hypertrophic scars - Raised, thickened scars that develop after inflammation. Microneedling performs poorly on these.
The best results come from using microneedling to treat rolling, boxcar, icepick and other atrophic indentations. Always consult a dermatologist to determine which treatments suit your scar characteristics.
Reference: https://link.springer.com/article/10.1007/s00266-022-02845-3 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450803/
How Does Microneedling Smooth and Soften Scars?
The microneedling process works to physically remodel scarred skin in several key ways:
It creates micro-injuries at precise depths within the dermis which activates the body's natural wound-healing cascade.
This wound healing process stimulates fibroblasts to ramp up production of new collagen and elastin fibers.
Thicker, denser collagen fibers replace the weaker, damaged collagen comprising atrophic scars. This helps lift indented scars closer to the surface.
The dermal layer remodels and regenerates with healthier, stronger collagen via the microneedling injuries.
New blood vessels form due to microneedling which improves blood supply and nutrients to scar tissue and enhances healing.
Overall, repeated microneedling sessions promote significant remodeling and smoothing of scar collagen and tissue. Visible improvements develop progressively over the course of treatments. Results may vary.
Multiple medical studies back these mechanisms of action behind microneedling for acne scars. The micro-injuries are key to "tricking" your body into healing and smoothing scars by generating new collagen. Importantly, microneedling can be helpful for many different types of scars, not just acne.
Reference: https://www.mdedge.com/dermatology/article/169785/acne/update-acne-scar-treatment
Different Types of Microneedling for Acne Scarring
There are a few common devices and techniques used in microneedling procedures:
Dermarollers - Handheld roller with microneedles that is moved over the skin. Less precise depth control. Mainly used for home microneedling.
Microneedling pens - Motorized handheld medical devices with differing reciprocating mechanisms – not all microneedling devices are engineered the same. Allows better control of needle depth during professional treatments. The #1 most prevalent microneedling device used in U.S. dermatology offices is the SkinPen Precision by Crown Aesthetics, which was the first microneedling treatment to achieve FDA clearance; first in 2018 for acne scars on the face and then in 2021 for neck wrinkles. SkinPen is the gold standard of microneedling with 90+ validation studies on efficacy and patient satisfaction.
Photo courtesy of https://skinpen.com/
RF microneedling - Microneedles conduct radiofrequency heat into skin. Adds thermal stimulation to wound healing response.
Reference: https://link.springer.com/article/10.1007/s00266-022-02845-3
What Should I Expect During a Professional Microneedling Treatment?
Most physicians will ask you to stop using any topical products containing retinoids (Tretinoin), Vitamin C, and AHAs about 1 week before your treatment. Once you’re at the office, here is a general overview of what to expect when getting microneedling done properly by a skin expert:
A topical numbing cream is applied for up to 45 minutes prior so needling feels like light pinpricks without significant pain.
The microneedling device smoothly glides over skin methodically covering scarred areas, usually for 10-20 minutes total to achieve thorough coverage.
Multiple passes are made fanning across the treatment zone in different directions. Pressure and speed are tailored to your needs.
Pinpoint bleeding is common. This subsides quickly when finished.
Some redness, edema, sensitivity are normal for the first 1-4 days as the wound healing cascade kicks into gear.
Makeup can typically be worn after just 1-2 days as micro-injuries close up.
Be sure to only undergo microneedling administered by a licensed, experienced medical professional using a clinical-grade device for optimal comfort, safety and results.
How Long is the Downtime and Recovery with Microneedling?
The recovery timeline and social downtime associated with professional microneedling is thankfully minimal compared to laser resurfacing or surgical scar revision:
Aside from some redness, swelling, and tenderness, most patients feel fine returning to normal activities in 2-4 days.
For a big event, schedule sessions at least 1 week before to allow more redness and swelling to resolve.
Avoid any sun, tanning, sweating, swimming, very hot showers for ~3 days. Gentle cleansing and moisturizing only.
Wait a week to resume retinoids, glycolic/salicylic acids, vitamin C, benzoyl peroxide or anything potentially irritating.
Avoid laser treatments, chemical peels, microneedling on the same area for at least 4 weeks after to prevent over-exfoliation.
Follow your provider's specific advice on skincare, sun protection, activity restrictions, and when to follow up carefully for optimal healing.
With good aftercare, you can expect only minimal downtime and be back to regular activities within just a few days. Microneedling's fast recovery is a major benefit compared to more invasive scar revision techniques.
How Many Microneedling Sessions Are Needed to Improve Acne Scars?
Most patients require 4-6 microneedling treatments spaced 4-6 weeks apart to achieve significant improvement of acne scarring:
It takes time for collagen remodeling to occur in the dermis, so spacing sessions allows this process to complete.
Prior to each session, the provider assesses if sufficient micro-injury has occurred to induce collagen or if deeper penetration is needed.
Milder scarring may see benefits with as few as 3 sessions. But deeper scars often need 6-8 sessions for full correction.
While some effect should be noticeable even after the first treatment, the full results emerge gradually - expect to wait 8-12 weeks after the final session to see the peak outcome.
Consistency is critical - skipping appointments often means losing ground as the collagen stimulated begins fading.
After the initial treatment course is completed, a follow up session every 6-12 months helps maintain results.
Being patient through the multiple session process is crucial. Follow your dermatologist's recommended schedule and you'll be rewarded with smoother, softer skin step-by-step.
