Within-Patient, Evaluator-Blinded, Randomized Controlled Clinical Trial to Assess the Efficacy of Microneedling for the Treatment of Hypertrophic Scars in Adult Burn Survivors

Objectives: Microneedling is a promising treatment for hypertrophic scars (HSc); however, documentation of its effects remains limited. The purpose of this study was to objectively quantify scar changes and patient-reported outcomes following microneedling compared with within-patient matched control scars. Methods: Thirty-six adult burn survivors with two similar HSc and who completed the study received five microneedling treatments at six-week intervals in addition to usual care on a randomly assigned HSc. The matched scar received usual care alone. Objective outcomes (elasticity, erythema, melanin, thickness, and transepidermal water loss (TEWL)) were assessed at baseline and at 6 and 12 weeks post-treatment. Participant perception was evaluated using the Patient Scar Assessment Scale at baseline and at 6 weeks post-treatment. Results: Within-scar comparisons at both post-treatment time points demonstrated significant reduction of erythema and TEWL in treated scars and improvement of elasticity and thickness for both scars. Linear mixed-effects models adjusting for baseline values revealed a significant between-group difference favoring the control scar at 6 weeks only for elasticity and the microneedling for erythema and TEWL at 12 weeks. Patient-reported improvements in color, stiffness and thickness were observed for both scars. A significant between-group difference was observed solely for overall scar opinion. Conclusions: Microneedling may enhance specific aspects of scar maturation and improve overall scar opinion.