What are you really gaining with microneedling?

I have some light scarring from SkinPen Microneedling on the neck. It’s now been a year. Is there anything that can be done to help repair the area? Can RF microneedling help? Love your website Dr. Irwin!

First we need make sure we’re talking about the same thing. Deep RF (radiofrequency) microneedling targets the dermis where collagen and elastic fibers and blood vessels are. These will bruise, swell and have some downtime.

On the other hand, superficial microneedling targets the epidermis and sometimes there’s a little collagen built in the high dermis, but not the deeper dermis.

To answer your question, it’s so individual on this type of scarring. I would recommend second opinions from a good dermatologist. It is very hard to say without seeing and feeling the area involved.

Pros and Cons of Deep Versus Superficial Microneedling

Deep Microneedling

  • Tightening… you don’t get this with superficial microneedling
  • Proven increase in elasticity (snap-back effect) with some systems (see papers on Profound).
  • Longer term results- 3-6 months to see full results and then it’s a permanent change; subject to continued aging of course.
  • Skin texture improves more, especially if it is combined with a laser for acne scarring.
  • Downtime- 3-7 days – depends on person and number of pulses. Some “yellowing” on the neck for 14 days. Cover with a sleeveless T-neck.
  • Needs topical and injectable numbing.
  • Waiting for results requires patience.
  • Complications always possible; informed consent important.

Superficial Microneedling

  • Can get superficial texture improvement (epidermis); including superficial scars.
  • Increases circulation temporarily.
  • Swelling from it makes pore size look better temporarily. But since pore size is determined by genes and amount of oil secretion, this is not permanent.
  • Increases cell turnover.
  • The slight swelling from the procedure for often makes lines look better, but then worse again at about 1 month later; a temporary effect.
  • Disruption of the epidermal layer decreases skin hydration through trans epidermal water loss. Skin looks dry and more lines after a week or two, if done too often.
  • Complications always possible; informed consent important.

Bottom Line:

Deep microneedling– After an initial series of 1-4 over 1-2 years, then perhaps every 2 years. No data on this that I’ve seen yet.

Superficial microneedling– No more than once every 3 months, in my opinion. I’d recommend a good post care moisturizer such as Madison MD Natural Lipid Moisturizer.

Hope this helps,

Brandith Irwin, MD

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