Does Microneedling Work for Acne Scars? An NP’s Evidence-Based Answer

Medically reviewed by Stefanie Drozd, MSN-APRN, Founder and Lead Nurse Practitioner | Updated September 18, 2026

The short answer: Yes, for the right scars. Microneedling improves the look of indented (atrophic) acne scars over a series of sessions, with the best response in rolling scars, a moderate response in boxcar scars, and the least in ice pick scars. It improves scars rather than erasing them, and results vary from person to person. The right approach (standard, PRP, or RF microneedling) depends on your scar types and skin tone.

Acne scars are one of the most common reasons patients come to our four Express Med Spa locations. They’re also one of the indications where microneedling has the most peer-reviewed research behind it, when it’s matched to the right scar type and performed correctly. Here’s the honest framework we use in clinic, with the studies linked so you can read them yourself.

Prefer to watch first? See our 25 second video: Does Microneedling Really Work for Acne Scars?

The Short Answer, Which Acne Scars Microneedling Can Help

Atrophic acne scars (the indented kind) fall into three subtypes that respond very differently:

That ranking comes from the studies that report results by scar type: in a split-face trial, rolling scars improved most, boxcar scars less, and ice pick scars least (Agrawal et al., 2024), and a radiofrequency microneedling study found that “rolling and box scars showed better response than ice-pick scars” (Chandrashekar et al., 2014). If the table above is the only thing you read, it’s the most important takeaway: microneedling is excellent for rolling scars, useful for boxcar, and an adjunct (rarely a solo solution) for ice pick.

Atrophic vs. Hypertrophic, Microneedling Is For One, Not the Other

Atrophic scars are indented, the dermis lost tissue during the post-acne wound-healing response. These are the scars microneedling addresses through collagen induction: tiny needles create a controlled injury, and the skin responds by producing new collagen that gradually fills and smooths the depression.

Hypertrophic and keloid scars are raised, the dermis produced too much scar tissue. Microneedling can trigger more collagen formation, which is the opposite of what hypertrophic and keloid scars need. A personal or family history of keloid scarring is an absolute contraindication to microneedling at Express. We will not perform microneedling on patients with keloid history, and we’ll refer you to a dermatologist instead.

Scar-Type Breakdown

Rolling Scars, Best Response

Rolling scars are broad, shallow depressions with sloping edges that give skin a “rolling” texture. They form when the post-acne wound-healing response creates fibrous attachments between the dermis and underlying tissue, pulling the skin surface downward.

Microneedling works particularly well for rolling scars because the mechanical micro-injuries help loosen those attachments while triggering new collagen formation. PRP microneedling adds your own platelet growth factors, and RF microneedling adds heat that remodels the deeper tissue.

In our experience, rolling scars often show the most visible improvement of any scar type over a full series. The research agrees: in one of the earliest studies, 32 patients with rolling scars had two needling sessions, and the severity grade of their scars was “greatly reduced” (Fabbrocini et al., Clinical and Experimental Dermatology, 2009).

Boxcar Scars, Mixed Response

Boxcar scars have defined edges and U-shaped or rectangular depressions. They form when post-acne tissue loss creates well-demarcated indentations. Shallow boxcars respond reasonably to microneedling alone. Deeper boxcars often do better with Sublative RF microneedling, which delivers heat into the deeper dermis where boxcar scar bases sit, or with a combination plan your nurse practitioner designs at consultation.

Ice Pick Scars, Limited Response (Honest)

Ice pick scars are narrow, deep, V-shaped punctures, often deeper than they are wide. Microneedling alone, regardless of variant, rarely produces dramatic improvement on ice pick scars because the needles can’t reliably reach the depth required, and the surrounding tissue response can’t restructure a narrow puncture. In the split-face trial above, ice pick scars “responded the least” of the three types.

So does microneedling help ice pick scars? A little, mostly by smoothing the skin around them. Ice pick scars often need a dermatologist for options such as subcision (releasing the fibrous bands under a scar), TCA CROSS (a strong acid placed directly into each scar), or laser resurfacing. We don’t offer those procedures at Express, so if ice pick scars are your main concern, we’ll say so at your consultation and refer you. Microneedling can then improve the surrounding texture as part of the overall plan. If you’ve been told microneedling alone will resolve predominantly ice pick scarring, we’d encourage a second opinion.

What the Research Actually Says

Peer-reviewed evidence for microneedling in atrophic acne scars is substantial, though most trials are small. A few of the foundational and current sources:

• Fabbrocini and colleagues reported significant improvement in acne scar severity after two to three needling sessions, including a 60-patient study across skin types I to VI with no lasting pigment changes (Journal of Dermatological Treatment, 2014).
• A randomized, evaluator-blinded split-face trial found that patients rated their microneedled side about 41% improved after three sessions, and the difference was clearest six months after treatment (Alam et al., JAMA Dermatology, 2014).
• The American Academy of Dermatology lists microneedling as an acne scar treatment, noting that the new collagen “helps diminish acne scars” and that “microneedling is safe for all skin tones” (AAD, acne scars: treatment).
• Adding PRP: a meta-analysis of 14 controlled studies found that microneedling with PRP improved scar scores and patient satisfaction more than microneedling alone (Kang and Lu, Frontiers in Medicine, 2021). A later review rated the certainty of that evidence low (Cruciani et al., 2024).
• RF microneedling: in a study of 31 patients with skin types III to V, about 81% improved by at least two scar grades after four sessions (Chandrashekar et al., 2014), and a 2025 systematic review of 16 studies supports its use for acne scars (Niaz et al., 2025).

