Microneedling for Acne Scars: Does It Work and How Many Sessions?

Most acne scars are depressed (atrophic) scars, which form when skin makes too little collagen while healing.

The three depressed types are ice pick (small but deep, and the most common type), rolling (wide and shallow, giving a wavy look) and boxcar (round or oval depressions, wider than ice pick but narrower than rolling).

Microneedling aims at exactly this category.

The American Academy of Dermatology (AAD) says microneedling, done by a dermatologist, is minimally invasive and works by stimulating collagen — it calls the approach collagen induction therapy.

On the regulatory side, microneedling devices are Class II devices under 21 CFR 878.4430, and the FDA has authorized them to improve the appearance of facial acne scars, facial wrinkles and abdominal scars in patients aged 22 or older.

The first, the SkinPen Precision System, was granted through FDA's De Novo pathway (DEN160029) on March 1, 2018, with a narrow prescription-use indication: to improve the appearance of facial acne scars in adults aged 22 years or older.

In regulator language that is an authorization, not an FDA approval.

What no study we found does is rank the scar types by how well they respond to microneedling.

The AAD's acne-scar guidance is that effective treatment depends on the scar type — ice pick scars need different treatment than rolling scars — and we found no study grading microneedling results separately for rolling, boxcar and ice pick scars.

The FDA study behind SkinPen enrolled adults with moderate-to-severe atrophic acne scars as a group.

So treat any claim that microneedling "works best" on one scar type with caution, and ask a provider to identify your scar type before booking a series.

Skin tone belongs in the decision too.

The AAD describes microneedling as safe for all skin tones when done by a dermatologist; FDA separately flags darker skin types because of a risk of the skin darkening or lightening after the procedure, and notes that some authorized devices were not studied in darker skin types.

Given FDA's warning, a claim that microneedling "cannot cause pigment changes" does not hold up.

For acne scars, the AAD says a dermatologist may recommend 3 to 5 microneedling treatments, performed every 2 to 4 weeks, and that studies have found this plan can fade acne scars by 50% to 70%.

That percentage is a range from studies the academy cites, not an outcome anyone can promise for your skin.

Cleveland Clinic, writing about microneedling in general rather than scars specifically, says most people need multiple treatments about 3 to 8 weeks apart, with results taking 3 to 6 months to appear.

Because that guidance is not scar-specific, let the provider who examines your scars set the count.

The FDA study behind SkinPen's authorization used three treatments about 30 days apart, then graded results 6 months after the final session.

Plain microneedling is the mechanical version: a device with many small needles repeatedly inserted into and removed from the skin, and the point is collagen growth.

Radiofrequency (RF) microneedling adds heat through the needles; the AAD says it may boost collagen, and that some small studies suggest results similar to laser with less downtime, while more research is needed in darker skin tones.

On scars specifically, the AAD's acne-scar page says combining radiofrequency with microneedling can produce less noticeable acne scars than either treatment alone.

That is a results statement, not a clearance: the Morpheus8 RF microneedling clearance we read covers coagulation/contraction of soft tissue or hemostasis, not acne scars, and in a 2025 safety communication FDA warned of reports of burns, scarring, fat loss and nerve damage with RF microneedling.

Our RF microneedling guide covers the devices in detail.

PRP — platelet-rich plasma, a blood product — is the third variant you will see marketed for use with microneedling.

The same AAD page says PRP used with microneedling can lead to less visible scarring.

The academy's separate review of PRP is more cautious: it describes PRP for skin rejuvenation as a treatment with little evidence behind it, with unanswered questions about the number of sessions, spacing and dosing, and notes that most patients who see results have had 3 or more treatments.

The clearest numbers come from the SkinPen study that supported its authorization: 41 adults with moderate-to-severe atrophic acne scars took part, and 20 were treated with the final device across three sessions about 30 days apart.

At 6 months after the last treatment, blinded assessors saw improvement in 55% (11 of 20); 45% showed no change, and none were graded worse.

A little over half of a small study group improved on blinded grading — and nearly half were judged unchanged.

Two context points keep that honest.

The study group was diverse in skin tone — 11 of 41 subjects were Fitzpatrick skin type V or VI — but Fitzpatrick type I was not studied.

And results build slowly: the AAD says some improvement may appear within a few weeks, full results usually take several months, and results fade as the body loses collagen, so a dermatologist may recommend a yearly maintenance session.

Before-and-after photos deserve the same caution.

Under the FTC's endorsement guides (16 CFR 255.2), an ad featuring one consumer's experience is likely to be read as showing what consumers generally achieve, and the FTC says disclaimers like "results not typical" do not adequately correct that impression.

Read any photo — a provider's or a manufacturer's — as one person's documented outcome, not a preview of yours.

The FDA's own review of SkinPen puts it plainly: no single acne-scar treatment works for everyone.

The alternatives it lists include laser treatment, punch excision, subcision, chemical peels, radiofrequency and temporary fillers, and it notes that lasers and peels may give more improvement but with higher risk and a longer recovery.

A 2026 systematic review and meta-analysis (11 studies, 713 participants) found microneedling and chemical peels broadly comparable for atrophic acne scars, with no clear superiority for clinically significant improvement of 50% or more; microneedling was associated with more procedural pain, peels with burning and exfoliation.

Scar type can also steer you elsewhere.

Ice pick scars need different treatment than rolling scars, and plans are often built from more than one treatment, based on scar type, number, age, skin tone and budget.

One lookalike to rule out: the AAD says microdermabrasion won't treat acne scars, though it can even out skin tone alongside other treatments.

The full comparison of acne scar treatment options — lasers, peels, fillers, and who to see — lives in our acne scar treatment options guide, and our acne scar treatment overview explains how med spa scar devices are cleared and used.

For cost, providers and the treatment generally, start with the microneedling guide.