If you’ve suffered from acne, you know that the condition can be persistent in more ways than one. First, there’s the initial battle of fighting active blemishes, which often requires an arsenal of products. Then, even after the last pustule fades away, it can leave a new struggle behind: scarring. Unfortunately, acne scars can be almost as difficult to treat as the blemishes that caused them in the first place. One treatment for acne scarring that has been getting a lot of buzz as of late: collagen induction therapy.
[Editor’s note: As always, talk to your doctor before starting any new treatment.]
The treatment sounds ultra-scientific and a little complex. The definition itself, however, is simple enough: “Collagen induction therapy refers to therapies that cause our body to make collagen,” says Papri Sarkar, MD, a board-certified dermatologist in Boston. While a handful of treatments fall under this definition, Dr. Sarkar notes that these days, the term usually refers to microneedling. In fact, the words are often used interchangeably.
There are different types of microneedling, Dr. Sarkar notes, but most use thin needles — thinner than a human hair — to create tiny, evenly spaced holes in the skin. According to Howard Sobel, MD, board-certified dermatologist based in NYC, founder of Sobel Skin™, and Clinical Attending in Dermatologic Surgery at Lenox Hill Hospital℠, these holes, or micro-channels “trick the skin into thinking there’s an injury.” This process, he says, stimulates the skin’s natural healing response, which produces collagen and elastin. Collagen is one of the proteins responsible for plump skin. When enough new collagen is generated in the area of the acne scar, the skin appears plumper, and thus, the scar looks diminished.
So: does it actually work? In short, yes — but there are a few caveats. Dr. Sarkar says collagen induction therapy has proven successful for most patients she has treated, but their success has been contingent on follow-up appointments. In most cases, multiple rounds of treatment are required. The exact number, however, depends on the type and severity of the scar. (Read about the different types of acne scars here.)
“Some people may be able to see smoother, more glowing skin after one treatment,” Dr. Sobel says. “For acne scars, though, up to six treatments repeated every four to six weeks may be necessary.” Dr. Sobel notes that only an in-person consultation with your dermatologist can determine how many collagen induction therapy treatments you might require.
This brings us to a second caveat: collagen induction therapy on its own might not be enough to treat serious acne scarring. In these cases, Dr. Sarkar says the treatment can be paired with other modalities, including TCA cross — a high concentration of trichloroacetic acid applied to small scars — or subcision. For this method, “we try to break apart the bottom of the scar that's tethering the skin down,” explains Dr. Sarkar. By doing this, the scar can appear smoother and less divot-like.
PRP, or platelet-rich plasma, is another supplemental treatment that can work in tandem with collagen induction therapy for acne scars. Once your provider takes your blood and separates out the plasma, they can apply it directly to your freshly-microneedled skin. “PRP contains growth factors,” Dr. Sarkar says, “which help stimulate the wound healing response and can cut down on healing time.” (Pairing PRP with collagen induction therapy can also cut back on redness post-microneedling.)
How much time your skin takes to heal from collagen induction therapy is contingent on a wide range of factors, including the depth of the needle your provider decides to use. That said, one of the best things about microneedling is its relatively brief downtime period — especially compared to lasers (which are another option for treating acne scars). “Because microneedling penetrates to the dermis , but removes only part of the uppermost part of the skin, there's minimal downtime,” Dr. Sarkar notes.
For all of the reasons mentioned above, it’s hardly surprising that collagen induction therapy is a popular treatment for acne scars. Perhaps this is one reason why at-home microneedling tools are more prevalent than ever. Despite the popularity of DIY microneedling, however, both derms agree that these OTC devices will not deliver the same acne scar-healing results as an in-office procedure would. For one, the needles on at-home tools are not long enough to deliver the same aforementioned wound healing response. “The devices allowed for use at home do not penetrate the skin deeply enough to actually stimulate [enough] collagen and elastin production [to treat acne scars],” says Dr. Sobel.
Secondly, when used incorrectly, at-home tools can backfire. “I've seen a number of patients who have tried at home [devices] who, unfortunately, caused more scarring,” Dr. Sarkar shares. Similarly, sterilization is another concern. “It’s difficult to create a completely sterile environment at home, [so you’re] increasing the chance of infections,” Dr. Sobel warns. Bottom line: Collagen induction therapy is a powerful option for treating acne scarring, but it’s probably best to leave microneedling up to the pros.