Is microneedling more effective than chemical peels?

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It is best to consult a professional for microneedling treatment to reduce acne scars. Ohlamourstudio/Stocksy
  • A new study has compared two dermatological treatments – microneedling and chemical peels – to see which works best for treating acne scars.
  • The researchers focused on people with darker skin and randomly assigned them to receive one of two treatments.
  • Participants who received the microneedling treatment had the best results, as 73% of this group saw a marked improvement.

While some may view acne as a minor inconvenience of puberty, some people in their teens and beyond experience difficult cases of acne that can last a long time and even lead to scarring.

A study from Rutgers University, located in New Brunswick, NJ, examined dermatological treatments for acne scars in patients with darker skin.

The study was published in The Journal of Clinical and Aesthetic Dermatology.

According to the American Academy of Dermatology Association (AAD), acne occurs when skin pores become clogged. It starts to happen more during puberty when people go through a hormonal change, but acne can affect people of all ages.

There are many treatments for acne. Some are over-the-counter (OTC) treatments, such as those containing salicylic acid or retinol. For people with more severe acne who don’t find success with over-the-counter treatments, there are prescription medications, such as clascoterone or tretinoin.

While acne disappears in some people, others have scars. According to the AAD, some people are more at risk than others of developing acne scars.

People who break out or squeeze their acne and don’t treat their acne are at a higher risk of developing acne scars. Also, people with cystic acne and nodular acne are prone to scarring.

Cystic acne penetrates the skin and causes pus-filled pimples, while nodular acne tends not to form a head. Scars affect 30% of people with moderate to severe acne.

Sometimes hyperpigmentation occurs as a result of acne, which is when the skin appears darker after a pimple disappears. This is more common in people with darker skin.

Acne scars belong to one of the following three categories:

  • Atrophic (like ice pick scars, which appear as pinpricks on the face)
  • Hypertrophic (which are raised and firm)
  • Keloidal (reddish/purple scars that extend beyond the boundaries of the original wound)

Depending on the severity of the acne scars, home treatments may help. Retinol serums can help minimize scarring and hyperpigmentation.

People who don’t respond to over-the-counter treatments can see a dermatologist, who can prescribe a treatment such as a chemical peel or microneedling.

When a dermatologist performs a chemical peel, they apply a chemical solution to a person’s skin and, after waiting for some time, peel it off. In addition to helping fight acne and scars, it can help fight signs of aging as it exfoliates the top layer of skin.

Dr. Michelle Tarbox, associate professor of dermatology at Texas Tech University Health Sciences Center, spoke about the microneedling process during a University of Utah health podcast. With microneedling, doctors puncture the skin with tiny needles as part of the treatment to stimulate collagen.

“Microneedling can be used to improve acne scars,” Dr. Tarbox commented. “It improves discoloration. It also improves some of the scars that may be left after an inflammatory process.

“And microneedling can be used to deliver different drugs to the skin,” Dr. Tarbox continued. “It can also be used with platelet-rich plasma or used to help improve hair growth at home, so there are plenty of options with microneedling.”

During the Rutgers Acne Study, researchers compared microneedling to a 35% glycolic acid chemical peel to see what worked best for acne scars.

The researchers recruited 60 participants who had darker skin classified as IV, V, or VI on the Fitzpatrick Skin Phototype Scale. They were between 15 and 50 years old and all had “clinically diagnosed scars” of acne.

People who had active acne, diabetes or HIV infections were excluded from the study.

Participants were randomly placed into Group A (the microneedling group) or Group B (the chemical peeling group). Both groups received treatments every 2 weeks for 12 weeks.

After the 12-week treatment plan was completed, the scientists waited two weeks and then brought in the participants to judge the effectiveness of their treatments.

Microneedling outperformed chemical peels in this study.

After analyzing each participant’s treated areas against the Goodman and Baron scar grading system, researchers found that 73% of microneedling participants improved by at least two points, compared to just 33% of chemical peel participants. .

“Based on the results of this study, patients whose darker skin precludes the use of stronger chemical peels, which can permanently discolor darker skin, should treat acne scars with microneedling,” explains Dr. Babar Rao, the lead author of the study. “For lighter-skinned patients who can use stronger peels without the risk of discoloration, chemical peels might still be the best option for some.”

Dr. Rao is a professor of dermatology and pathology at Rutgers Robert Wood Johnson Medical School.

Dr. Geeta Yadav, board-certified dermatologist and founder of FACET Dermatology, spoke with Medical News Today on the results of the study.

“Acne scars tend to be more prominent in people with darker skin due to the increased risk of hyperpigmentation after skin trauma,” Dr. Yadav explained.

“Professional microneedling is one of the few in-office procedures that effectively treats scars in darker skin tones, and it makes sense that the microneedling patients observed in this study showed greater improvement,” commented Dr. Yadav.

Dr Yadav described the 35% glycolic acid peel as “superficial” and said she “wasn’t surprised the results weren’t as robust as the group that received the microneedling”.

Other Hyperpigmentation Treatments

Dr. Yadav also discussed other treatments for acne scars in people with darker skin.

“Beyond microneedling (or radiofrequency enhanced microneedling), treatments for acne scars in deeper skin tones can also include resurfacing fractional ablative lasers,” Dr. Yadav said. “This must be done with adequate care before and after to reduce the risk of hyperpigmentation.”

“All of these energetic and mechanical treatments can be enhanced by topical application of vitamin C,” Dr. Yadav commented.

“Vitamin C promotes the production of collagen, which helps smooth the appearance of scars, as well as blocking the production of tyrosinase, the enzyme that produces melanin. Considering that vitamin C is also a powerful antioxidant, this makes it a complete treatment option to support healthier looking skin with more even texture and tone.
— Dr. Geeta Yadav

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