Published results vary widely from study to study, because scar types, devices, session counts, and scoring systems all differ. You may see a single headline number online (our own short video uses one). The honest summary is that most patients see meaningful, visible improvement over a complete series, with rolling scars at the upper end and ice pick scars at the lower end.

That’s improvement, not removal. Microneedling does not eliminate acne scars. It improves their appearance, texture, shadow, and the visual smoothness of the surrounding skin, to a degree that most patients describe as worthwhile, when expectations are set correctly.

PRP vs. RF vs. Standard Microneedling for Acne Scars, Which Variant?

Atrophic acne scarring is the indication where the case for adding platelet-rich plasma is strongest: the meta-analysis above found microneedling with PRP improved scar scores more than microneedling alone, though the overall quality of that evidence is low. If that is your main concern, our microneedling with PRP page covers the protocol, the pricing, and what a series realistically achieves.

If you’re at Express trying to choose, your NP will recommend a variant based on your scar type distribution, skin tone, age, and budget. There’s no universal “best” variant, there’s a best variant for your situation.

Read the full PRP microneedling explainer or the full Sublative RF microneedling explainer.

How Many Sessions to See Improvement?

Acne scar plans run longer than rejuvenation plans. Published studies typically use three to five sessions spaced two to six weeks apart, and in clinic we plan acne scar series this way:

• Typical acne scar series: 4 to 6 sessions, spaced 4 to 6 weeks apart
• Severe or mixed scarring: 6 to 8 sessions, sometimes with other treatments or a dermatologist referral in the plan
• Maintenance: optional single sessions every 6 to 12 months after the series

Many patients start to notice smoother texture after the second or third session. Improvement keeps building for months after the last session as collagen remodels: in the randomized trial above, the difference between treated and untreated skin was clearest six months after treatment ended.

Realistic Expectations: Improvement, Not Erasure

When a series goes well, here’s what improvement usually looks like:

• Scars become less visible in standard lighting
• Texture under the fingertips becomes noticeably smoother
• Before-and-after photos taken in the same lighting show softer shadows
• In small studies, most patients rated their results good to excellent (Majid, 2009; Dogra et al., 2014)

Here’s what it doesn’t mean:

• Complete scar removal, that requires surgical excision
• Skin returning to pre-acne appearance, scars are permanent structural changes
• Dramatic single-session results, collagen remodeling takes months

The patients who are happiest with their results are the ones who came in with realistic expectations and completed the full series.

Does Microneedling Remove Acne Scars Permanently?

No, microneedling does not remove acne scars, permanently or otherwise. What it can do is make them permanently less noticeable. The improvement comes from new collagen your own skin builds, which is structural, so the gains from a completed series are generally long-lasting. Three things can change the picture over time:

• Natural aging keeps breaking down collagen, which is why some patients add an occasional maintenance session.
• New breakouts can leave new scars, so controlling active acne comes first.
• Sun exposure speeds collagen loss and darkens marks, so daily SPF protects your result.

Is Microneedling Safe for Acne Scars on Darker Skin Tones?

Yes, with the right protocol. Microneedling is one of the more skin-tone-friendly scar treatments: a review of procedures in Fitzpatrick skin types IV to VI concluded that it “may offer a more advantageous safety profile” (Cohen and Elbuluk, 2016), and a 2026 meta-analysis found fractional CO2 laser carried about three times the risk of post-inflammatory hyperpigmentation (PIH) compared with microneedling (Batool et al., 2026). That risk is lower, not zero: in one study, 5 of 30 patients with skin types IV to V developed temporary darkening (Dogra et al., 2014). That’s why we calibrate the protocol carefully. For the full screening checklist and contraindications we use at consult, see our microneedling side effects and safety breakdown.

Protocol adjustments your NP may use for Fitzpatrick IV to VI skin:

• Gentler needle depth at the first session
• Longer intervals between sessions (often 6 weeks instead of 4)
• A pre-treatment skincare regimen for several weeks before the first session, when your NP recommends one
• Strict 14-day post-treatment sun avoidance with mineral SPF 30+ daily
• Lower-energy first session for RF microneedling specifically

If dark marks left behind by acne bother you as much as the texture, see our guide to chemical peels for dark spots.

Combination Plans, When Microneedling Alone Isn’t Enough

For deeper or mixed scarring, microneedling often works best as one part of a sequenced plan:

• Microneedling + chemical peel, Peel first (skin priming, pigmentation reduction), then microneedling 2 to 4 weeks later (collagen building). See our VI Peel vs. microneedling comparison and our chemical peel options.
• Microneedling + stem cell growth factors, The Stem Cell Facial delivers a laboratory sourced growth factor matrix into the channels instead of your own platelets, with no blood draw required
• Microneedling + topical retinoid maintenance, Daily retinoid use between sessions and after the series for ongoing collagen support
• Microneedling + a dermatologist referral, For deep ice pick or tethered scars that need subcision, TCA CROSS, or laser resurfacing, which we don’t perform at Express

Your NP will sequence the right combination based on your scar profile. Our acne scar treatment page shows every option we offer side by side.

