Infini RF while on the Obagi system (tretinoin 0.1% + hydroquinone 4%)

Question

I have been on the Obagi system (tretinoin 0.1% and hydroquinone 4%) for the past five years which has helped control my outbreaks and helped with acne related hyper pigmentation on my Indian skin. I am exploring the option of Infini RF micro needling for correction of acne scars (rolling, ice-pick, box car etc). Do I need to prepare my skin in anyway for this procedure (i.e. stop using tretinoin every night)?

Jason Emer, MD · Answer

I do not restrict any topical skin care before radiofreuqency treatments but with peels it would be a good idea.  Acne scarring needs a combination apporach so please see an expert.  Best, Dr. Emer.

Jeff Rapaport, MD · Answer

We have a slightly different approach to preoperative instructions with Infini. We like to stop for one week any exfoliating treatment including tretinoin, salicylic acid, azelaic acid tazarotene,Etc prior to performing the treatment. We encourage one week of preoperative bleaching in  patients who have darker skin. We will also post-operatively include the bleaching cream. Most recently we have been adding PRP and gentlewaves to our postoperative regimen. Hope this helps. Please seek an infini expert. Good luck.

Frank Barone, MD, FACS · Answer

Infini RF is safe for darker skin types but it is highly recommended that you do prep your skin with Tretinoin and 4% HQ for AT LEAST 6-8 weeks prior to the procedure to reduce the risk of post inflammatory hyperpigmentation. Because you have been using the products for several years all that I would recommend would be discontinuing use of tretinoin and HQ 5 days prior to your procedure. I would explore an option to gradually reduce and then discontinue use of HQ after your series of Infini RF treatments to reduce the risk of rebound pigment caused by overuse of HQ.  Dr Obagi’s more recent recommendations are to limit the use of hydroquinone to 4-5 months at a time and then substitute non-HQ pigment suppressants which can be found in his new ZO Skin Health products in order to avoid complications associated with long term hydroquinone use such as dependency and rebound pigmentation.

Steven Swengel, MD · Answer

Although Infini has a reputation for being 'safe' in darker skin tones, I still prefer to pretreat darker skin with HQs and some tretinoin prior to treatment time.  We like to pretreat for a month ahead of time and after the Infini treated areas have healed, encourage patients to return to prior skin care, usually within a week.  For even faster healing, we are now encouraging the use of growth factor serums or PRP during and after treatment. These really do change the pace of healing for most patients.

Steven F. Weiner, MD · Answer

I think that being on the Retin A for a long time means that results and healing time should be improved. The only thing I might do is stop the Retin A and hydroquinone for a few days after the procedure. It is a great choice for your problem and skin type.

Infini RF while on the Obagi system (tretinoin 0.1% + hydroquinone 4%)

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