How much time should I wait between CO2 laser treatments and RF Microneedling?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Usually there is a 3 to 6 month wait period before further treatment is recommended. This is to allow adequate time for the skin to heal. A release from the provider that performed the CO2 laser treatment is necessary. You may find that after an adequate wait period your skin has improved and further treatments such as microneedling are not necessary. 

Both procedures can be done on the same day. In the context of your question, wait 3-10 after you heal up from Co2 laser. Microneedling RF is an extension of microneedling with ‘energy’. Generation one devices such as Dermapen/ Skin Pen etc. use needles without heat to remodel collagen. Generation Two devices are microneedles that are not insulated, hence heat is delivered along the length of needles. Examples include Secret RF and Intensif. Generation Three devices use insulated needles to deliver heat at the point of the needle. Examples include Infini RF, as well as Genius. 
Newer generation devices will generally give better outcomes, however with insulation, the safety of microneedling RF devices is usually better than generation two machines. With insulation the incidence of skin colour darkening and ‘grids’ secondary to ‘stamping’ is less, however it is largely technique dependent. 
Microneedling RF should be viewed as a tool to be incorporated in the suitable clinical context. As with most other ‘fractional technology’ 3-5 sessions spaced 3-6 weeks apart will give the best results. Be guided by your specialist.  All the best, 
Dr Davin Lim and the team at Clinic Cutis
Brisbane. Australia.