One of the potential complications of acne is scarring. Acne scarring, particularly on the face, significantly impacts the quality of life and self-esteem, highlighting the need to eliminate them. 

Microneedling, or collagen induction therapy, is an effective treatment for naturally eliminating acne scars. It’s cost-effective, offers minimal side effects, and minimal downtime. 

If you’ve tried countless skincare products with minimal results or are simply curious about professional treatments to address acne scars more effectively, this guide is for you. It explores microneedling as a potential option for you.

We’ll walk you through the different types of acne scars, explore the causes and risk factors, and provide tips on preparation and aftercare to get the most out of your treatment.

 

Types of acne scars

 

There are two major classifications of acne scars: depressed or atrophic acne scars and raised or hypertrophic acne scars. Under these two classes of scars, there are different types of scars. 

 

Depressed or atrophic acne scars

Depressed acne scars are the most common scars you’ll likely experience after your acne clears. It simply means the scar is more or less a small hole or crater on your skin. 

Ideally, when acne clears, your body should produce new collagen to fill the space left by the acne. 

Depressed scars form when the skin doesn’t produce enough collagen to fill the newly vacant spot. The different types of depressed scars include:

 

• Ice pick scars: The best way to describe ice pick scars is small indentations akin to being pricked multiple times by a needle or toothpick. They are deep and narrow (not more than 2mm) and are the most common type of depressed scars (60-70%). 
• Rolling scars: Do you know how it feels when a vehicle passes a bumpy road? That’s what rolling acne scars feel like on the skin, giving your skin little hills and valleys. They are the largest of atrophic scars and makeup 25% of all depressed scars. 
• Boxcar scars: Boxcar scars are similar to ice picks, but they are wider and do not go as deep. What also separates them from other types of scars is that they form clusters, which you can feel underneath your skin. Boxcar scars make up 15-25% of atrophic scars. 

 

Raised or hypertrophic scars

Hypertrophic scars exist above the skin surface. They are also known as raised acne scars. 

As opposed to depressed scars that happen due to limited collagen, raised scars occur when the body produces too much collagen after the acne has healed. 

People with darker skin tones are more at risk of hypertrophic scars. The three major types of raised acne scars include: 

 

• Papular scar
• Keloid

 

Causes of acne scars

On average, for every 100 persons who suffer acne, about 43% are likely to develop acne scars. Several factors determine whether acne leaves scars after healing. These factors include:

 

Severity of acne

One of the leading risk factors determining if acne turns into scars is the severity or grade of the acne. One study found that only 46% of mild acne is likely to leave behind a scar. This number jumps to 67% and 82% for moderate and severe acne, respectively.  

 

• Mild acne: This type of acne typically only contains comedones, also known as black or whiteheads. Acne is also classified as mild if it contains only a few or no acne pimples. 
• Moderate acne: People with moderate acne have a few more acne pimples than those with mild acne. Additionally, these pimples may be small bumps (papules) or pimples filled with yellow pus (pustules). 
• Severe acne: People with severe acne have significantly more pimples on their skin. In addition to papules and pustules, they have multiple nodules on their skin. Nodules are (often) reddish, painful, and hard lumps under the skin.

 

Family history

Although there’s limited scientific evidence on this, research shows that the presence of several heritable traits makes a person more susceptible to the appearance of acne scars. 

These traits, such as “SELL (i.e., Selectin L) and TGFB2 (i.e., Transforming Growth Factor Beta 2),” are implicated in the onset of acne scarring. 

 

Gender

Men are more predisposed to getting acne scars than women. On average, 58 out of 100 men with acne develop scars. This figure is 46 out of 100 for women. 

This inclination may also be because men are more likely to suffer from severe acne than women, which, as we mentioned earlier, increases the risk of acne scar formation. 

 

Habits

Picking, squeezing, and popping your acne can increase the risk of scarring. Such behaviors often lead to increased inflammation and, consequently, scarring. Picking on pimples may also lead to infections. 

In addition, not treating acne early on increases the likelihood of scarring. 

