Last updated: October 27, 2026
Acne can leave marks long after the breakouts are gone. Some fade on their own, but true scars, the small dents and pits in the skin, usually don’t. Microneedling is one treatment dermatologists use for these scars. It helps the skin rebuild collagen where it was lost.
This guide explains which acne scars microneedling helps, how many sessions you may need, what recovery looks like and how it compares with other scar treatments.
Is it a scar or a dark mark?
Not every mark acne leaves behind is a scar. According to the American Academy of Dermatology (AAD), a flat spot of color left after a breakout is usually post-inflammatory hyperpigmentation (PIH), not a scar. PIH tends to fade over time and is treated differently. Our guide to chemical peels for acne scars and dark marks covers this.
A true acne scar changes the surface of the skin. It’s either sunken (depressed) or raised.
Types of acne scars
| Scar type | What it looks like | Does microneedling help? |
|---|---|---|
| Rolling | Wide, shallow dips that give skin a wavy look | Yes |
| Boxcar | Round or oval dents with sharper edges | Yes |
| Ice pick | Small, narrow and deep. The most common type | It can help, but deep, narrow scars may need a different treatment as well |
| Hypertrophic and keloid | Raised, firm scars, often on the jawline, chest or back | No. Raised scars need different treatment |
Depressed scars form when the skin loses collagen, so the goal is to rebuild it. Raised scars form when the body makes too much collagen, so they’re treated with options like steroid injections or lasers instead.
How microneedling works on acne scars
Microneedling, also called collagen induction therapy, uses a pen-like device with very fine needles to make tiny, controlled punctures in the skin. At Trillium we use the DermaPen.
The skin responds by producing new collagen and elastin. Over the following weeks this helps fill in sunken scars from below, so the surface looks smoother. Because the top layer of skin stays largely intact, recovery is quicker than with deeper resurfacing treatments.
Does microneedling work for acne scars?
Yes, for depressed scars. A 2021 systematic review of nine randomized controlled trials found microneedling was effective for atrophic (sunken) acne scars, both on its own and combined with other treatments, with no serious side effects reported. The authors noted that larger studies with longer follow-up are still needed.
Results are gradual and vary by scar type and depth. Most people see their scars soften rather than disappear completely.
What to expect at your appointment
- Your dermatologist examines your scars and checks that your acne is under control. The AAD notes that scar treatment usually starts once breakouts are managed.
- Your skin is cleansed and a topical numbing cream is applied to keep you comfortable.
- The microneedling treatment itself takes about 20 to 30 minutes.
- You get aftercare instructions to follow at home.
How many sessions will I need?
Acne scars usually need a series of treatments because collagen builds gradually. Dr. Weiss typically recommends 3 to 6 sessions spaced about 4 to 6 weeks apart. The exact number depends on how many scars you have and how deep they are.
Once you’re happy with the results, maintenance sessions every six months to a year can help keep them.
Combining microneedling with other treatments
The AAD notes that microneedling is often paired with another treatment, such as a chemical peel, radiofrequency or platelet-rich plasma (PRP), to improve results. PRP uses a small amount of your own blood, processed to concentrate the platelets, which is then applied to the treated skin. At Trillium, microneedling can be combined with PRP or a chemical peel when it suits your scars.
Recovery and aftercare
Downtime is usually short. Your skin may look pink for several hours after treatment and feel tight for a few days.
For the first 24 hours:
- Don’t wear makeup, especially with a brush you’ve used before.
- Avoid swimming pools, saunas, hard workouts and anything that makes you sweat heavily.
- Keep the skin clean and follow the aftercare plan your dermatologist gives you.
Protect your skin from the sun while it heals, as your dermatologist advises.
Is microneedling safe for darker skin?
Yes. The AAD says microneedling is safe for all skin tones. Your dermatologist will still tailor the treatment depth to your skin.
Side effects and who should wait
The systematic review found no serious side effects in any of the trials. Temporary pinkness and a tight feeling in the skin are the most common effects.
Tell your dermatologist before treatment if you:
- Still have active breakouts. Scar treatment usually begins once acne is under control.
- Have a skin infection or a cold sore flare in the area.
- Tend to form raised scars or keloids.
- Are taking or recently took acne medications such as isotretinoin.
Microneedling vs other acne scar treatments
| Treatment | How it works | Often used for |
|---|---|---|
| Microneedling | Fine needles trigger new collagen | Depressed scars, all skin tones |
| Chemical peels | Remove outer layers so new skin and collagen form | Depressed scars and dark marks |
| Laser resurfacing | Laser removes or heats skin to rebuild collagen | Depressed scars, texture |
| Radiofrequency microneedling | Needles plus heat for extra collagen | Depressed scars |
| Fillers | Add volume under sunken scars | Individual depressed scars |
| Scar surgery | Lifts or removes deeper scars | Deep or stubborn scars |
| Steroid injections, lasers | Flatten excess collagen | Raised scars |
Many people get the best result from a combination of treatments, planned by a dermatologist. Read more in our guides to chemical peels for acne scars and dark marks and laser scar removal, or see our laser skin resurfacing page.
Microneedling at Trillium
Microneedling is offered through Trillium’s med spa. Learn more on our microneedling page, or see our microneedling treatment guide. If you still get breakouts, our acne treatment team can help get them under control first.
Want smoother skin after acne? Book a consultation at Trillium in Chapel Hill, Smithfield or Burlington to find out whether microneedling or another scar treatment suits you. Call 919-710-8100 or schedule online.
Frequently asked questions
Yes, for sunken (atrophic) scars. A systematic review of nine randomized trials found it effective on its own and combined with other treatments, with no serious side effects reported. Results are gradual, and scars usually soften rather than disappear.
Depressed scars such as rolling and boxcar scars. Deep, narrow ice pick scars may need another treatment as well. Raised scars, such as hypertrophic scars and keloids, need different treatment.
Microneedling is used for acne scars, not active breakouts. Scar treatment usually starts once your acne is under control, so your dermatologist may treat the breakouts first.
Most people need 3 to 6 sessions spaced about 4 to 6 weeks apart, since collagen builds gradually. Your dermatologist will suggest a number based on how many scars you have and how deep they are.
Usually short. Skin may look pink for several hours and feel tight for a few days. Avoid makeup, pools, saunas and heavy sweating for the first 24 hours.
Yes. The American Academy of Dermatology says microneedling is safe for all skin tones.
About Dr. Weiss
Stefan C. Weiss, MD, FAAD, is a board-certified dermatologist, the medical director of Trillium Clinic and an adjunct professor of dermatology at Brown University. He trained at Duke University School of Medicine and Stanford University Medical Center, has authored more than 100 peer-reviewed abstracts, posters and manuscripts, and has over two decades of experience in medical and cosmetic dermatology.
References
- American Academy of Dermatology. Acne scars: Overview.
- American Academy of Dermatology. Acne scars: Signs and symptoms.
- American Academy of Dermatology. Acne scars: Diagnosis and treatment.
- Sitohang et al. Microneedling in the treatment of atrophic scars: a systematic review of randomised controlled trials. 2021.
- Trillium Clinic. Microneedling.
This article is for general education and isn’t a substitute for personal medical advice. A board-certified dermatologist can tell you which treatment is right for you.
