Microneedling for Acne Scars: Does It Work and Is It Safe
Microneedling may improve the appearance of some indented acne scars by encouraging the skin’s natural repair and collagen-remodelling processes.
However, microneedling is primarily used for acne scarring, not for treating active acne. It should not be performed directly over inflamed spots, pustules, cysts, infected skin or open wounds.
If you currently have moderate or severe acne, controlling the breakouts should normally come before considering a cosmetic treatment for the remaining scars.
The Short Answer
Microneedling may be suitable for certain indented acne scars, particularly rolling and some shallow boxcar scars.
It is less likely to correct deep ice-pick scars, raised scars or active acne. Results vary according to the scar type, depth, skin condition and the experience of the practitioner performing the treatment.
Microneedling is not an overnight solution. Several professionally planned treatments may be needed, with improvements appearing gradually as the skin heals and remodels.
What Is Microneedling?
Microneedling is a cosmetic procedure that uses a device containing very fine needles to create controlled micro-injuries in the skin.
These controlled injuries trigger a wound-healing response. As the skin repairs itself, collagen and other structural components may be remodelled, potentially helping some indented scars look shallower and the skin texture appear smoother.
Professional microneedling devices can include:
- Microneedling pens
- Dermarollers
- Dermastamps
- Radiofrequency microneedling devices
These are not identical treatments. Radiofrequency microneedling uses heat energy as well as needles and has different risks, costs and treatment requirements.
Can Microneedling Treat Active Acne?
Microneedling should not normally be performed directly over active, inflamed acne.
Passing needles over pustules, cysts, infected spots or broken skin may increase irritation and could raise the risk of infection, delayed healing, pigmentation changes or further scarring.
Microneedling also does not address the main causes of acne, such as blocked follicles, excess sebum and inflammation. It should not replace suitable acne treatment.
The NHS recommends speaking to a pharmacist about mild acne and seeing a GP when acne is moderate, severe, causing distress or producing nodules and cysts. Treating acne properly can help reduce the risk of additional scarring.
Active Acne Versus Acne Scars
It is important to know whether you have active acne, temporary marks or permanent scars.
| Skin concern | Typical appearance | Is microneedling normally suitable? |
|---|---|---|
| Active inflammatory acne | Red, swollen or painful spots, pustules, nodules or cysts | Usually no |
| Post-inflammatory redness | Flat red or pink marks after spots | Not usually the first treatment |
| Post-inflammatory pigmentation | Flat brown or darker marks after spots | Requires careful assessment |
| Rolling scars | Broad depressions with sloping edges | May respond |
| Shallow boxcar scars | Round or oval indentations with defined edges | May respond |
| Deep ice-pick scars | Small, narrow and deep holes | Often need another treatment |
| Raised scars | Firm, elevated scar tissue | Generally unsuitable without specialist advice |
A qualified practitioner or dermatologist can examine the skin and determine which type of scarring is present.
Which Acne Scars Can Microneedling Help?
Rolling Scars
Rolling scars create broad, shallow depressions that can make the skin appear uneven or wavy.
Microneedling may improve some rolling scars by supporting collagen remodelling, although scars tethered to deeper tissue may require another procedure, such as subcision.
Boxcar Scars
Boxcar scars are round or oval depressions with more defined edges. Shallow boxcar scars may respond better than deeper ones.
The depth of the scar and the amount of remaining healthy tissue can affect the outcome.
Ice-Pick Scars
Ice-pick scars are narrow but extend deeply into the skin.
Microneedling alone is unlikely to remove deep ice-pick scars completely. A dermatologist may recommend another treatment or a combination approach.
Raised and Keloid Scars
Raised scars form when the body produces excessive scar tissue.
Microneedling is not generally the first choice for raised or keloid scars. Anyone with a personal or family history of keloid scarring should tell the practitioner before considering treatment.
How Effective Is Microneedling for Acne Scars?
Research suggests that microneedling can improve the appearance of some atrophic—or indented—acne scars. However, the results vary considerably.
