Besides the usual acne program which is made up of topical medications, antibiotics, and laser, Microneedling is gaining popularity for its efficacy.
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Acne vulgaris is the most common skin disorder affecting male and female teenagers and young adults across all races. Studies have shown that around 88% of individuals in Singapore within that age range will experience acne vulgaris, which is chronic in about 50% of cases [1].
Although acne is often classified as a mild to moderate skin condition, its effects go far beyond physical appearance. The psychological impact of acne is great and should not be overlooked.
Many people feel self-conscious, anxious, or have low self-esteem because of their acne, especially if it is severe (and painful!). They may withdraw from social settings and may succumb to feelings of depression and negative self-image.
Microneedling emerges as an effective treatment for acne vulgaris in Singaporeans
Besides the usual acne program which is made up of topical medications, antibiotics, and laser, Microneedling in Singapore is gaining popularity for its efficacy in treating acne vulgaris over the past decade.
Microneedling is a non-invasive regenerative aesthetic treatment that creates controlled micro-injuries in the skin with tiny needles to stimulate the body's natural healing processes and promote collagen production for multiple benefits.
Numerous studies with accumulating evidence have proven the effectiveness of microneedling as a promising option for individuals seeking to reduce acne vulgaris, visibility of scars and enhance overall skin quality. It can reduce acne lesions, improve skin texture, and increase collagen with few side effects and downtime.
Case Study #1: Reducing non-inflammatory and inflammatory acne with Microneedling

Objective
A 2023 study [2] examined how effective and safe microneedling is for treating acne vulgaris.
Method
Two groups of participants followed different treatment plans. One group had three treatments, each four weeks apart. The other group had four treatments, each two weeks apart.
Results
Both groups showed significant improvements in reducing non-inflammatory and inflammatory acne lesions after two months compared to when they started. The first group had a 48% decrease in non-inflammatory lesions and a 58% decrease in inflammatory lesions. The second group saw a 54% reduction in non-inflammatory lesions and a 37% reduction in inflammatory lesions.
Conclusion
The study concluded that microneedling can be an effective and safe option for acne vulgaris, with no post-treatment problems or harm to the skin microbiome.
Case Study #2: Microneedling sans chemical peel is effective enough for treating atrophic acne scars

Objective
A study by Solanki et al. in 2023 looked at how well microneedling works when combined with either a 15% trichloroacetic acid (TCA) peel or a 25% pyruvic acid peel for treating atrophic acne scars [3].
Method
A TCA peel uses a chemical solution to remove damaged skin cells, addressing issues like sun damage, acne scars, and dark spots. Pyruvic acid peels target inflammatory acne, moderate scars, oily skin, and signs of ageing, offering medium-depth exfoliation to improve skin texture and appearance.
Thirty patients took part in the study and were split into two groups. Each patient received microneedling on both sides of their face at weeks 0, 6, and 12. They also received either the 15% TCA or the 25% pyruvic acid peels on alternate sides of their face at weeks 3, 9, and 15.
Results
Patients and doctors evaluated how well the treatments worked using the ECCA grading scale. This measurement helps dermatologists assess the severity of acne scars and visual analogue scales (VAS) at different times, ending at week 21.
The results showed a clear improvement in ECCA scores for both treatments. However, by week 21, there was no significant difference between the effectiveness of the two peels. Both treatments improved the look of scars, mainly rolling and boxcar scars, and helped enhance skin texture and patient satisfaction.
Conclusion
While there are clear improvements in the acne skin condition with microneedling, overall, there was no significant difference in the effectiveness of the TCA and pyruvic acid peels.
Case Study #3: Combining phenytoin cream with microneedling showed better results in treating atrophic acne scars

Objective
A 2024 study [4] examined how effective microneedling is for treating atrophic acne scars alone and with 1% phenytoin cream. Phenytoin cream, which contains phenytoin, may help with nerve pain and has potential benefits like reducing pain, bacteria, and inflammation.
Method
The study involved 25 patients aged 18 to 40. One side of each person's face received microneedling, while the other side received microneedling followed by 1% phenytoin cream applied three times a day for a week. Each patient had three microneedling sessions over one month.
Results
Researchers gathered initial data and checked in with patients during treatment and two months after the last session. They measured and compared pore size, pore count, spot count and scar severity before and after the microneedling sessions, as well as patient satisfaction, and complications.
Conclusion
Both treatments significantly improved pore area, pore count, spot count, and overall skin condition. However, the side treated with phenytoin cream had better results for acne scar grade and patient satisfaction at all follow-up visits compared to the side treated only with microneedling.
Case Study #4: Radiofrequency (RF) Microneedling treats various dermatologic conditions and suitable for those with darker complexion

