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Scarring of the face is common both from traumatic injuries as well as from aesthetic surgeries. The difference between aesthetic surgery and traumatic facial scars is their location. Most aesthetic surgery facial scars are placed in such locations to be relatively inconspicuous as opposed to those from trauma in which the patient has no control. But in either case patients are motivated to minimize their scars for which a wide variety of scar treatments exist.

Scar reduction strategies include non- to minimally invasive external therapies, light and laser devices to surgical scar revisions. One of the minimally invasive treatments is that of needling. Known medically as percutaneous collagen induction therapy (PCIT), it involves the superficial puncture of the scar essentially creating spot areas of injury. By so doing the scar tissue is disrupted and a wound healing response is generated.

In the March/April 2020 issue of the Journal of Craniofacial Surgery an article was published on this topic entitled ‘Evaluation of Microneedling Therapy in Management of Facial Scars’. In this clinical study the authors treated fourteen (14) patients who had a wide variety of facial scars due to surgery, acne or trauma. (2/3s were depressed scars, 1/3 were hypertrophic scars) A series of microneedling treatments produced a 100% flattening response in all raised scars to the surrounding skin surface. Depressed scars were improved but not up to the level of the surrounding skin. The color of the scars, whether they were lighter or darker, improved to the color of the surrounding skin. Patients tolerated the treatments without the need for local anesthesia.

Needling or PCIT is a well known scar treatment that is popular because of its low cost, relative tolerance to the treatments and a wide variety of practitioners that can perform it. While some call it a poor man’s laser therapy (comparing it to fractional laser treatments), it does not have the thermal effects associated with it. This is both an advantage (faster recovery) and disadvantage. (less profound healing response) This study, limited as it was to a low number of patients, showed its benefits which have been demonstrated by other clinical studies as well.

Dr. Barry Eppley

Indianapolis, Indiana

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