Acne and Microneedling

Acne vulgaris, a common dermatological condition primarily affecting adolescents and young adults worldwide, poses a complex challenge with significant consequences for individuals and society. Although it is often classified as a moderate skin disorder, its impact reaches beyond physical symptoms, leading to a substantial economic burden due to healthcare expenses and lost productivity. Additionally, acne vulgaris brings considerable psychosocial challenges, including lowered self-esteem, social isolation, and an increased risk of depression (1,2)

The cause or reason for acne vulgaris is intricate and multifactorial, involving a combination of genetic predisposition, hormonal fluctuations, environmental factors, and lifestyle habits. Pathologically, acne vulgaris manifests through the development of comedones, inflammatory papules, pustules, nodules, and, in severe instances, scarring. The pathogenesis generally begins with the obstruction of hair follicles by hyperkeratinized sebum, which is subsequently followed by inflammation triggered by the colonization of bacteria, particularly Propionibacterium acnes (2,3).

Topical treatments, including azelaic acid, benzoyl peroxide, retinoids (tretinoin, adapalene, tazarotene), salicylic acid, and antibiotics (clindamycin, erythromycin, tetracycline), are commonly prescribed as first-line therapy. For moderate to severe cases, oral medications such as antibiotics (doxycycline, erythromycin, minocycline, tetracycline), hormonal agents (oral contraceptives containing estrogen and progesterone), and isotretinoin (a potent oral retinoid) may be prescribed (1).

Dermatological procedures are frequently recommended as part of acne treatment. Chemical peels, which commonly use alpha and beta hydroxy acids or trichloroacetic acid, exfoliate the skin and unclog pores. Professionals may also manually extract comedones, such as black and whiteheads, using specialized tools. Laser and light-based therapies are employed to target acne-causing bacteria, reduce inflammation, and promote skin healing. For cases involving severe inflammation and large lesions, corticosteroid injections may be administered directly into the affected areas to accelerate healing and diminish inflammation.

In recent years, microneedling has gathered significant attention as a promising therapeutic approach for treating acne-related issues. Microneedling, or percutaneous collagen induction therapy (PCIT) or collagen induction therapy (CIT), involves the creation of controlled micro-injuries in the skin using fine needles. This process stimulates the body’s natural wound-healing response, promoting collagen and elastin production. By utilising specialised devices equipped with fine needles to create micro-perforations in the skin, microneedling initiates the skin’s natural regeneration and repair mechanisms. As a result, this procedure can lead to improved skin texture, enhanced wound healing, and a potential reduction in the visibility of acne scars (4,5).

Microneedling was first introduced in the early 1990s by Dr. Desmond Fernandes, a South African plastic surgeon, who developed the technique to treat scars and skin imperfections by stimulating collagen production. Over the years, the procedure has evolved with technological advancements, becoming widely adopted for various dermatological conditions, including acne scarring and skin rejuvenation.

Microneedling demonstrates significant potential as a therapeutic option for individuals with acne-prone skin, offering notable improvements in the reduction in acne lesions and the enhancement of skin texture, particularly in the appearance of acne scars. The technique’s effectiveness is further amplified when combined with adjunctive therapies such as PRP or glycolic acid peels, highlighting its versatility in tailored treatment plans. Its minimally invasive nature and favorable safety profile underscores microneedling’s value in modern dermatological practice. Future research should aim to standardize treatment protocols, optimize patient outcomes, and explore long-term benefits to solidify microneedling’s role in comprehensive acne management strategies.

This is an extract from the article shown below. The article contains the details of many studies that have been made in this field and are too many to be enumerated here. For further details, please refer to the article as mentioned, below.

NOT MY OWN WORK. Taken from:

Măgerușan, Ș.E.; Hancu, G.; Rusu, A. Current Understanding of Microneedling Procedures for Acne Skin: A Narrative Review. Cosmetics 2024, 11, 193. https://doi.org/10.3390/cosmetics11060193

References:

(1) Eichenfield, D.Z.; Sprague, J.; Eichenfield, L.F. Management of acne vulgaris: A review. JAMA 2021, 326, 2055–2067.

(2) Heng, A.H.S.; Chew, F.T. Systematic review of the epidemiology of acne vulgaris. Sci. Rep. 2020, 10, 5754.

(3) Akl, E.M.; Ibrahim, S.E.; Fouad, N.A.; Mowafy, E.A. Etiopathogenesis of Acne Vulgaris.

(4) Benha J. ApRamaut, L.; Hoeksema, H.; Pirayesh, A.; Stillaert, F.; Monstrey, S. Microneedling: Where do we stand now? A systematic review of the literature. J. Plast. Reconstr. Aesthet. Surg. 2018, 71, 1–14

(5) Iriarte, C.; Awosika, O.; Rengifo-Pardo, M.; Ehrlich, A. Review of applications of microneedling in dermatology. Clin. Cosmet. Investig. Dermatol. 2017, 10, 289–298. [Google Scholar] [CrossRef]pl. Sci. 2024, 9, 7–10.

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