Whats better: microneedling/PRP vs. Fraxel?

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Thanks for your query. If we consider purely the results, then for anti aging, wrinkles, melasma and skin discoloration micro needling with PRP would give better results as the growth factors in PRP will stimulate the formation of new collagen which will lead to resurfacing of the skin thus leads to decreased wrinkles and improves melasma and skin pigmentation , giving it a glow. Acne scar respond better to fraxel. Both the treatments require multiple sittings and involve a little bit of downtime but the result is appreciable. Hope it helps.All The Best

Thank you for your question!  It is hard to give you generalized opinion stating that one or the other treatment is better for one or the other condition. I had patients with different skin condition and acne scars that had to receive different combination of treatments. For some Fraxel laser worked better while others had better results with microneedling. I would avoid using Fraxel for Melasma since skin is more sensitive and it may lead to hyperpigmentation. I would preferably use chemical peels for Melasma. All treatments are great and it is important to determine if you are the right candidate for the treatment. Best of luck!

It is hard to give you generalized opinion stating that one or the other treatment is better for one or the other condition. I had patients with different skin condition and acne scars that had to receive different combination of treatments. For some Fraxel laser worked better while others had better results with microneedling. I would avoid using Fraxel for Melasma since skin is more sensitive and it may lead to hyperpigmentation. I would preferably use chemical peels for Melasma. All treatments are great and it is important to determine if you are the right candidate for the treatment. Good luck! 

I perform both microneedling with PRP and Fraxel and eMatrix and other lasers.  There is a place for all of these treatments and the key is selecting the right patient with a certain skin type and condition for these treatments.  They are both extremely effective for the correct patient.  Please consult an expert.  Best, Dr. Green

I think you must watch for the hype with the microneedling and PRP. I have yet to see demonstrated science behind it or great results. Also, PRP is all over the map as far as concentrations. It must be 6X (6 times the normal platelet concentration) to be most effective. Most is about 2. Fraxel will be better for all the cases you are asking about . I also don't believe that one is driving in the PRP with the microneedling. If it is laid on the surface after microneedling with a soaked facial mask, this might allow the PRP to penetrate. Also, injecting the PRP is better too.

Each device has its own optimal use, namely, for acne scars I prefer energy based insulated RF microneedling compared to Fraxel - why? Because it works better, and spares the upper layers of skin. For pigmentation such as melasma, the use of the 1927 wavelength in either Fraxel low density pass, or the Clear and Brilliant Permea is best as it targets the upper layers of skin. As work anti ageing and wrinkles, depending on the severity, microneedling can be combined with Fraxel to give results in the epidermis and deep dermal layer to stimulate collagen. All the best, Dr Davin S. Lim