The final outcome can depend on:
- The type of acne scar
- The depth and age of the scars
- The person’s natural healing response
- Skin tone and pigmentation risk
- The device and needle settings
- The practitioner’s training
- The number and spacing of treatments
- The aftercare followed
- Whether acne remains active
The British Association of Dermatologists lists microneedling as one of several procedures that may be used to improve acne scars. Other options can include chemical peels, steroid injections and subcision.
No responsible practitioner should promise that microneedling will remove acne scars completely.
How Many Microneedling Sessions Are Needed?
Some people may notice a gradual improvement after one treatment, but acne scars often require a planned course of treatments.
The appropriate number and spacing of sessions should be decided by a suitably qualified practitioner after assessing the skin.
Treatments need sufficient time between them because collagen remodelling and skin repair do not happen immediately. Performing treatments too frequently may increase irritation without improving the final result.
Does Microneedling Hurt?
The level of discomfort depends on the device, treatment depth, area being treated and the person’s sensitivity.
Professional clinics may use a topical numbing product before treatment. The skin can still feel warm, tight or tender afterwards.
A qualified practitioner should explain what to expect and provide clear aftercare instructions before beginning the procedure.
What Does Skin Look Like After Microneedling?
Temporary redness and sensitivity are common after professional microneedling.
The skin may initially look or feel:
- Red or flushed
- Slightly swollen
- Tight
- Warm
- Dry or flaky
- More sensitive than usual
These effects should gradually improve. Recovery time varies according to the treatment intensity and the individual’s skin.
Contact the practitioner or seek medical advice if you develop worsening pain, spreading redness, significant swelling, pus, blistering, fever or other signs of infection.
Microneedling Risks and Side Effects
Microneedling creates controlled damage to the skin, so it is not risk-free.
Possible complications include:
- Prolonged redness
- Swelling and discomfort
- Infection
- Skin irritation
- Post-inflammatory pigmentation
- Cold-sore reactivation
- Allergic or irritant reactions
- Delayed healing
- Further scarring
- Uneven results
People with deeper skin tones can undergo microneedling, but careful assessment and appropriate settings are important because inflammation can sometimes lead to pigmentation changes.
Who Should Avoid Microneedling?
Microneedling may be unsuitable if you have:
- Active inflammatory acne
- An active skin infection
- Cold sores in the treatment area
- Open wounds or broken skin
- Active eczema, psoriasis or dermatitis in the area
- A history of poor wound healing
- A tendency to develop keloid scars
- A condition or medication affecting bleeding or healing
- Recent use of certain acne medicines
- Pregnancy or breastfeeding where the clinic’s products or anaesthetics are unsuitable
This is not a complete list. Always tell the practitioner about medical conditions, allergies, pregnancy, previous cosmetic treatments and every medicine or supplement you take.
Do not stop prescribed medication without speaking to the clinician who prescribed it.
Professional Versus At-Home Microneedling
Professional microneedling and at-home dermarolling should not be treated as the same procedure.
A qualified professional can assess scar type, select appropriate equipment, work in a controlled environment and recognise contraindications.
At-home needling carries risks including:
- Poor sterilisation
- Reusing damaged or contaminated needles
- Using an unsuitable needle length
- Applying too much pressure
- Treating active spots
- Repeating treatment too frequently
- Applying irritating products to freshly needled skin
- Infection, pigmentation changes and further scarring
Trying to treat established acne scars at home may cause more damage than improvement. Professional assessment is the safer option, especially for deeper scars or darker skin tones.
What Should You Put on Skin After Microneedling?
Freshly treated skin is more sensitive than normal. Follow the practitioner’s aftercare instructions rather than applying your usual routine automatically.
Aftercare commonly focuses on:
- Gentle cleansing
- Avoiding unnecessary touching
- Using simple products recommended by the practitioner
- Avoiding retinoids and exfoliating acids until advised
- Avoiding scrubs and fragranced products
- Protecting the skin from sunlight
- Not picking flaking or peeling skin
Do not assume that an everyday cosmetic serum is sterile or suitable for application during microneedling or immediately afterwards.
Products used during professional treatment should be specifically selected by the practitioner for that purpose. Once the skin has settled, a straightforward hydrating serum may be reintroduced according to professional advice.
Can Hyaluronic Acid Help After Microneedling?
