Skin needling as a treatment for acne scarring: An up-to-date review of the literature☆

BACKGROUND Skin needling is a technique used to improve the appearance of acne scarring. OBJECTIVE To comprehensively review the medical literature regarding skin needling as a treatment for acne scarring. METHODS A literature search was performed using the PubMed, Medline, and Embase databases, in addition to reviewing the bibliographies of relevant articles. RESULTS Ten studies presented patients treated with skin needling alone, while eight studies discussed skin needling in combination with other treatments for acne scarring. All studies showed improvements in scarring after needling, with 12 reporting statistical significance. The median number of treatments when needling was used alone was three, the median duration between treatments was 4 weeks, and the median needle length used was 1.5 mm. Reported adverse events were infrequent and included post-inflammatory hyperpigmentation, "tram track" scarring, acne, and milia. There were no reports of bacterial infections. LIMITATIONS The studies reviewed were heterogeneous in design and of variable validity, with some not reporting statistical significance. CONCLUSION There is moderate evidence to suggest that skin needling is beneficial and safe for the treatment of acne scarring. However, double-blinded, randomized controlled trials are required to make more definitive conclusions.