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Dermatology · Scar treatment
Microneedling for acne scars
Microneedling is mainly used for depressed acne scars. This article explains the different scar types, how the procedure works and what research says about combining microneedling with PRP.
Basics
Why acne scars require different treatment approaches
Acne scars may develop when pronounced inflammation damages deeper skin structures. During the subsequent healing process, the affected tissue is reorganised.
When less tissue is formed than was originally present, depressed or atrophic scars develop. Excessive tissue formation may instead lead to raised hypertrophic scars or keloids.
Red or brown marks after inflammation has healed are not automatically scars. They may be post-inflammatory colour changes that require a different treatment approach.
Microneedling does not mechanically remove scars.
The procedure is intended to trigger controlled repair and remodelling processes in the skin. The potential response depends partly on the scar type.
Clinical scar atlas
Three common types of atrophic acne scars
Classification helps with treatment planning. A method that may be useful for shallow depressions will not necessarily have the same effect on narrow, deep scars.
Rolling scars
Shallow, wave-like depressions with softer transitions. They may be tethered by fibrous bands in deeper tissue.
Boxcar scars
Round or oval depressions with more clearly defined edges. Their depth and severity can vary considerably.
Ice-pick scars
Narrow, punctiform and often deep indentations. They generally respond less well to superficial procedures.
Controlled micro-injury
What happens in the skin during microneedling
During medical microneedling, a needle device creates numerous controlled microchannels in the skin. This initiates a local wound-healing response.
Over time, collagen structures may be reorganised. For this reason, the method is also called collagen induction therapy. Existing scar tissue is not simply dissolved or removed.
The aim is to reduce differences in height and irregular texture. Visible changes develop gradually because tissue remodelling can take several weeks or months.
Professional users can find suitable devices and accessories in the microneedling category.
01Microchannels
Fine needles create controlled, spatially limited injuries.
02Early response
The tissue responds with the typical processes of local wound healing.
03Tissue remodelling
Collagen structures may be reorganised over time.
04Later assessment
The outcome should not be assessed conclusively immediately after treatment.
Evidence
When microneedling may be useful
More suitable
Microneedling has mainly been studied for atrophic scars. Rolling scars and shallower boxcar scars may respond better than very deep scars.
Limited suitability
Deep ice-pick scars often require other or additional procedures. Treating every scar type in the same way is not appropriate.
Requires separate assessment
Raised scars and keloids need a separate medical evaluation. Results from studies on atrophic scars cannot simply be transferred.
Autologous blood product
Microneedling combined with PRP
Platelet-rich plasma is prepared from the patient's own blood. Centrifugation separates the blood components and provides a plasma fraction with concentrated platelets.
PRP is not a cosmetic serum or cream. Its composition depends on the preparation system, blood collection and the protocol used.
Depending on the treatment concept, PRP may be applied to the treated skin after microneedling or administered intradermally. These approaches must be distinguished professionally.
Treatment planning
Typical course of a session
The exact procedure depends on the scar pattern, skin condition, treatment depth and device used. When PRP is added, blood collection and preparation are also required.
Assessment
Scar type, depth, active inflammation and previous treatments are assessed.
Preparation
The skin is cleansed and, depending on the procedure, a local anaesthetic may be applied.
Treatment
Microneedling is carried out with a suitable professional needle device.
Aftercare
Skin care, sun protection and the individual instructions of the treating professional should be followed.
Safety
Side effects and situations that require assessment
Redness, swelling, burning, dryness and pinpoint bleeding may occur immediately after treatment.
Persistent pigment changes, allergic or granulomatous reactions and additional scarring have been reported rarely.
Active inflammatory acne
Ongoing inflammation should first be controlled to reduce the risk of additional lesions and scars.
Infections and open skin
Herpes, bacterial infections, open wounds and acute skin disorders must be assessed before treatment.
Coagulation and medication
Bleeding disorders and anticoagulant medication may be relevant to treatment planning.
Tendency to form keloids
A known tendency toward excessive scar formation requires particularly careful medical evaluation.
Product selection
Cosmetic serums must not be introduced into opened skin merely because they are well tolerated when used topically.
The goal is to improve texture, not to promise completely scar-free skin.
During the first few days after treatment, gentle skin care and consistent sun protection are commonly recommended. Strongly irritating active ingredients, peels, mechanical friction and intense heat may place additional stress on the temporarily impaired skin barrier.
Deep scars often remain at least partly visible. Mixed scar patterns may require several procedures, such as subcision, chemical peels, laser treatment or radiofrequency microneedling, depending on the findings.
The appropriate aftercare and treatment concept must be determined individually by suitably qualified professionals.
Further professional information
From treatment concept to technical implementation
Internal specialist pages on microneedling, PRP preparation and centrifugation for professional users.
↗Category
Microneedling devices and professional accessories
Devices, attachments and complementary products for qualified users.
↗PRP preparationPRP tubes for different preparation concepts
Observe the technical product information on materials, additives and intended use.
↗Online toolConvert RCF and RPM correctly
Calculate rotational speed and relative centrifugal force using the rotor radius.
↗Specialist articlePRP centrifugation: RCF, RPM, rotor and running time
Why manufacturer protocol, rotor radius and centrifuge type must be considered together.
Frequently asked questions
Briefly explained
Can acne scars disappear completely with microneedling?
Complete removal cannot be predicted. The aim is a possible improvement in surface texture, not a guarantee of scar-free skin.
Is microneedling suitable for every type of acne scar?
No. The method is mainly used for atrophic scars. Very deep ice-pick scars, raised scars and keloids may require other procedures.
Is PRP the same as a cosmetic serum?
No. PRP is prepared from the patient's own blood and is not equivalent to a cosmetic cream or conventional skin serum.
Is the combination of microneedling and PRP better?
Studies show average benefits compared with microneedling alone. The results are not fully standardised because PRP and treatment protocols differ.
Can microneedling be performed when acne is active?
Active inflammatory acne should first be medically controlled. Scar treatment usually starts only when the skin condition has stabilised sufficiently.