Scars Won't Fade? Why Microneedling Works + Medically Approved Steps

Scars can be frustrating. Whether from acne, surgery, injury, or piercings, some marks fade with time—others don't. If you've tried creams and home remedies with little success, you may be wondering if there's something that actually works.

One treatment that continues to gain medical support is microneedling. Backed by dermatologists and clinical studies, microneedling helps improve the appearance of certain scars by stimulating your skin's natural repair process.

Here's what you need to know—clearly, honestly, and based on credible medical evidence.

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Why Some Scars Don't Fade

Scars form when the skin repairs itself after injury. Instead of regenerating normal tissue, the body lays down collagen quickly to close the wound. That collagen doesn't always organize in the same way as healthy skin.

There are different types of scars:

• Atrophic scars – Depressed or sunken scars (common with acne)
• Hypertrophic scars – Raised but confined to the original wound
• Keloids – Thick, raised scars that grow beyond the original injury
• Post-inflammatory hyperpigmentation – Dark marks left after inflammation

The type of scar matters because not all scars respond to the same treatments. For example, microneedling works well for atrophic acne scars but may not be appropriate for active keloids.

If you're noticing a thick, raised scar that seems to be growing beyond the original wound area—especially around a piercing site—you can check whether you might be dealing with Keloids (Including Piercing Keloids) using a free AI-powered symptom checker to help identify your scar type before seeking professional treatment.

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What Is Microneedling?

Microneedling (also called collagen induction therapy) is a minimally invasive dermatological procedure that uses tiny, sterile needles to create controlled micro-injuries in the skin.

These micro-injuries:

• Trigger your body's natural wound-healing process
• Stimulate collagen and elastin production
• Help remodel scar tissue
• Improve skin texture and tone

It may sound intense, but the procedure is controlled, precise, and performed under sterile conditions by trained professionals.

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Why Microneedling Works for Scars

The reason microneedling works comes down to collagen remodeling.

Scar tissue is made of collagen, but it's arranged differently than healthy skin. Microneedling helps break up that rigid scar structure and encourages new, more evenly distributed collagen to form.

Over time, this can:

• Reduce the depth of depressed scars
• Improve overall skin smoothness
• Fade discoloration associated with scarring
• Improve skin firmness

Clinical studies show that microneedling is particularly effective for:

• Acne scars
• Surgical scars
• Traumatic scars
• Stretch marks

It is less predictable for thick, raised scars like keloids.

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What to Expect During Microneedling

If you're considering microneedling, here's what typically happens:

Before the Procedure

• A topical numbing cream is applied.
• Your provider evaluates your skin and scar type.
• Photos may be taken to track progress.

During the Procedure

• A microneedling device passes over the skin.
• Tiny needles create controlled micro-injuries.
• The session typically lasts 30–60 minutes.

After the Procedure

• Mild redness (similar to a sunburn) for 24–72 hours
• Slight swelling or sensitivity
• Gradual improvement over weeks

Most people need 3–6 sessions, spaced about 4–6 weeks apart, for noticeable improvement.

Microneedling is not a one-time miracle fix. It works gradually as your skin rebuilds collagen.

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Is Microneedling Safe?

When performed by a trained medical professional, microneedling is considered safe for most skin types.

However, it may not be recommended if you have:

• Active acne infections
• Active keloids
• Certain autoimmune conditions
• Poor wound healing
• Blood clotting disorders

Side effects are usually mild and temporary but can include:

• Redness
• Mild swelling
• Temporary hyperpigmentation
• Minor pinpoint bleeding

Serious complications are rare when performed properly.

If you have a history of abnormal scarring (like keloids), speak to a doctor before considering microneedling.

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Medically Approved Steps to Improve Scars

Microneedling works best when combined with evidence-based skin care and medical guidance.

Here are medically supported steps you can take:

1. Get a Proper Diagnosis

Not all scars are the same. Before starting microneedling:

• Confirm the type of scar
• Rule out keloids
• Assess skin tone and sensitivity

This is critical because treating the wrong scar type can worsen it.

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2. Use Sun Protection Daily

Sun exposure can:

• Darken scars
• Slow healing
• Increase hyperpigmentation

Use:

• Broad-spectrum SPF 30 or higher
• Protective clothing when possible

This step is simple but powerful.

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3. Consider Topical Treatments

Before or alongside microneedling, a doctor may recommend:

• Retinoids (to promote collagen production)
• Silicone gel sheets (especially for raised scars)
• Hydroquinone (for discoloration, short-term use)
• Prescription-strength exfoliants

These treatments can improve microneedling outcomes.

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4. Choose a Qualified Provider

Microneedling devices vary widely in quality and depth control.

For scar treatment:

• See a board-certified dermatologist or trained medical professional
• Avoid unregulated "at-home" devices for deep scars
• Ensure sterile technique is used

Home rollers can increase infection risk and are usually not deep enough to significantly improve scarring.

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5. Follow Aftercare Instructions Carefully

After microneedling:

• Avoid sun exposure
• Skip harsh skincare products for several days
• Use gentle cleansers and moisturizers
• Do not pick or scratch treated areas

Following aftercare advice directly impacts results.

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How Long Does It Take to See Results?

Microneedling works by stimulating collagen, and collagen takes time to rebuild.

Most people notice:

• Brighter skin within 1–2 weeks
• Texture improvements after 4–6 weeks
• Continued improvement for up to 6 months

Realistic expectations are important. Microneedling can significantly improve scars—but it rarely erases them completely.

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When Microneedling May Not Be Enough

Some scars require additional treatments such as:

• Laser therapy
• Subcision
• Chemical peels
• Steroid injections (for hypertrophic scars)
• Surgical scar revision

If your scar is:

• Rapidly growing
• Painful
• Itchy and expanding beyond the original injury
• Causing functional problems

Speak to a doctor promptly. Certain types of scars, especially keloids, may require specialized care.

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The Bottom Line

If your scars won't fade, microneedling may offer a medically supported solution. By stimulating collagen and remodeling scar tissue, microneedling can improve skin texture, reduce scar depth, and restore smoother-looking skin over time.

However:

• It's not instant.
• It's not appropriate for every scar type.
• It works best under professional supervision.

If you're dealing with a raised, growing scar—particularly around piercing sites—you should first determine whether you're experiencing Keloids (Including Piercing Keloids) before pursuing microneedling, as keloid scars require different treatment approaches.

Most importantly, speak to a doctor or dermatologist before starting microneedling—especially if you have raised scars, underlying medical conditions, or symptoms that concern you. While most scars are not dangerous, certain skin changes can signal more serious conditions that require medical evaluation.

Scars can be stubborn. But with the right diagnosis, realistic expectations, and medically guided treatment like microneedling, meaningful improvement is possible.