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Microneedling therapy for long term changes to scars

Can microneedling therapy bring about long term changes to scars?

Dr David Sharp

Dr David Sharp

Specialist Plastic Surgeon + Registered Medical Practitioner

Article written by Director and Journalist Liz Washington B.Journ, and medically reviewed by Dr. David Sharp, MBBS, FRACS (Plast)

Microneedling is a minimally invasive treatment that has been increasingly used to treat both cosmetic and dermatologic conditions, including scarring from acne, trauma or surgery. In this article, we will explore the benefits of microneedling for scar reduction, including its underlying mechanisms and examine the scientific evidence that supports its application.

A study published in the Journal of Plastic and Reconstructive Surgery in February 2020, Microneedling of Scars: A Large Prospective Study with Long-Term Follow-Up reported that 100% of the patients involved in the research experienced improvement in scarring.

Study participants received one to six consecutive monthly microneedling treatments, with all scars showing a minimum 50% improvement, after an average of 2.5 treatments.

Researchers found that over 80 percent of patients had 50%-75% improvement. No significant differences were found between the response of facial scars vs scars on any other part of the body – nor was there a difference between acne, trauma or surgical scars.

Other studies support these findings, showing similar improvements.

Why is microneedling used as a first line treatment for reducing scars?

Scarring is a common concern for many people, especially after acne or accidents, where it can serve as an ongoing reminder of physical or emotional trauma.

While scars serve as a testament to the body’s healing process, they can also be a source of self-consciousness and discomfort.

Pictured, right, before and 4 weeks after a series of microneedling treatments at the Sharp Clinic.

Patient before dermapen microneedling for acne scars 2a
Treatment results 2b, Dermapen for acne scars and Microneedling

This minimally invasive procedure carries lower risks than other scar interventions, such as CO2 laser or steroid injections, and has been shown to be efficacious in improving the appearance of scars.

One of the benefits of microneedling is that it has a good safety profile for otherwise healthy patients, which can be applied to all phototypes – including Fitzpatrick skin types IV and V, due to its low risk of hyper or hypopigmentation.

How does microneedling change scars?

Microneedling involves the use of very tiny needles, from 0.5mm (half a millimetre) to 3mm in length, to cause micropunctures that reach the dermis and trigger an inflammatory response.

This induces the release of growth factors, which stimulate the formation of new collagen and elastin in the papillary dermis, associating with the production of new capillaries. Neovascularisation and neocollagenesis leads to scar improvements.

Microneedling, also known as collagen induction therapy, is a non surgical procedure that involves the use of a specialised device equipped with tiny needles to create controlled micro-injuries in the skin’s surface.

 

Microneedling has a number of potential benefits for treating acne, trauma or surgery scars, including:

1. Enhanced collagen production: One of the primary mechanisms through which microneedling reduces scars is by promoting collagen production. Collagen is a crucial protein that provides skin with its strength and elasticity. As the body heals the micro-injuries created during microneedling, it generates new collagen, leading to smoother and more even toned skin.

2. Improved skin texture: Microneedling helps to break down the tough, fibrous tissue that forms in scars, such as hypertrophic or keloid scars. This process gradually softens the scar tissue over multiple treatments, resulting in a smoother texture and less tightness in the scar tissue.

3. Increased Absorption of Topical Treatments: Microneedling creates tiny channels in the skin, which significantly enhance the absorption of topical treatments. This means that if your clinician applies specific products after microneedling, they can penetrate deeper into the skin, assisting their effectiveness.

4. Minimised Hyperpigmentation: For scars with hyperpigmentation, microneedling can help by dispersing melanin more evenly throughout the skin. This can lead to a reduction in the darkened appearance of the scar.

 

Microneedling recovery and risks

Microneedling is generally considered a safe procedure when performed by trained and experienced professionals. However, like any medical or cosmetic treatment, there are potential risks and side effects that patients should be aware of:

1. Skin irritation and redness: After microneedling, it is normal to experience some degree of skin irritation, redness, and swelling. This typically subsides within a few days but can be more pronounced depending on the depth and intensity of the treatment.

2. Pain and discomfort: While microneedling is generally well tolerated, some patients may experience mild discomfort or pain during the procedure. Topical anaesthetics can be applied to minimise this sensation.

3. Risk of infection: The tiny needles used in microneedling create microchannels in the skin. While these channels close quickly, there is a slight risk of infection if proper post procedure care is not followed. It’s essential to keep the treated area clean and avoid touching it with dirty hands. Patients who smoke, have poor nutrition or poor immune function are at a higher risk.

4. Skin sensitivity: Microneedling can increase skin sensitivity to sunlight. Patients are advised to use sunscreen and avoid prolonged sun exposure for a few days after the procedure to reduce the risk of hyperpigmentation.

5. Bruising and swelling: Some patients may experience bruising or more significant swelling, especially if they have sensitive skin or are prone to these reactions. It usually resolves within a week but can persist longer in rare cases.

6. Post-inflammatory hyperpigmentation (PIH): In individuals with darker skin tones or a family history of PIH, there is a slight risk of developing post inflammatory hyperpigmentation, which is characterised by darkening of the skin in the treated area. Proper aftercare and sun protection can help mitigate this risk.

7. Allergic reactions: Although uncommon, some individuals may experience allergic reactions to the topical numbing creams or serums used during or after microneedling. It’s crucial to inform the practitioner of any known allergies before the procedure.

8. Unpredictable results: Microneedling’s effectiveness can vary from person to person, and not all scars or skin conditions may respond as desired. While many individuals see improvement, results are not guaranteed.

9. Skin peeling and dryness: Some patients may experience skin peeling and dryness in the days following microneedling. This is part of the skin’s natural healing process and usually resolves within a few days.

To minimise these risks, it is essential to consult with an experienced therapist who can assess your suitability for microneedling, customise the treatment plan to your specific needs, and provide proper aftercare instructions. Additionally, patients should disclose their medical history and any medications they are taking to ensure the procedure’s safety and effectiveness.

Microneedling for scars requires multiple treatments in most cases, and failing to complete the prescribed course of treatments can compromise the therapy’s outcome. Noticeable results are rarely achieved through just one session alone, so patience is required when undertaking this treatment!

The scientific evidence supporting the efficacy of microneedling in scar reduction is robust, making it a clinically informative and effective option for those seeking to improve the appearance of scars. For medically qualified professionals, microneedling presents a safe and evidence-based approach to helping patients regain confidence in their skin’s appearance. If you are interested in this treatment, the first step is to book a complimentary consultation with one of our clinicians to assess your skin and provide a customised quote and treatment plan.

Dr David Sharp plastic surgery Brisbane

About Dr. David Sharp:

Dr. David Sharp is an experienced specialist plastic surgeon in Brisbane, with a special interest in breast, body and facial cosmetic surgery.

With over two decades of experience in medicine, Dr. Sharp has performed over 20,000 surgical procedures in Australia and has an established surgical and non surgical practice in Brisbane.

Read more about Dr Sharp's credentials and expertise here. 

For more information and to schedule an appointment with Dr. David Sharp, please contact our patient support team at 3202 4744 or visit our online booking request form here.

This information is intended for general knowledge and should not replace personalised advice from your surgeon. Always consult with your surgeon for individual care.

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