What is more effective: 5 sessions of microneedling or 1 session of CO2RE laser to treat wrinkles, fine lines and large pores?

Question

What is more effective: 5 sessions of microneedling or 1 session of CO2RE laser to treat static wrinkles, fine lines and large pores? And also to improve the complexion in general, tighten the skin up a bit and create a more youthful look? I'm 35 years old and have some fine lines, few static wrinkles and my pores are very large and I have few small acne scars.

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Johnson C. Lee, MD · Answer

Both laser and microneedling work to achieve the goals you are describing. A CO2 laser is much more powerful for a single treatment than microneedling. You may need 5-6 treatments of microneedling with PRP for maximum improvement. A CO2 laser has longer single downtime as well although the results will be more dramatic. Hope this helps!Johnson C. Lee. MDBoard-Certified Plastic Surgeon

Lindsay Sturm, DO · Answer

Great question, thank you!  These are both great options for all of your concerns.  What it will come down to is how much downtime you would like to have and how often you would like to return to your provider to get these treatments.  The CO2 laser resurfacing is an amazing tool to overall freshen your face, tighten fine lines/wrinkles, minimize discoloration/pigmentation, brighten your tone, improve your texture and help with acne scarring.  Yet, the downtime with this is often a full week of swelling and redness and then another few weeks of redness (everyone is different).  Microneedling with radiofrequency and PRP is another amazing tool/treatment.  It works to increase collagen production thereby improving your skin tone/texture, tightening your skin, and minimizing acne scarring.  Often the downtime is a day or two depending on how deep your provider treats.  You can't go wrong with either option, it ultimately is up to you to determine what you would like to do.  Whichever option you decide make sure you continue a good skincare routine and sun protection as both will help to maintain your investment! Thanks again for your question.  Best wishes, Dr. Lindsay J. Sturm.

What is more effective: 5 sessions of microneedling or 1 session of CO2RE laser to treat wrinkles, fine lines and large pores?

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