Does Dermapen Really Work? Evidence for Acne Scars and PRP Combination Effects

Does Dermapen Really Work? Evidence for Acne Scars and PRP Combination Effects

"Is that 'effectiveness' real? Research papers answer the truth about Dermapen."

"Don't you think 'Dermapen just hurts and doesn't make sense?'"
One of the most frequently asked questions in aesthetic medicine clinics. While various opinions circulate on social media and reviews, the only truly reliable source is "scientific evidence." This article thoroughly explains the true power of microneedling (Dermapen) and the remarkable synergistic effects of PRP (platelet-rich plasma) combination, based on the latest international medical literature and randomized controlled trial (RCT) data.

The Mechanism Behind Dermapen's Skin Transformation — More Than Just "Puncturing with Needles"

Dermapen (microneedling) is not merely a treatment that creates holes in the skin. Its essence lies in a mechanism called "Percutaneous Collagen Induction (PCI)," which maximizes the skin's self-regeneration ability (wound healing cascade) [1, 2].

The Mechanism of Skin Regeneration Using the Wound Healing Cascade

In research by Alster et al. (2018), it was demonstrated that fine needles reach the dermal layer while preserving the epidermis, physically severing old collagen fibers that form scars (acne scars) [3, 4]. This microscopic trauma serves as a trigger, causing growth factors to be released explosively within the skin, activating fibroblasts to generate new collagen and elastin [1, 4].

Signal Transduction via TGF-β and Direct Approach to the Dermal Layer

Particularly important is signal transduction that controls cell proliferation and differentiation. According to research by Alster et al. (2018), microneedling preferentially increases the expression of "TGF-β3," which promotes scar-free regeneration, compared to "TGF-β1" and "TGF-β2," which promote fibrosis (scarring) [3]. Furthermore, as mentioned in research by Amer et al. (2020), when combined with PRP and other treatments, growth factors such as IL-8 (interleukin-8), which suppress inflammation while promoting angiogenesis, act powerfully [5, 6].

Effects on Acne Scars — Improvement Rates Proven by RCT

The effectiveness of Dermapen against atrophic scars (crater-like acne scars) has been demonstrated in numerous randomized controlled trials (RCTs).

Specific Improvement Rates Shown by RCTs and Changes in Goodman & Baron Classification

In research by Ismail et al. (2022), a split-face trial with different treatments on the left and right sides of the face (targeting 30 subjects) was conducted. In the "Goodman & Baron Classification" (qualitative evaluation) used to assess acne scar severity, patient scores that were Grade 3 (moderate) or Grade 4 (severe) before treatment showed clear improvement after treatment [7, 8].

According to the data, even on the side of the face treated with Dermapen (microneedling) alone,73.3% of patients achieved "Excellent" or "Marked" improvementwas obtained [9]. Additionally, in a review by Alster et al. (2018), it was reported that performing 3–5 treatments at 2–4 week intervals yields50%–70% clinical improvement[10].

Differential Effects on Rolling Scars, Boxcar Scars, and Ice Pick Scars

Effectiveness varies depending on acne scar morphology. According to research by Alster et al. (2018), "Rolling scars" (gentle depressions) and "Boxcar scars" (vertical step-like indentations) show very high effectiveness, while "Ice pick scars" (deep narrow punctures) tend to show relatively lower effectiveness [10].

How Many Sessions Until Results Are Visible? Data by Number of Treatments

In a systematic review by Sitohang et al. (2021),"A minimum of 4–6 treatments is required to achieve significant improvement"was concluded [11]. Additionally, since it takes time for newly generated collagen to stabilize, optimal results may take 8–12 months post-treatment [11].

What Changes When Combined with PRP (Platelet-Rich Plasma)?

"Why does mixing in PRP nearly double the effectiveness? — The answer lies in how growth factors are 'delivered'"

Synergistic Effects of Microneedling and PRP

PRP (platelet-rich plasma) contains ultra-high concentrations of growth factors essential for tissue repair, including PDGF (platelet-derived growth factor), VEGF (vascular endothelial growth factor), TGF-β, and IL-8 [5, 6]. By applying PRP immediately after Dermapen creates countless "microscopic tunnels" in the skin, these growth factors are directly delivered deep into the dermal layer, causing collagen production to accelerate explosively [12-14].