Reference: http://jddonline.com/articles/dermatology/S1545961617P0308X
How Much Does Professional Microneedling Cost on Average?
Microneedling costs can range widely based on your provider, number of sessions recommended, and any devices used:
In the U.S., fees typically range $150 - $700 per session. Smaller treatment areas like isolated scars cost less.
Full face treatments tend to run $400 - $600 per session at reputable derms' offices.
A package pricing 6 sessions across 6 months often discounts the per treatment fee. This makes the process more budget friendly.
With 4-6 sessions usually needed, expect an average total investment of $1500 - 3000 to significantly improve acne scarring.
Work with your dermatologist to map out a customized treatment schedule that fits within your budget.
Key Takeaways on Microneedling for Acne Scars
Microneedling can be effective for rolling, boxcar and icepick indent scars - not raised or thickened scars.
It smooths scars by reorganizing scar collagen and triggering new collagen formation.
In-office treatments are far superior to at-home devices for results and safety.
Requires multiple sessions and patience to see final outcome.
Causes minimal downtime - just temporary redness and swelling for a few days.
More affordable than lasers in most cases. Costs range $150-$700 per treatment.
Discuss your options with a board-certified dermatologist to determine if microneedling is the right choice for reducing your acne scarring. While results can vary, this popular collagen induction technique offers a compelling way to gradually smooth and soften many types of acne marks and pockmarks when performed skillfully. Be patient through the multi-session process and follow proper aftercare to achieve beautiful, blemish-free skin.
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Does microneedling work on "ice pick" acne scars?
While every patient may respond differently, microneedling can be effective for improving the appearance of indented "ice pick" acne scars as it rebuilds healthy collagen under these narrow depressions.
Can I do microneedling if I have skin of color?
Microneedling is safe for most skin tones since it poses little risk of post-inflammatory pigmentation issues that traditional laser resurfacing does. However, it's still best to consult a dermatologist experienced in treating patients with skin of color to assess your individual needs and determine optimal settings.
Can I do microneedling at home?
At-home microneedling comes with risks of improper technique, inadequate disinfection, and potential scarring. While very gentle use of an FDA-cleared 0.25mm microneedling roller may provide mild improvement over time, in-office microneedling administered properly by a medical provider is far superior for safety and results.
When will I see results from microneedling?
Some subtle improvement may be apparent after the first session. But the peak results fully develop after completing your entire recommended microneedling course as it takes 4-6 weeks after each session for collagen remodeling to occur. Final results are often not visible until 8-12 weeks after the last microneedling treatment. Results may vary.
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We are a group of dermatology residents and attending physicians based in Boston, MA. Our team of Ivy League-trained dermatologists is demystifying the cosmeceutical industry by offering unbiased, scientifically supported reviews of skincare products. We are extremely passionate about skincare and making it accessible to all through education. We value integrity, practicality, and inclusivity. No sponsorships were received for the products prior to testing; we feel strongly about providing un-biased reviews. After blogs are published, following the links in this blog post may result in commission.
Dr. David Li is a recent graduate from the Harvard Combined Dermatology Residency Program. He is now in private practice as a procedural dermatologist in Downtown Boston where he offers skin cancer screenings, skin cancer surgeries, and laser and cosmetic rejuvenation. He has published more than 25 peer-reviewed research articles, is active as an advisor for multiple early-stage companies, and is an angel investor in the healthcare technology space. In his free time, he enjoys running to stay fit, cooking, and playing with his Australian shepherd, Laika.
Dr. Jacqueline Stevens is currently a resident in the Harvard Combined Dermatology Program. She completed her undergraduate studies and MD-PhD at the University of Virginia with a PhD in microbiology, immunology, and infectious disease. Jacqueline has interest in cutaneous oncology, melanoma, and dermatologic surgery. She has published work on the basic science of inflammation at skin barriers, dermatologic diseases, and systems used to classify squamous cell skin cancer. In her free time, she enjoys skiing, hanging with her rescue pup, and the outdoors.
Dr. Olivia Davies is a dermatology resident at the Harvard Combined Dermatology Residency Program. Her dermatology interests include inpatient dermatology, complex-medical dermatology and medical education. She enjoys exploring the intersection between medicine and media — with past experiences that include rotating through the ABC News Medical Unit, publishing a graphic perspective in the New England Journal, and serving as a poetry editor for Intima: A Journal of Narrative Medicine. When she’s not learning or working, she can be found making cheese plates for friends, sipping a warm cup of coffee, or solving the newest NYT crossword puzzle.
Dr. Nelson Ugwu is a dermatology resident at the Harvard Combined Dermatology Residency Program. His clinical interests include general dermatology, skin of color and skin cancer prevention. Nelson has discovered mutations that cause skin diseases, as well as new treatments for skin conditions. In his free time, Nelson enjoys weightlifting, playing soccer and trying new recipes.
Dr. Arash Mostaghimi is an associate professor of dermatology at Harvard Medical School, the director of the inpatient dermatology consult service, and co-director of the Complex Medical Dermatology Fellowship at Brigham & Women’s Hospital. He is also the principal investigator of the Mostaghimi Lab, where he leads a diverse group of physicians and researchers to study alopecia areata, an autoimmune hair loss condition which afflicts his daughter. In addition to his research, he is an advisor to multiple companies and is an associate editor of JAMA Dermatology.
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