It is well known that microneedling (MN) is an effective method in treating atrophic acne scars. But is it also useful in treating raised, hypertrophic acne scars? If so, how does it work (what is the mechanism behind)?

I ask because there are contradicting claims on the internet regarding this issue:

Sources claiming MN can treat hypertrophic scars:

(Source 1) Microneedling for the Treatment of Scars: An Update for Clinicians, Clin Cosmet Investig Dermatol. 2020 Dec 22;13:997-1003.

(Source 2) Combination Therapy Using Radiofrequency Microneedling and Corticosteroids for Hypertrophic Scars: A Case Report, J Clin Aesthet Dermatol. 2020 Dec; 13(12): 27–28.

(Source 3) "Microneedling can break up acne scar tissue and encourage the growth of new tissue. In fact, it works very well for hypertrophic scars caused by acne, burns, injury and surgery. Microneedling for acne scars can significantly improve skin appearance, texture and overall quality."

(Source 4)

Sources claiming MN canNOT treat hypertrophic scars:

(Source 1) "... it should be noted that it (microneedling) is not recommended for hypertrophic scars since there is excess collagen already. "


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