Objective
A review aims to find higher-quality evidence supporting the use of radiofrequency microneedling and to identify the skin conditions it can help.
Method
The researchers searched MEDLINE and EMBASE, two major medical databases, for studies from their beginning until May 13, 2020. They used terms like "radiofrequency microneedling," "fractional radiofrequency," and others related to the treatment on human subjects but excluded studies that were not in English or did not focus on dermatology.
They included 42 high-quality studies. Of these studies, 14 focused on skin rejuvenation, 7 on acne scars, 6 on acne vulgaris, 5 on stretch marks and excessive sweating, 2 on melasma, and 1 on rosacea, cellulite, and hair loss due to genetics.
Results
Radiofrequency microneedling is an effective treatment that can be safely repeated and combined with other therapies, making it a good option for people with darker skin [5].
Conclusion
The treatment helps with skin improvement over time; patients can see continued results even 6 months after treatment.
Radiofrequency (RF) microneedling and Erbium Glass Laser in Singapore for acne and acne scar treatment
Combining RF microneedling and Erbium Glass Laser effectively addresses active acne symptoms. This Singapore’s popular regenerative aesthetic treatment greatly reduces the visibility of acne scars, which can vary in depth and type. Selecting the best treatment plan depends on evaluating the severity and characteristics of these scars.
RF energy in RF microneedling helps tighten the skin, improving its texture and overall appearance. Meanwhile, the Erbium Glass Laser delivers targeted energy that stimulates collagen production, enhancing skin clarity, texture, and tone by addressing pigmentation issues and minimising fine lines and wrinkles.
This powerful combination not only treats active acne but also reduces scarring and promotes the development of clear, healthy skin.
Other benefits of microneedling, according to research
RF Microneedling and Erbium Glass Laser are versatile skin treatments not limited to facial skin, aimed at patients seeking practical solutions, such as:
- Eye bag reduction
- Hair regrowth for androgenetic alopecia
- Treatment for hyperhidrosis
- Improvement in the appearance of stretch marks
- Mild to moderate skin tightening
- Minimisation of pores
- Non-ablative skin resurfacing
- Non-surgical facelift
- Normalisation of skin structure and texture on both legs and/or arms
- Promotion of collagen formation
- Reduction of fine lines and large pores
- Reduction of wrinkles and fine lines
- Skin remodeling and rejuvenation
- Treatment for acne scarring and active acne
- Treatment for acne scars and improvement in their appearance
- Treatment for atrophic scars
- Wrinkle reduction
Real Patient Story at Amaris B. Clinic: Treating Acne Scars, Comedones, and Sun Spots with RF Microneedling and Erbium Glass Laser

Background
Ms. LP is a busy yoga instructor in her 30s who leads an active lifestyle and is an outdoor enthusiast. She had struggled with severe acne in her late 20s, which left her with acne scars and sun spots on her face.
She believes that not applying topical sunblock has contributed to the development of her sun spots and long-term effect of sun exposure. While her acne has improved over time, she still experiences breakouts during her menstrual cycle, which affects her self-confidence.
In 2024, she visited Dr Ivan Puah to address these skin concerns.
Consultation and Assessment
During her consultation, Ms LP expressed concerns about comedones, sun spots, and acne scarring. Dr Puah examined her skin and analysed that she has combination skin with oily areas in her T-zone, with small sun spots, comedones, and deep acne scars on both cheeks. Having never tried any aesthetic treatments before, she is seeking clearer, healthier skin.
Treatment Plan
Dr Puah recommended a treatment plan tailored to Ms. LP's specific needs with Radiofrequency (RF) Microneedling and Erbium Glass Laser Therapy. He recommended eight treatment sessions, scheduled once every four to six weeks, making it easy for her to fit into her busy schedule.
Post-Treatment Care
After each session, Ms LP received post-treatment care instructions to maximize her results. She was advised to follow a gentle skincare routine, protect her skin from the sun, and avoid harsh products that could cause irritation. She diligently followed these instructions.
Results
After completing eight sessions of RF microneedling and Erbium glass laser treatments, Ms. LP noticed significant improvements in her skin's appearance, tone, and texture. She felt pleased with her brighter complexion, lighter acne scars, and a reduction in both comedones and sun spots.
Combining RF Microneedling and Erbium Glass Laser treatments with Exosome Therapy

Exosome therapy is one of the skin regenerative treatments Amaris B. Clinic provides, which focuses on long-term skin health and anti-ageing by enhancing skin from the inside out.
Exosomes come in serum or gel forms applied to the skin but can't reach deeper layers on their own. They act like messengers that enhance collagen production to improve skin's elasticity and youthfulness. They are tiny particles released by cells, including skin cells, and contain essential materials like lipids, proteins, and growth factors, making them safe for skin care.
Their effectiveness increases when a medical device creates tiny wounds in the skin, allowing for better absorption and activating the skin's natural rejuvenation. This is why using exosomes in combination with RF Microneedling and Erbium Glass Laser treatments can lead to better skin health, texture, hydration, and firmness while reducing scars and wrinkles by calming inflammation and promoting collagen production.