Last Updated on August 7th, 2019
In the hundreds of entries on this site, you can find articles about skin peels for eliminating acne scars, dermabrasion and microdermabrasion for eliminating acne scars, and laser ablation and traditional surgery for eliminating acne scars1. There is one very important method we have not mentioned yet, however, and it’s dry tattooing.
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A dry tattoo, also known as dry needling, is a tattoo without ink or pigment2. It’s a procedure that can be done by a tattoo artist (make very, very sure you establish the result you want before you begin if you go this route), but it is better to go to an aesthetician who specializes in dry needling for acne skin repair. Usually you would go to an aesthetician or cosmetologist who does permanent makeup.
Dry needling is sometimes called “cosmetic acupuncture,” but that description is wholly inaccurate. Acupuncture is an ancient Asian healing technique that was conceived in terms of blockages and flows of an invisible energy called chi.
Dry needling is not acupuncture. It is based on the scientific observation that the basal layer of the skin can be stimulated to produce collagen3 that can fill in scars from the inside out. And dry needling around raised scars can stimulate the growth of skin that pulls the skin taut and flattens the area of scarring so it can at least be concealed with makeup.
Dry needling is not something you should ever try at home. Especially if you have more than one scar, stimulating the growth of skin in ways that are helpful on one part of your face may be detrimental to the appearance of another part of your face. Leave the procedure to a professional who has seen many cases and knows how to prevent problems. But you don’t have to get the procedure from a doctor.
Most people who have acne scars and get dry needling find that the results of needling last a lot longer than the results of collagen injection. Collagen injections begin to break down as soon as the procedure is done. Collagen creation stimulated by needling the skin continues for months or years. Dry needling can also be an alternative for Botox injections for wrinkles.
A skilled aesthetician does not try to bring the skin to its original contours. That is asking too much of your skin. What the dry needle operator does is to make subtle changes to the skin that either take shadows off raised acne scars or that make indented acne scars appear to be filled in. In some cases the patient decides to go with “wet needling,” or traditional tattooing. The design used for the tattoo, however, usually is chosen to cover up scars that otherwise would have to be removed by laser or surgery.
All professional aestheticians will make sure they understand your health needs. Give honest answers when asked whether you use aspirin or blood thinner (either of which should be stopped at least 24 hours before the procedure under your doctor’s supervision) and whether you have herpes or cold sores. Any kind of trauma to the skin can “awaken” herpes or cold sores viruses.
Aestheticians will also want to make sure that you are able to give informed consent4, that you have made arrangements to stay indoors for a few days while your skin heals, and that you understand what they are about to do. The aesthetician first puts a topical anesthetic on the skin to dull the pain of needling. The needles used in dry needling are bulkier and go in deeper than the needles most American acupuncturists use for acupuncture. (If you were to get acupuncture in China, usually without pain killers there, you would experience a sensation similar to dry needling in the United States).
The aesthetician then choose sites that need extra collagen to make scars less visible. A needle is stuck 1 to 2 mm (about 1/20 of an inch to about 1/10 of an inch) into the skin at a 45-degree angle. It’s less painful and less injurious to needle the skin at a 45-degree angle than it is just to jab the needle straight in. (This is something it is helpful to remember if you ever have to give yourself or a family member or a pet shots at home.) There is usually no bleeding at all, or if there is bleeding, it is usually only momentary and very slight.
The needling process follows the outline of the scar being treated. Your aesthetician should never place a needle into a raised scar. The skin’s healing processes kick in and create just enough collagen at just the right places.
Dry needling is often used when other procedures, such as dermabrasion or facial peels, go wrong. While it would be better to use dry needling before using harsher skin treatment techniques, the simple fact is that the technique is usually a second choice.
Many other procedures for removing acne scars5 require down time of 1 to 2 weeks. Dry needling usually requires 2 or 3 days. If you have an issue with hypopigmentation (a common problem after surgical removal of acne-scarred skin and small skin cancers), needling will stimulate production of the pigment melanin in the skin so that your entire face has the same coloration. On the other hand, if you have an Asian, Hispanic, or African skin type, you should be sure to get assurances from the dry needler that the procedure will not cause excessive pigmentation of your face.
A good dry needler can achieve either a natural look, simply restoring the appearance of normal skin contours and even coloration, or a dramatic look, replacing a scar with a tattoo that is more noticeable than the skin problem. But before you even look into dry needling for acne scar repair, consider using microdermabrasion cloths and microdermabrasion creams available from Exposed Skin Care.
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