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Microneedling of Immature Scars Is Safe and Improves Scar Esthetics

Chopra, Vinod K. MD; Claytor, Brannon Brannon MD

Plastic and Reconstructive Surgery - Global Open: August 2019 - Volume 7 - Issue 8S-1 - p 13
doi: 10.1097/01.GOX.0000584264.07381.7c
Aesthetic Abstracts
Open

Cooper University Healthcare, Camden, NJ

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

PURPOSE:

1. Dispelling previous myths that immature scars could not be treated with microneedling.

2. Microneedling scars as early as 6 weeks following wound closure is safe.

3. Microneedling improves scars esthetics. Scar formation involves the remodeling of extracellular matrix proteins.

Wound contraction and hyperproliferation can result in hypertrophic or keloid scars with features linked to poor cosmetic results. Currently early intervention with microneedling in immature scars is not the standard of care and some recommend waiting upward of 1 year before microneedling treatment. Our hypothesis is that mechanical stimulation of the myofibroblasts at the early tissue formation stage can positively influence the extracellular matrix to influence cell activity to produce collagen, matrix metalloproteinases, and cytokines which lead to flat scars with minimal discoloration as a result of small parallel collagen bundles

METHODS AND MATERIALS: Subjects were enrolled between 6 weeks and 4 months following closure of their wounds. Once enrolled, the patients were treated with 3 microneedling treatments 1 month apart and a final evaluation at 2 months following the last treatment. The treatment areas included facelift, breast mastopexy, and tummy tuck scars. The patients consented to participate in the Institutional Review Board–approved study. Twenty-five patients were enrolled, and data were analyzed using analysis of variance and post hoc testing.

RESULTS: The Vancouver Scar Scale demonstrated a statistically significant improvement when compared from the initial evaluation to the final evaluation at the 2-month follow-up following the 3 treatments (7.00 versus 3.08; P < 0.001). The Patient and Observer Scar Assessment Scale showed statistically significant improvement when initial evaluation was compared to the 2-month follow-up (23.72 versus 11.76; P < 0.001).

CONCLUSIONS: Early microneedling on immature scars is safe and has demonstrated improvement in both Vancouver Scar Scale and Patient and Observer Scar Assessment Scale scores when initial evaluation is compared to 2-month follow-up.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.