Should I have microneedling to correct mild acne scars and large pores?

Hi! I've read your articles regarding microneedling treatments and how you're against it. I was planning to do a series of microneedling treatment with my board certified dermatologist for my acne scars. But since reading, i became skeptical with the procedure. Is the treatment safe when done by a board certified derma or is it better to do a different treatment? If a different treatment is better, which one would you suggest for acne scars? My acne scars just look like big pores, so it's just mild scarring but I'm still bothered by it...I've had it for almost a decade now since I've had my "acne phase". I'm 22, just in case my age is of important information. Thank you for your time. Regards, L.

I’m not sure I’d say I’m against microneedling for mild acne scars and large pores. It’s just that I’m very skeptical because there’s a lot of hype and not much real research. Also, there are a lot of variables that can make a huge difference in whether someone gets good results or has problems and complications.

What is microneedling?

For those who haven’t seen a micro needling device, they are usually roller or “stamping”  devices.  Rollers look like a small rolling pin with needles sticking out of it which are rolled across the skin in different directions. The “stamping” ones have little needles on a platform about the size of a postage stamp.   Here’s why I’m skeptical about the treatment.

Unanswered questions about microneedling:

  • What is the best width for the the tiny needles (“pins”).  Right now there is no agreement on this.  Some patients have reported being able to see the pin marks after they heal, presumably because the needles were too large?  Or too many passes were done?
  • What depth should be needles or “pins” be set to?  Depth matters in the skin.  Neck and eye skin are very thin, scars can be quite thick, but some are thinner.  You see the problem.  Skin thickness varies.  To get consistently good results, this question needs to be answered.
  • What is the plan for sterilizing both the skin and the device?    Most spas and salons don’t own autoclaves which is the gold standard for sterilzing.  If they use solutions, are they doing is correctly.  If they are using disposables, do they understand how to recognize an active skin infection?
  • What is the correct density for the tiny holes that the needles make? We know that density makes a difference from the laser studies.  Density is how close together the little needles that are being inserted into the skin.   Too much density and it leaves you exposed to infection risks, scars, and very dry skin that’s prone to irritation for about a month.

Complications of microneedling:

  • Skin infections
  • Scarring
  • Darkening of the treated site
  • Irritation and eczema – usually temporary
  • Pain or discomfort
  • Results not as expected
  • Expensive for results achieved

Bottom Line:

I would avoid for now, unless you are with an office with a LOT of experience, and where ideally they are involved in studies and know the science on this.   Might be good in future.  It’s still a developing technology.   Consider for your acne scars, a Fraxel laser instead.

Hope this helps,

Dr. I


Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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