Microneedling is proving itself to be a viable alternative to laser treatments in acne scarring.
There has been a lot of hype in certain circles about microneedling, but it hasn’t always stood up to scrutiny – there can be over-the-top claims made, without the evidence required to back it up (yet). Microneedling is a very effective treatment for promoting skin healing and repair, and collagen production. There isn’t really any specific treatment guidelines for practitioners, however, who may all be using different techniques to each other.
Most practitioners are using an automated pen, with no definitive guidelines on how often to go over the same area and at what depths for the various areas of the face and body.
Many patients with darker skin types can develop post-inflammatory hyperpigmentation after laser treatments, because lasers use heat to exert their effect. Microneedling, however, uses mechanical manipulation of the skin, which reduces the risks of hyperpigmentation significantly. Heat stimulates melanocyte-stimulating hormone that occurs during the healing response.
One study found that after 12 weeks, microneedling increased epidermal thickness and promoted collagen remodelling in scars, making microneedling a viable option to make a dent in acne scarring.
Another study found that both nonablative fractional lasers and microneedling were comparable and effective in treating acne scars, with microneedling having less downtime and fewer side-effects. In this study, the participants had three dermaroller microneedling treatments a month apart. After six months, there was no difference observed between the outcomes of laser treatments and microneedling, indicating they are as effective as each other.
The major difference between the two treatments was that with laser treatments, the participants’ faces remained red for two or three days, compared with just one day for microneedling. There were also no instances of post-inflammatory hyperpigmentation from microneedling.
Another study did laser treatments on one side of the face and microneedling on the other. At three months post-treatment, the laser treated side averaged a 70 per cent improvement over 30 per cent for microneedling, however the laser treatment patients had more side-effects like swelling, redness and downtime. One patient in this study developed pigmentation issues from the laser treatments.
In 2015, an article was published in a dermatology publication reporting statistically significant improvements in scarring in 10 patients who had dermaroller microneedling treatments, with six sessions at two-weekly intervals.
Microneedling can also be used as a drug delivery system, since it causes microscopic wounds in the skin that remain open for a few minutes. Once open, these channels can absorb medicine to address various skin conditions, and to deliver topical anaesthesia if required for deeper microneedling treatments.
A study of 15 patients with acne scarring found that performing 0.5mm microneedling (a light treatment that doesn’t cause pain) prior to applying anaesthetic before deeper microneedling treatments significantly reduced pain from treatments.
Platelet-rich plasma (PRP) is being delivered into the skin via microneedling for hair loss and acne scarring, and being used for facial rejuvenation, including improving the look of fine lines and wrinkles. Some microneedling devices also use radiofrequency, for extra effect.
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