 

How microneedling works for acne scars

 

Microneedling is an effective acne scarring treatment. One study found that doctors used microneedling to treat acne scars, and in all instances, “the patients treated with microneedling achieved some improvement in scar appearance in the range of 31–62%.” 

But how exactly does it work? Remember earlier when we mentioned that the type of scarring (depressed or hypertrophic) you experience depends on how much collagen your skin produces? 

The central idea behind microneedling is to “force” your body to produce more collagen and elastin by inducing small injuries with tiny needles attached to derma rollers. 

So, in an attempt to heal from these small injuries, the body produces more collagen, which helps to improve the appearance of the region to which the needles are applied. 

 

Best skin types for microneedling acne scars?

One significant advantage of microneedling is that it works and is safe for all skin tones, including darker skin tones. 

That said, research suggests that microneedling is a better choice for darker skin tones (skin types IV to VI), and that’s because health professionals do not recommend procedures like laser treatment for this group due to the risks of scarring. 

 

What is the cost of microneedling for acne scars?

The total cost of microneedling for treating acne scars depends on multiple factors. The primary factor is the total surface area that requires treatment; the bigger the area, the higher the cost. 

Next, the severity of the scars will inform how many sessions your aesthetician recommends. You’ll typically require 3-6 treatment sessions, spanning about six weeks.  

Geography also impacts the average cost per session. Another major factor affecting cost is also the experience and skill of your esthetician or plastic surgeon. 

Overall, expect to spend an average of about $350 per skin needling session, with prices generally ranging between $100 and $700 per session, depending on your location.  

 

Who is an ideal candidate for microneedling?

You’re an ideal candidate for microneedling if you have no active acne lesions in the treatment area, as this can increase the risk of infection and scarring in other areas. 

Additionally, microneedling is best for atrophic post-acne scars. So, if you have a keloid or other forms of hypertrophic scars, your medical professional will recommend another procedure. 

As we’ve mentioned, microneedling works for all skin tones and types. We recommend speaking to a professional to ascertain the best procedure for your context. 

 

Who should avoid microneedling?

As we explained earlier, microneedling inflicts micro-injuries that need healing. Anyone with an underlying medical condition that inhibits the body’s healing ability or taking medication that does the same should avoid microneedling. 

Per the FDA, those with “eczema, diabetes, or a weakened immune system” should avoid microneedling. 

 

What to expect before, during, and after the procedure

Microneedling is a minimally invasive procedure with little to no downtime. That said, it’s very important to understand what microneedling therapy looks like from beginning to end, to set clear expectations, and to prepare adequately and properly. 

 

Before the procedure

The first step in the procedure is to consult with your plastic surgeon or esthetician. This consultation serves one primary purpose: determining if you’re an ideal candidate for the procedure. 

Your surgeon will examine the target area to ensure no active acne lesions. They’ll also ask about your medical history, lifestyle, and medications. For example, certain medications make your skin more sensitive and prone to irritation. 

This consultation will also help the surgeon determine the sessions you need. Once you’ve been confirmed as an ideal candidate, your doctor will work with you to schedule dates for your sessions. 

These dates and times are super essential to plan your itinerary. Expect to spend anywhere between 1-2 hours for each session. You can add a buffer of 60 minutes to rest post-treatment and account for the time it takes for the numbing cream to work. 

After confirming your sessions, your doctor will provide a list of things for you to do and avoid leading to your sessions. Some of these tips include:

 

• To avoid accutane at least six months before your first session. 
• Stay away from skincare products with hydroquinone, salicylic acid, and retinoids at least one week before your first session. 
• Not shaving close to your sessions.
• Skip any anti-inflammatory drugs at least three days before your sessions. 
• To avoid procedures like laser operations. 
• Limiting sun exposure in the weeks leading to your microneedling sessions. 

 

During the procedure

Ideally, you should not have makeup or any skincare product on your face on the day of your session. Irrespective, the team at the center will help clean your face to keep it dry and makeup-free. 

Next, about 45 minutes before the start of the procedure, your doctor will apply topical anesthetics or numbing cream to your face. This numbing cream will help minimize any discomfort from the needles. 

Despite the numbness of the treated area, it’s not uncommon to feel some sensation as your doctor moves the derma roller over your skin. 

