For microneedling to treat boxcar scars, how should the needle be oriented?

Boxcar facial scars are difficult to treat because the dermis is fibrous, the sides are fixed, and they can range in size from several millimeters. The purpose of microneedling is to improve the underlying dermis, so it would make the most sense to aim the needle directly under the deepest part of t...

I would start with perpendicular (90°) passes with vertical stamping when treating boxcar scars with microneedling to create dermal injury and collagen induction. I like to add oblique passes 30–60°, along the edges of the scar, to break up the fibrotic bands along the borders. Cross-hatching in all...