Microneedling—sometimes called collagen induction therapy—has exploded in popularity for its ability to rejuvenate the skin with minimal downtime. The procedure involves creating tiny controlled punctures in the skin using a device with fine needles. This triggers the body’s natural healing response, stimulating the production of collagen and elastin. But does microneedling work for acne and acne scars? This comprehensive article explores the science, benefits and limitations of microneedling for acne, drawing on peer‑reviewed research and authoritative dermatology sources.
Understanding the Mechanism
By creating micro‑injuries, microneedling initiates three stages of wound healing:
- Inflammation: The tiny punctures cause a localized inflammatory response, increasing blood flow and bringing growth factors to the site.
- Proliferation: Fibroblasts (cells that make collagen and elastin) proliferate, producing new extracellular matrix proteins that thicken and smooth the dermis.
- Remodeling: Over time, the newly formed collagen reorganizes, improving skin texture and reducing the appearance of scars.
Because acne scars result from disrupted collagen after inflammatory acne lesions heal, microneedling’s collagen‑induction effect can theoretically improve them. But what does the evidence show?
Evidence for Acne Scar Improvement
Randomized Trials and Systematic Reviews
A 2025 systematic review of randomized controlled trials on microneedling for non‑cosmetic dermatologic conditions found that microneedling monotherapy consistently benefits acne scars, significantly improving objective scar grading and patient satisfaction. Importantly, the review noted that microneedling has a low incidence of post‑inflammatory hyperpigmentation, making it suitable for darker skin types.
The same review highlighted emerging research on fractional microneedle radiofrequency (FMR)—a variation that combines needles with radiofrequency heat. FMR reduced inflammatory acne lesions more effectively than photodynamic therapy (PDT), with fewer side effects such as post‑inflammatory hyperpigmentation. These findings suggest that combining microneedling with RF may enhance outcomes for active inflammatory acne.
American Academy of Dermatology (AAD) Guidance
The American Academy of Dermatology notes that microneedling combined with platelet‑rich plasma (PRP) is especially effective for fading acne scars and is safe for people with darker skin tones. The AAD cites studies showing that a course of 3–5 treatment sessions performed every 2–4 weeks can fade acne scars by 50–70%. Results appear gradually over several months as collagen remodels, and annual maintenance sessions may be recommended.
Cleveland Clinic Insights
Cleveland Clinic’s acne scar resource describes microneedling as a procedure that uses small needles to purposefully injure the skin, stimulating collagen production that can smooth scars. The clinic notes that microneedling can be performed alone or with radiofrequency (RF). Microneedling with RF has been shown to improve skin texture from acne scarring and can even reduce the risk of new breakouts. They also emphasize that microneedling does not cause skin discoloration, making it ideal for darker skin tones.
Additional Clinical Observations
Dermatology practices and medical spas report similar outcomes. In a JEM Medspa article, clinicians advise that microneedling may require 4–6 appointments spaced 4–6 weeks apart, with results appearing over 1–2 months as collagen forms. They note that microneedling improves acne scars, discoloration and uneven texture, though multiple sessions are needed for optimal results.
Effectiveness for Active Acne
While microneedling is well‑documented for treating acne scars, its role in active acne is more nuanced. The 2025 systematic review mentioned above highlighted that fractional microneedle radiofrequency (FMR) significantly reduces inflammatory acne lesions compared with photodynamic therapy. However, this benefit stems from the combined thermal effect of RF energy destroying sebaceous glands and reducing inflammation.
Traditional microneedling (without RF or other adjuncts) is not typically used to treat active inflammatory acne, and some sources advise against it. Allure Dermatology explains that performing microneedling over active pimples can spread bacteria and exacerbate breakouts. The tiny punctures may pick up bacteria from the lesions and deposit them into surrounding skin, potentially worsening acne. Therefore, microneedling should only be performed once active acne is under control, either through oral/topical medications, chemical peels or other dermatologist‑recommended therapies.
Microneedling Combined with Platelet‑Rich Plasma (PRP)
PRP therapy involves drawing a patient’s blood, processing it to concentrate platelets and growth factors, and reapplying it to the treated area. When used with microneedling, PRP can amplify collagen production and enhance healing. The AAD notes that this combination is especially effective for fading acne scars and remains safe across skin tones. Patients often see improved texture and tone more quickly than with microneedling alone.
Who Is a Good Candidate?
Microneedling is suitable for many people seeking to improve mild to moderate acne scarring or uneven texture. However, certain considerations apply:
- Skin Type: Microneedling is safe for all Fitzpatrick skin types because it does not use light or heat that can cause hyperpigmentation. People with dark skin often prefer microneedling over lasers for this reason.