At La ViE MD, patient comfort and safety are always top priorities, especially during treatments like microneedling. Our expert team ensures a soothing procedure where every step of the process is designed with your well-being in mind. 

 

Post-treatment

Post-treatment is all about doing the right things to ensure you reap the rewards of the procedure. After the procedure, here are a few checkpoints to take note of:

 

• The first 60 minutes: Reddening of the treated area
• Up to 24 hours after: Expect some rash and maybe minor swelling
• Day 2-5: Expect the treated area to feel dry or tight. It may also feel itchy. 
• Five days after: Expect your skin to return to normal.

 

Aftercare for microneedling

Here are our tested and trusted tips to help your skin heal properly and prevent infections.

 

• Avoid the sun: Sun exposure after microneedling can damage your healing skin, especially the first-week post-treatment. If you must go under the sun, wearing sunscreen of SPF30 or above is essential. Note that you should avoid sunlight on the day of your treatment. We do not recommend wearing sunscreen on the same day as your session. 
• Hydrate properly: Staying hydrated helps your skin heal faster. Drink plenty of water and eat antioxidant-rich fruits and vegetables like blueberries, strawberries, mango, oranges, kale, and more. You may also use cooling and hydrating face masks occasionally. Ensure the mask you get is very mild and free from acids. 
• Keep your skin pores unclogged: Avoid things that can clog your newly opened pores, particularly the 24-48 hours after your procedure. Things like makeup can penetrate the opened channels and cause irritation. In the same vein, avoid skin care products with retinol and alpha acids, as they irritate your skin and lengthen the healing process. 
• Skip the gym: Exercising after your treatment will not allow your opened pores to close, causing bacteria to seep inside your pores and cause infection. Avoid going to the gym or doing intensive exercise for at least the first three to four days after your procedure. 

 

Other activities to avoid after your treatment include swimming and tattooing. Additional treatments include microdermabrasion, laser, microblading, chemical peels, hot baths, and showers.

 

Can I undergo a microneedling treatment if I still have active acne?

Your medical personnel will not perform microneedling if you have active acne lesions in the proposed treatment area. Microneedles spread the bacteria present in active acne deep into your pores and worsen your acne. 

 

How many microneedling sessions do I need for the best results?

The number of microneedling treatments you need will depend primarily on the severity of the scars and the type of results you seek. 

Some people just want to achieve moderate skin texture, while others want total skin rejuvenation. 

Your doctor will work with you to determine how many sessions you need, but as a guide, expect 3-6 sessions for mild to moderate scars and as many as 12 sessions for very severe acne scars. 

 

How long is a microneedling session for acne scars?

The microbleeding itself takes between 15-30 minutes depending on the size of the treatment area. However, prepare to spend 3 hours in the clinic, accounting for preparations and post-treatment monitoring. 

 

When can I start seeing results from microneedling?

Although results may vary from person to person, you’ll start seeing results as collagen production increases. Notwithstanding, full and long-lasting results take several months to show. How soon you begin to see results also depends on the severity of the scars and how many sessions you do. 

 

Are the results of microneedling treatment for acne scars permanent?

We describe the results from microneedling as semi-permanent. This is because acne scars begin to return as collagen levels reduce.  

 

How long do the results from microneedling for acne scars last?

How long the results from microneedling treatment last depends largely on the rate at which your body loses collagen. Factors such as smoking, old age, poor skincare routine, and constant sun exposure can deplete collagen quickly. 

When this happens, you’ll begin to see the acne scars return. As such, your dermatologist or plastic surgeon may recommend coming for a maintenance microneedling session per year.

 

How often should I get microneedling for acne scars?

Your dermatologist will determine how many sessions you need, and these acne scar treatments will be scheduled for 2-4 weeks between sessions. However, depending on the specific context, your doctor may also recommend coming in for one session every year. 

 

Is there any downtime after microneedling for acne scars?

Barring some mild discomfort and potentially uneven skin tone due to redness or darker shades, there’s little downtime after microneedling. You can resume work as long as it doesn’t involve heavy lifting or strenuous work. 