Microneedling vs. Chemical Peels for Acne Scars

Both treat acne scars, through completely different mechanisms. A 2026 meta-analysis of 11 studies found the two performed about the same for acne scars, with no clear winner (Agu-Jefferson et al., 2026). Chemical peels, especially the VI Peel, are also well suited to the dark marks that often accompany acne scars, so many patients use both. Full comparison: VI Peel vs. microneedling.

Microneedling vs. CO2 Laser for Acne Scars

Fractional CO2 laser is a more aggressive resurfacing option. It can deliver more improvement per session, but it comes with a longer recovery and a higher risk of darkened patches in darker skin tones (Batool et al., 2026). Express does not offer CO2 laser. For patients whose scarring is severe enough to warrant it, we’ll refer you to a dermatologist.

Microneedling vs. Filler for Boxcar Scars

Filler lifts a depressed scar base right away; microneedling builds collagen gradually. The two work differently rather than competing, so whether filler has a place in your plan is a question for your consultation.

Cost of Acne Scar Microneedling

Acne scar plans cost more overall than rejuvenation plans because they require more sessions (4 to 6 vs. 3). Our current published prices, per session, on our pricing page:

• Microneedling, face: $295
• Sublative radiofrequency microneedling: $495
• PRP add-on to any microneedling: $195
• Stem cell growth factor add-on: $295

Pricing is subject to change, and your exact plan and total are confirmed at your consultation. See the microneedling treatment page for spot treatment and body pricing, or call 877-363-3772.

What to Expect, Sessions, Downtime, Aftercare

Most acne scar visits run about 45 to 60 minutes, including 20 to 30 minutes for numbing cream. Downtime is typically 1 to 3 days of mild, sunburn-like redness. Aftercare is strict sun protection, no active skincare for 5 to 7 days, and a follow-up that we book before you leave. Full aftercare guide here | Pain expectations here.

FAQs

Can microneedling remove acne scars completely? No. Microneedling improves the appearance of atrophic acne scars, often meaningfully, but it does not remove them. Complete removal requires surgical excision.

Does microneedling remove acne scars permanently? It doesn’t remove them, but the improvement is generally long-lasting because it comes from new collagen your skin builds. Aging, sun exposure, and new breakouts can affect results over time, which is why some patients add an occasional maintenance session.

Does microneedling help ice pick scars? Only a little on its own. Ice pick scars respond least of all acne scar types, and they often need a dermatologist for subcision, TCA CROSS, or laser resurfacing. Microneedling can improve the surrounding texture as part of that plan.

How long until I see acne scar improvement? Many patients notice smoother texture after the second or third session of a series. Improvement keeps building for months after the last session as collagen remodels.

Will microneedling cause more pigmentation on my acne scars? With the right protocol and screening, the risk is low, but it is not zero, especially in darker skin tones. That’s why we adjust the protocol for higher Fitzpatrick types and screen carefully at consult.

How much does acne scar microneedling cost? Our published prices are $295 per session for face microneedling and $495 per session for Sublative RF microneedling, with a $195 PRP add-on. Pricing is subject to change, and your plan and total are confirmed at your consultation.

Is microneedling safe if I’m still getting active acne? Mild active acne is generally fine, many patients have a few active spots when they come in. Severe active cystic acne is an absolute contraindication. We’ll assess at consult.

Can microneedling improve teenage acne scars in my 30s? Yes, collagen response works regardless of when the scars formed. Older scars may need more sessions, but they respond.

Microneedling vs. CO2 laser for acne scars, which is better? CO2 laser can deliver more improvement per session, with a longer recovery and a higher risk of darkened patches in darker skin. Microneedling is gentler and needs more sessions. Both have a place; we don’t offer CO2 at Express and will refer you if it’s the right call.

What if my scars don’t respond? Some scars (especially deep ice pick) respond minimally to microneedling alone. We’ll honestly say so at consult and recommend a combination plan or a dermatologist referral if microneedling isn’t likely to help. We’d rather be honest upfront than have you finish six sessions disappointed.

Book a Consultation

Schedule at any of our four locations:

• Frankfort, 11 S White St, Suite 104
• La Grange, 320 W Burlington Ave
• Mount Greenwood, Chicago, 3314 W 111th St
• Shorewood, 707 W Jefferson St, Ste M

Call 877-363-3772, book your consultation online, or see our current specials.

This article reviews microneedling for atrophic acne scars based on peer-reviewed clinical evidence and our practice experience at Express Med Spa. Individual results vary by scar type, skin type, variant chosen, session count completed, and aftercare adherence. This content is reviewed by our NP-led clinical team and was last updated September 18, 2026. It is not a substitute for an in-person medical consultation.