[RCT Data Comparison] Dermapen Alone vs. PRP Combination

Dermapen Alone

Excellent/Marked Improvement Rate

73.3%

Acne Scar Improvement Rate

45.84%

Grade Improvement Range

1 Grade (Ibrahim et al.)

Downtime

Several days (mild)

Dermapen + PRP Combination

Excellent/Marked Improvement Rate

80.0%

Acne Scar Improvement Rate

62.20%

Grade Improvement Range

2 Grades (Ibrahim et al.)

Downtime

Shortened (anti-inflammatory effect)

Improvement rate increases approximately 1.35-fold with PRP combination

(Ismail et al. 2022, Asif et al. 2016 RCT data)

Improvement rate difference: Dermapen alone vs. PRP combination (Contrast)

The difference in effectiveness between Dermapen alone and PRP combination is immediately clear when looking at the following comparative data.

In the RCT studies by Ismail et al. (2022) and Asif et al. (2016),PRP combination therapy increases the improvement rate by approximately 1.3x to 1.5xhas been demonstrated [9, 15]. Furthermore, in Ibrahim et al.'s study, while Dermapen alone improved acne scars by only "1 grade," the PRP combination group showed "2 grade" improvement [17].

Reason for shortened downtime

In El-Domyati et al.'s study (2018), PRP powerfully promotes wound healing, and it has been shown that post-procedure redness and swelling (downtime) are rapidly calmed [18]. Because the anti-inflammatory components in PRP accelerate tissue repair, recovery after treatment is smooth despite being a powerful therapy.

Electric microneedling (Dermapen) — How does it differ from older models? Key evolutionary points

According to Alster et al.'s research (2018), compared to the older "dermaroller (manual roller type)," electric pen-type devices (such as Dermapen) have undergone dramatic evolution [3, 19, 20].

• Vertical needle penetration and reduced epidermal damage:While roller types risked needles entering at an angle and tearing the epidermis, electric pens stamp vertically, significantly reducing unnecessary epidermal damage (lacerations), bleeding, and pain [3].
• Precise control of speed and depth:Electric devices operate at ultra-high speeds of 10,250–23,750 rotations per minute, with needle depth precisely adjustable from 0–3.0mm depending on the treatment area [20].
• Hygiene and localized treatment application:Using 12–36 disposable sterile needle tips reduces infection risk and allows precise targeting of localized areas such as small acne scars [3, 20].

How many treatments do you need? — Recommended schedule based on research papers

• Standard treatment interval:In most clinical trials,"Every 2–4 weeks"is the recommended pace [10, 11].
• Number of treatments required:According to Sitohang et al.'s research (2021), mild to moderate improvement can be seen from around 3 sessions, but for significant improvement of severe atrophic acne scars,"minimum 4–6 sessions"are necessary [11].
• Depth and maintenance therapy:For acne scar treatment, needle depths of typically 1.5mm–2.0mm (up to 3.0mm for severe cases) are used [11, 20]. Since collagen remodeling progresses slowly over months after treatment, it is recommended to monitor progress over a 6-month to 1-year timeframe after completing one course of treatment (or to undergo maintenance treatments) [11].

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Summary of this article

• Reliable evidence:Dermapen (microneedling) is a scientifically proven acne scar treatment that activates TGF-β3 and other factors through physical stimulation, promoting collagen and elastin production.
• Dramatically improved results with PRP combination:By combining PRP, growth factors reach deep into the dermis, significantly raising the acne scar improvement rate compared to treatment alone (to approximately 62%).
• Effectiveness varies by crater type:Particularly effective for rolling and boxcar types, but may have limitations for ice-pick types.
• Appropriate number and duration of treatments:To experience results, continuous treatment of at least 4–6 sessions at 2–4 week intervals is essential.

[Consultation Information]
As research data demonstrates, Dermapen delivers reliable improvement for acne scars when performed with "the appropriate number of sessions," "appropriate depth," and "appropriate combinations" such as PRP. The optimal approach differs depending on whether your acne scars are "rolling type" or "ice-pick type." Please feel free to consult with us first.

Author of this article

Hiromitsu NakamuraPhysician, Ginza Clinic

Zetith Beauty Clinic Ginza Clinic, Osaka Shinsaibashi Clinic, Fukuoka Clinic

With a track record of research presentations at domestic and international academic conferences, and involved in technical guidance and education across all Zetith Beauty Clinic locations. Specialized in precision aesthetic medicine based on anatomical foundations, pursuing natural results tailored to each individual's skeletal structure and tissues.