Clin Exp Dermatol. 2009 May 21; Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi DSummary Background. Acne is a common condition seen in up to 80% of people between 11 and 30 years of age and in up to 5% of older adults. In some patients, it can result in permanent scars that are surprisingly difficult to treat. A relatively new treatment, termed skin needling (needle dermabrasion), seems to be appropriate for the treatment of rolling scars in acne. Aim. To confirm the usefulness of skin needling in acne scarring treatment. Methods. The present study was conducted from September 2007 to March 2008 at the Department of Systemic Pathology, University of Naples Federico II and the UOC Dermatology Unit, University of Rome La Sapienza. In total, 32 patients (20 female, 12 male patients; age range 17-45) with acne rolling scars were enrolled. Each patient was treated with a specific tool in two sessions. Using digital cameras, photos of all patients were taken to evaluate scar depth and, in five patients, silicone rubber was used to make a microrelief impression of the scars. The photographic data were analysed by using the sign test statistic (alpha < 0.05) and the data from the cutaneous casts were analysed by fast Fourier transformation (FFT). Results. Analysis of the patient photographs, supported by the sign test and of the degree of irregularity of the surface microrelief, supported by FFT, showed that, after only two sessions, the severity grade of rolling scars in all patients was greatly reduced and there was an overall aesthetic improvement. No patient showed any visible signs of the procedure or hyperpigmentation. Conclusion. The present study confirms that skin needling has an immediate effect in improving acne rolling scars and has advantages over other procedures.