Does microneedling work for wrinkles and scars?

Standard microneedling shows noticeable improvement for atrophic acne scars (the sunken scars that acne leaves behind) and wrinkles across multiple clinical studies. The results are comparable to other treatments such as lasers or chemical peels, but the recovery time is shorter and the side effects are milder. The methodological quality of the studies is not optimal, so firm guarantees cannot yet be given.

Radiofrequency microneedling, in which the needles simultaneously deliver heat energy deep into the skin, appears to work somewhat more effectively than standard microneedling. The effect builds up slowly and continues to improve for up to six months after treatment. This type of treatment has also proven safe for people with darker skin tones, which with some other techniques carries a risk of pigmentation spots.

Combining microneedling with PRP (platelet-rich plasma derived from the patient's own blood) or stem cell exosomes (cell-free particles that stimulate collagen production) yielded significant added benefit over microneedling with saline alone in studies. Wrinkles, elasticity, hydration and pigmentation all improved to a greater degree. PRP and exosomes performed comparably to each other. No serious side effects were reported in these specific studies. Note: the overall quality of evidence for PRP combinations remains limited; the studies are small and methodologically variable, meaning the optimal dosage and treatment interval are still unknown.

In combination treatments that also involve biostimulators -- substances that prompt the skin to produce collagen -- side effects such as redness and bruising occurred in 15 to 30% of cases. Rare but serious complications such as inflammatory nodules and vascular occlusion have also been described. The studies on this type of combination treatment are small and difficult to compare with one another, which makes the conclusions less reliable.