- Scarring vs. Active Lesions: It is ideal for atrophic (depressed) scars and discoloration left after acne but not recommended during active breakouts. Wait until acne has cleared before beginning treatment.
- Health Conditions: People with blood disorders, keloid tendencies, or those on anticoagulants should avoid microneedling. Always consult a physician if you have underlying medical conditions.
- Pregnancy and Lactation: While microneedling is minimally invasive, there is limited research on its safety during pregnancy and breastfeeding. Many providers postpone treatments until after delivery.
Treatment Protocol and Expectations
- Consultation and Preparation: A dermatologist or licensed provider assesses your skin, reviews medical history and discusses goals. They may recommend topical vitamin A or C creams for several weeks prior to treatment to enhance collagen production.
- Procedure: On the day of treatment, the skin is cleansed and a topical numbing cream is applied for 30–45 minutes. The provider then uses a microneedling device or pen to create controlled micro‑channels across the treatment area. If PRP or serum is used, it is applied during or after the needling.
- Post‑Treatment Care: Immediately after microneedling, expect redness, swelling or a feeling similar to a sunburn. These effects usually subside within a few days. Avoid makeup for 24 hours and direct sun exposure until healing is complete. Some flaking or dryness may occur as the skin renews.
- Number of Sessions: According to the AAD, 3–5 sessions spaced 2–4 weeks apart may be needed to achieve a 50–70% reduction in acne scars. JEM Medspa suggests 4–6 appointments spaced 4–6 weeks apart. The exact number varies based on scar severity and individual response.
- Results Timeline and Maintenance: Collagen production and remodeling take time. You may notice improvements within a few weeks, but full results develop over three to six months. Annual maintenance sessions can help sustain results.
Risks and Side Effects
Microneedling is generally safe when performed by qualified professionals. Risks include:
- Temporary Redness, Swelling and Bruising: These are common and usually resolve within a week. Applying cold compresses and gentle skincare can alleviate discomfort.
- Skin Sensitivity and Dryness: Flaking or dryness may occur as the skin heals. Use mild, non‑irritating products and sunscreen.
- Infection: Rare but possible if equipment isn’t sterile or aftercare instructions aren’t followed. Ensure your provider uses single‑use needles and a clean environment.
- Scarring or Hyperpigmentation: Uncommon in professional settings but more likely with at‑home devices or aggressive technique. This underscores the importance of choosing a licensed practitioner and avoiding self‑treatment.
At‑Home Microneedling vs. Professional Treatment
Consumer‑grade derma rollers promise easy DIY collagen induction at home. However, they have shorter needles (usually 0.25–0.5 mm) and cannot penetrate deeply enough to stimulate significant collagen production. Inexperienced users risk infection, scarring or pigmentation issues. Allure Dermatology warns that microneedling over active acne or without proper sanitation can spread bacteria and worsen breakouts.
Professional microneedling devices have adjustable needle depths (up to 2–3 mm) and deliver more precise treatments tailored to individual needs. When combined with RF or PRP, these devices produce far more significant results than at‑home rollers. For acne scars and serious skin concerns, always seek treatment from a board‑certified dermatologist or trained medical aesthetician.
Complementary and Alternative Treatments
Microneedling is just one of several options for acne scars. Depending on scar type, your dermatologist may recommend:
- Chemical Peels: These remove the outer skin layer to improve mild scars and discoloration. They may complement microneedling for more dramatic results.
- Laser Resurfacing: Fractional lasers (CO2 or erbium) ablate scar tissue and stimulate collagen. They are more aggressive than microneedling but can be effective for deep scars. Combining lasers with microneedling is being studied.
- Subcision: A needle is inserted under a depressed scar to break fibrous bands pulling the skin downward.
- Dermal Fillers or Fat Grafting: These temporarily or permanently lift depressed scars by adding volume.
- Radiofrequency Microneedling (FMR): As mentioned, FMR adds heat to microneedling to shrink sebaceous glands and improve active acne.
Consult a dermatologist to determine which combination suits your skin type and scar pattern.
Summary
Microneedling is a versatile treatment that works particularly well for acne scars, stimulating collagen production to smooth and remodel the skin. Clinical studies and dermatology associations report that a series of microneedling sessions can fade acne scars by 50–70%, especially when paired with PRP. For active acne lesions, microneedling with radiofrequency shows promising results, but traditional microneedling alone is not recommended until breakouts are controlled. Moreover, microneedling should always be performed by trained professionals to minimize risks and maximize outcomes. When used appropriately, this minimally invasive procedure can be a powerful tool in the fight against acne scarring.