Microneedling for the Treatment of Scars: An Update for Clinicians

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Abstract

Background

Microneedling (MN) is used for the treatment of scars, amongst other indications. Although used in Asia and the Middle East for decades, related to the supposed lack of post-procedure pigmentary alterations even in darker skin types, MN only recently gained attention in the United States as an effective, well-tolerated aesthetic treatment.

Materials and Methods

A systematic review of the Medline database was completed using search terms “microneedle” or “microneedling” or “micro needle” or “micro needling” and “scar”. Included articles were written in English and discussed the use of MN for the treatment of scars in human subjects.

Results

Fifty-eight studies were included for review, with a total of 1845 patients treated for acne scarring, hypertrophic or keloid scars, and those resulting from surgery, trauma, varicella or smallpox. MN and its counterpart fractional radiofrequency MN (FRF-MN) were used as monotherapy or in combination with topical, surgical or systemic modalities. MN and FRF-MN treatment resulted in clinical improvement of scar appearance from baseline. No serious adverse events occurred.

Conclusion

MN is a well-tolerated, minimally invasive procedure that can be used for the treatment of scars with a high level of patient satisfaction. Further clinical studies are needed to develop standardized treatment protocols.

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Most cited references 69

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Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles.

N Orentreich, D Orentreich (1995)

A new method of subcuticular underming for the treatment of depressed cutaneous scars and wrinkles is introduced. To define the newly coined term "Subcision" and to describe this minor surgical procedure for treating depressed scars and wrinkles. A tri-beveled hypodermic needle is inserted through a puncture in the skin surface (hence, "incisionless" surgery), and its sharp edges are maneuvered under the defect to make subcuticular cuts or "-cisions." The depression is lifted by the releasing action of the procedure, as well as from connective tissue that forms in the course of normal wound healing. This technique is useful in treating a variety of cutaneous depressions, including scars and wrinkles.

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Strategy for hypertrophic scar therapy: Improved delivery of triamcinolone acetonide using mechanically robust tip-concentrated dissolving microneedle array

Shiqi Lin, Guilan Quan, Ailin Hou … (2019)

A hypertrophic scar (HS) is a cutaneous condition characterized by deposits of excessive amounts of collagen that produces a raised scar, causing physical, psychological, and cosmetic problems for the patient. The therapeutic efficacy of conventional transdermal drug delivery systems is often limited because the HS tissue is more compact than normal skin. At present, intralesional multi-injection of triamcinolone acetonide (TA) using a syringe is one of the most commonly used treatments for HS. However, the efficacy of this treatment is highly dependent on the skill of the medical professionals administering the injection. Even with co-administration of local anesthetics, traditional injection still causes pain to the patients, resulting in poor compliance. The purpose of this study was to provide an alternative treatment for HS by establishing a novel intradermal delivery system with a dissolving microneedle array (DMNA). To produce needles of higher mechanical strength for successful insertion into the compact and hard HS tissue, hydroxypropyl-β-cyclodextrin (HP-β-CD) was added into sodium hyaluronic acid (HA), the needle material. The hydrogen interaction between HP-β-CD and HA restricted the mobility of the molecular chains, and subsequently increased the elastic modulus of the complex materials. The HP-β-CD also contributed to improved loading of the hydrophobic drug molecules into the DMNA needle tips. To assess the delivery of TA to the HS site via DMNA, an HS model was established in the ventral skin of New Zealand rabbits' ears. It was found that the value of the scar elevation index was decreased to normal, together with the down regulation of mRNA expressions of Collagen I and transforming growth factor-β1 (TGF-β1) following the administration of DMNA containing TA (TA-DMNA). Western blotting results also revealed decreased protein expressions of both Collagen I and TGF-β1. Hence, TA-DMNA appears to be a promising alternative to multi-injection of TA injection, providing a convenient and low-pain therapeutic strategy for HS treatment.

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Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study

Mohd Asif, Sanjay Kumar Kanodia, Kishor Singh (2016)

Acne scarring causes cosmetic discomfort, depression, low self-esteem and reduced quality of life. Microneedling is an established treatment for scars, although the efficacy of platelet-rich plasma (PRP) has not been explored much.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Cosmet Investig Dermatol

Journal ID (iso-abbrev): Clin Cosmet Investig Dermatol

Journal ID (publisher-id): ccid

Journal ID (pmc): ccid

Title: Clinical, Cosmetic and Investigational Dermatology

Publisher: Dove

ISSN (Electronic): 1178-7015

Publication date (Electronic): 22 December 2020

Publication date Collection: 2020

Volume: 13

Pages: 997-1003

Affiliations

[1 ]University of California , Department of Dermatology, Irvine, CA, USA

[2 ]AboutSkin Dermatology and DermSurgery , Greenwood Village, CO, USA

Author notes

Correspondence: Margit LW Juhasz University of California , Department of Dermatology, 118 Med Surge I, Irvine, CA92697, USATel +1 718-309-7368 Email mjuhasz@uci.edu

Article

Publisher ID: 267192

DOI: 10.2147/CCID.S267192

PMC ID: 7764156

PubMed ID: 33376377

SO-VID: fda10180-884d-4e32-9474-3c27656476ba

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 28 October 2020

Date accepted : 03 December 2020

Page count

Figures: 0, Tables: 2, References: 70, Pages: 7

Funding

Funded by: no funding;

The authors received no funding for this research.

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Microneedling for the Treatment of Scars: An Update for Clinicians

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Abstract

Background

Materials and Methods

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Conclusion

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Karger: Dermatology

Most cited references 69

Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles.

Strategy for hypertrophic scar therapy: Improved delivery of triamcinolone acetonide using mechanically robust tip-concentrated dissolving microneedle array

Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study

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