To understand how microneedling works on scars, it is first important to understand how wounds heal. The healing process of a wound can be divided into different phases;
- Hemostasis – The wound stops bleeding by forming a scab.
- Inflammatory phase – Any bacteria and debris that has entered the wound that can impair wound healing is removed from the wound. Growth factors are also released. These growth factors ensure that more skin cells such as fibroblasts (responsible for formation of connective tissue), keratinocytes (main cells of the epidermis) and epithelial cells are formed.
- Proliferation phase – New blood vessels, connective tissue (consisting of collagen type 3) and epithelial tissue are formed.
- Remodeling phase – The above structures continue to be formed. The collagen type 3 formed in the previous phase also changes into collagen type 1. Collagen type 1 provides much more elasticity than type 3. In addition, the cells that provide the feeling of tightness (myofibroblasts) in the wound decrease.
The formation of a scar
Sometimes the damage to the skin is too deep, so that normal skin cells can no longer fully recover. When this is the case, the skin becomes stiffer, harder, contains fewer blood vessels, elastin and moisture. A scar has formed. A normal scar can be cosmetically disturbing, but will become much less visible when the red color decreases. Sometimes something goes wrong during wound healing, causing a scar that causes more complaints. A distinction is made between the following scars;
An atrophic scar occurs when the edges of the underlying dermis have separated, while the epidermis (the top layer of the skin) is still intact. This causes the skin to sink. These scars are often soft, thin, supple, stretchy and wrinkly. Often these arise after acne.
A hypertrophic scar is created because an extra amount of fibroblasts are produced in the inflammatory phase. These fibroblasts then produce additional connective tissue. This often happens when an infection occurs or because a lot of pulling forces are created on the scar, for example due to localization on the bone. These scars can cause pain and itching. These are red, raised, stiff and give a pulling feeling.
A keloid is a scar that has grown much larger than the area that was originally damaged. Dark-skinned people have an increased risk of developing a keloid. Complaints are often pain, itching and limitation of movement.
Microneedling for scars
Microneedling can be used for the treatment of atrophic and hypertrophic scars. There are other treatment options for keloid scars. Microneedling acts on the inflammation, proliferation and the remodeling phase of a scar. This is done by making small wounds in the skin again, but this time safe and controlled. These wounds can then heal properly, so that the scar tissue is replaced by new tissue.
Advice: first a small test spot treatment to better assess how your scar responds to the microneedling.
The scar would never go away completely, but microneedling can provide the following benefits;
- Reduction of redness
- Better pliability
- Decrease in scar thickness
- reduction of itching.
More about microneedling treatment
Now that you’re here
Scars cosmetically be disturbing, but can also cause pain, itching, and irritation. There are home products on the market that claim to (visibly) reduce scars and complaints. But which home products are actually proven effective and when do you start using them?
Much research has been done into the effect of scar creams. Plant extracts such as onion extract, green tea, aloe vera, vitamin E and vitamin D are well-known researched ingredients for scar treatment. Evidence that these have an effect, however, is lacking. You will regularly discover vitamin E in the ingredient list of scar cream.
Adverse side effects are even described about vitamin E, such as the development of contact dermatitis and worsening of itching and skin rashes. Is the application of a scar cream of no use at all? Massaging the scar, with any creams or oils. The skin is kept supple by massaging with a cream, the scar can indeed become less noticeable. This massage does not have to be with a “special” scar cream and you can start with this carefully as soon as the wound is closed.
More about a scar, and now?