Peng et al.'s 2026 combination trial found microneedling helped atrophic acne scars in every arm, with the bovine bFGF combination doing best. If you have rolling scars, read that as a subtype clue, not a promise of clearance. Rolling scars are broad, shallow depressions with sloping edges and an undulating look. They are one atrophic subtype alongside ice-pick and boxcar scars.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
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Table of Contents
- What the 2026 trial tested
- Why rolling scars need a narrower reading
- Why the headline score can mislead
- What to ask before you book
What the 2026 trial tested
The trial compared microneedling alone against microneedling combined with insulin, bovine basic fibroblast growth factor gel, and recombinant human acidic fibroblast growth factor. Springer Nature reports the work as a 2026 randomized trial in the European Journal of Medical Research the trial report. Every treatment arm significantly improved atrophic scarring.
No treatment-related serious adverse events occurred in any group, according to the same Springer Nature report the safety findings. Only microneedling plus bovine bFGF showed statistically superior clinical and histologic improvement over microneedling alone. The insulin and rh-aFGF combinations showed potential enhancement, not the same proven edge.
Why rolling scars need a narrower reading
The trial enrolled atrophic scars as a group. Rolling scars are only one part of that group, so a group average does not predict your cheek texture. The Art of Dermatology describes rolling scars as broad depressions that affect face, back, and chest the scar-type guide.
Sloping edges respond differently than narrow ice-pick tracts or sharp boxcar walls. Treat "potential enhancement" as early signal. Ask whether before-and-after photos show your subtype, depth, and skin tone.
Why the headline score can mislead
Most scar headlines rest on visual grades. Standard ECCA and Goodman-Baron scales lack objectivity and miss 3D shape. Dermatology Times reports those scales do not reflect 3D morphology, shift with ambient light, and take time the imaging report.
A score can drop while shadows, redness, or swelling still bother you. The 2026 trial was retrospectively registered as ChiCTR2500115176 on Dec. 23, 2025. Late registration does not erase the results, but it favors careful reading over quick booking.
What to ask before you book
Plan for a series, not a single visit. A reported atrophic-scar protocol allowed up to three microneedling plus three chemical-reconstruction sessions to gain improvement, as Healio Dermatology News describes the protocol example. Use this short check with a dermatologist: Bring bare-skin photos in window light from front and both sides.
- Is my scarring mainly rolling, or mixed with boxcar and ice-pick?
- Which combination, device depth, and interval fits my subtype and downtime?
- How will we track change in same light, same angle, and texture?
- What is the stop rule if improvement stalls after two to three sessions?
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