Is PRP better in combination with Fraxel or micro-needling?

I appreciate your question and you are correct in your assumption that Fraxel and microneedling both work in a similar fashion. These treatments are categorized as collagen induction therapies because the trigger additional collagen production by the body to support the dermal structure. Some doctors will add PRP to the treatment because platelet-rich plasma contains growth factors that are thought to enhance the healing process. I offer RF microneedling, which heats the underlying dermal structure to enhance results even more effectively than PRP, in my opinion. It also doesn’t require a blood draw before treatment. 
No matter what treatment you choose, make sure it is administered by a board-certified dermatologist who has expertise in this method of skin rejuvenation. With a qualified doctor and the right treatment, you should be able to achieve very good results. 

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. 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

PRP can help to heal your skin after both Fraxel and micro needling. It is more commonly combined with micro needling. The Fraxel laser is a more expensive treatment than microneelding with PRP, and this may be why it is not combined with the Fraxel as often. The average price for one Fraxel treatment to the face here in Houston is $1100. It is recommended that you have 3-5 treatments spaced 4-6 weeks apart. If you add ~$250 more to this price to add PRP it makes this more costly.

Thank you for your question.  PRP enhances lessens the downtime and the results of any resurfacing treatment it is combined with. Had you included pictures, it would have helped me to advise you in the right direction. Depending on your skin health and aesthetic goals, I would customize a treatment plan for you.  I have included information on both microneedling and Fraxel for you.
Microneedling

Microneedling is great for minimizing the appearance of pores, evening out skin tone and texture, smoothing wrinkles and fine lines, improving acne scars, surgical scars and stretch marks.  Here is some information about enhancing your microneedling treatment with PRP.  Although the micro-treatment zones are only open for a few hours, they are used to facilitate absorption of topically applied active products to the deep layers of the skin.  The skin will be pink to red immediately post treatment.  The next day, skin will feel tight like a mild wind-burn.  PRP Microneedling is finished with PRP application which speeds up skin healing and eliminates downtime.  The skin may peel very lightly from day 2 or 3 for up to 5 days.  Chemical Peel Microneedling enhances results but will result in some peeling.  The skin will peel lightly from day 2 or 3 for up to 5 days. 

 Fraxel

Fraxel was FDA approved in 2005.  The process is like repairing a digital photograph pixel by pixel.  Fraxel delivers Microscopic Treatment Zones (MTZ) which are deep columns of treatment under the skin.  Fraxel treats only a fraction of the skin at a time.  Untreated skin cells are stimulated to heal the skin quickly by replacing the old and damaged cells with fresh, glowing, healthy skin.  There are 3 different Fraxel Laser that I offer in my practice. 

Fraxel 1927- Penetrates more superficially. Targets pigmentation, pre-cancerous cells and to some degree skin texture. Is ideal for patients who are no longer seeing results from IPL treatments. Is ideal for patients who have severe sun damage and precancerous rough spots which are beyond the scope of an IPL treatment

-Fraxel 1550- Penetrates deeper into the skin. Targets texture, fine lines, wrinkles, scars, and stretch marks. Is ideal for the patient who needs texture improvement but wants a treatment with less downtime than a CO2 laser resurfacing

Best Regards,

Monica Bonakdar MD

In my opinion, both treatments would be optimized with PRP. It all depends on what you are treating. I find microneedling with PRP a good treatment option for uneven skin texture, fine lines, and enlarged pores.