 

What are the possible side effects of microneedling for acne scars?

The body generally tolerates microneedling well. Multiple research studies on the effect of microneedling on acne scars came to similar conclusions: treatments with microneedling “showed improvement of acne scars in all patients without any side effects apart from redness and swelling, which disappeared within 2 to 3 days.”

It’s important to stress that these treatments, with limited side effects, were performed by trained and certified hands. Microneedling yourself or at a quack can lead to serious complications like “infections, scarring, or long-term skin discoloration.” 

 

Should I use an at-home microneedling device or see an expert?

We do not recommend using an at-home microneedling in any circumstance because it’s inherently risky. 

Firstly, if you’re not trained, you’ll likely overuse the derma roller, irritating your skin more than necessary. 

Additionally, medical derma rollers for treating acne scars have a standard. Using a different derma roller will likely not achieve the desired results. 

Furthermore, viruses can be spread easily with at-home microneedling devices. Dermatologists and plastic surgeons use single-use derma rollers, reducing the risk of spreading these viruses. 

Based on the above, we recommend that you see an expert, like LA ViE MD, to enjoy benefits such as:

 

• Safe, tailored care
• Noticeable and long-lasting results
• Reduced risk of infections and skin damage.

 

Takeaway: Fade acne scars and regain confidence

Acne scars don’t have to be permanent. Microneedling offers a valuable solution for anyone dealing with acne scars. The procedure stimulates collagen and elastin production, gradually filling the scarred areas and fading them to the background. 

Microneedling is minimally invasive with little downtime. To get the best results, engage a qualified professional and follow the recommended pre and post-treatment care. 

Are you ready to take the next step in your skin journey? Book a consultation with our skincare experts at La ViE MD, a premier med spa in Danville and Los Gatos, California. 

 

FAQs

Below, we’ve answered some of the most common questions we get asked about microneedling: 

 

Is microneedling the most effective option for treating acne scars?

This is a difficult question to answer for many reasons. One is that minimal studies have done a direct apples-to-apples comparison between all the primary treatment options for acne scars. 

Additionally, in many studies, treatment options are sometimes combined with other solutions, such as platelet-rich plasma, making the comparison more difficult. 

Lastly, these research studies utilize different scales, making comparison largely impossible. What cannot be denied is that these research studies show microneedling as an effective treatment for acne scars, leading to significant scarring improvements.  

 

Which is better for acne scars: microneedling or CO2 laser?

Objectively, data shows that CO2 laser provides superior outcomes in scar treatment than microneedling. However, microneedling is linked to lower side effects and downtime. Microneedling is also more cost-effective than CO2 laser treatments.

 

Which is more effective for acne scars: microdermabrasion or microneedling?

In a study comparing the effectiveness of microdermabrasion and microneedling in treating acne scars, 11 of 15 participants in the microneedling group showed scar improvements between 50% and 100% versus only 5 in the microdermabrasion group. This result suggests that microneedling is more effective than microdermabrasion. 

 

Is microneedling more effective than laser treatment for acne scars?

Laser treatment is a more powerful procedure than microneedling and because of its targeted nature, it’s more effective at dealing with acne scars. Microneedling is more subtle, often requiring multiple sessions for optimal results. Both treatments offer unique benefits that can fit into individual needs. 

 

What skincare products work well with microneedling?

Your dermatologist or doctor would be in the best position to suggest the best skincare products for you. What works for person A may not work for you due to underlying medical conditions, your skin type, and your location. Generally, though, you want to avoid alcohol-based skincare products, vitamin C serum, and retinol 24-48 hours after your session. 

 

Can microneedling worsen my acne scars?

A review of countless studies does not show any instance where microneedling performed by a trained professional made acne scars worse. However, when you do it yourself or engage a quack, yes, microneedling can worsen your acne scars because you may overdo it or use an improper microneedling device. 

 

Will I notice results after just one microneedling session?

It depends on the severity of the scars. With mild and relatively new scars, you may begin to observe results after a single session. However, for the most part, you’ll start seeing noticeable results a week after your procedure, irrespective of the scar severity. You’ll see the most dramatic results 4-6 weeks after your session.