Hyaluronic acid is a humectant that helps retain water at the skin’s surface. It can support hydration between treatments and may help the skin feel smoother once it is ready for normal skincare again.
However, hyaluronic acid does not perform the microneedling treatment, rebuild scars by itself or guarantee faster healing.
Only use products approved by your practitioner during the immediate recovery period. After the skin has healed sufficiently, a simple fragrance-free hyaluronic acid serum can be used as part of an everyday hydration routine.
Hollyberry Cosmetics’ 1% high-molecular-weight hyaluronic acid serum contains only three ingredients: Aqua, Hyaluronic Acid and Phenoxyethanol.
It is intended to support everyday hydration. Ask your practitioner when it is appropriate to restart ordinary skincare after treatment.
500ml Hyaluronic acid serum - Hollyberry Cosmetics
How to Prepare for a Professional Consultation
Before booking microneedling, ask the practitioner:
- What qualifications and training do you have?
- Do you regularly treat acne scars?
- Which type of scars do I have?
- Is my acne controlled enough for treatment?
- What device will you use?
- What results are realistic for my scars?
- What are the risks for my skin tone?
- What products will be applied during treatment?
- What aftercare will I need?
- What should I do if I experience a complication?
- Are before-and-after photographs taken under consistent lighting?
You should be given enough time to understand the benefits, limitations, costs and risks before deciding whether to proceed.
Frequently Asked Questions
Can microneedling get rid of acne scars completely?
No treatment can guarantee the complete removal of acne scars. Microneedling may make some indented scars appear shallower and improve overall texture.
Can you microneedle over active spots?
Microneedling should not normally be performed directly over inflamed spots, pustules, cysts, infections or broken skin.
Is microneedling good for hormonal acne?
Microneedling does not address the hormonal causes of acne. Hormonal acne should be assessed and managed appropriately before treating the scars it may leave.
Can microneedling make acne worse?
It could aggravate the skin if performed over active acne or if unsuitable products, poor hygiene or incorrect technique are used. This is why professional assessment is important.
Does microneedling help dark marks left by spots?
Microneedling is mainly used for texture and indented scars. Flat pigmentation marks are different from scars and may require a different treatment plan.
Is microneedling suitable for sensitive skin?
It depends on the cause and severity of the sensitivity. Active eczema, dermatitis, infection or a damaged skin barrier may make treatment unsuitable until the condition is controlled.
Can I use retinol after microneedling?
Do not restart retinol until your practitioner says your skin is ready. Applying it too soon may cause significant irritation.
Can I use salicylic acid after microneedling?
Exfoliating acids are normally avoided during the immediate recovery period. Follow the aftercare instructions given by your practitioner.
Can I wear makeup after microneedling?
Your practitioner should tell you when makeup can safely be reapplied. Applying it too soon may irritate the skin or introduce contamination.
When should I see a GP about acne?
Speak to a GP if you have moderate or severe acne, painful nodules or cysts, acne that is causing scarring, or acne that is affecting your mental wellbeing.
Final Verdict
Microneedling may improve certain indented acne scars, particularly rolling and shallow boxcar scars. It is not a treatment for active acne and should not be performed directly over inflamed, infected or broken skin.
The best results begin with an accurate assessment of the scar type and realistic expectations. A qualified practitioner can determine whether microneedling is appropriate or whether another treatment would be more suitable.
Control active acne first, choose a properly trained professional and follow the aftercare instructions carefully.
Summary
Microneedling is a professional cosmetic procedure that may improve some indented acne scars by encouraging collagen remodelling. It is most often considered for rolling and shallow boxcar scars. It should not be performed directly over active inflammatory acne, cysts, pustules, infection or broken skin. Deep ice-pick scars and raised scars may require different treatments. Results vary, and professional assessment is recommended before treatment.
Key Takeaways
- Microneedling is used for acne scars, not as a treatment for active acne.
- Rolling and shallow boxcar scars may respond better than deep ice-pick scars.
- Active acne should normally be controlled before scar treatment begins.
- At-home needling can cause infection, pigmentation changes and further scarring.
- Several professional treatments may be required.
- Only use immediate aftercare products recommended by the practitioner.
- Hyaluronic acid supports hydration but does not remove acne scars by itself.