How effective is one facial treatment of microneedling with exosomes for improving crepey aging skin and fine lines?

Question

I'm 65 and have had Botox in various areas for years. Never had filler. I am getting that older lady crepey skin and a friend recommended microneedling with exosomes. I guess they are popular in larger cities like LA, Chicago, NYC, etc. I have rosacea, and my eczema flares up once in a while (it's been dormant for several years now, thank God!). Will microneedling aggravate my rosacea or eczema?

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

sounds like you need a much more comprehesive approach, exosomes do very little for the skin unless its already damaged. you likely need lasers (+/- PRP or exosomes), fillers, and a comprehensive skin tightening regimen. Id suggest a consultation.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging which can be done virtually.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

How effective is one facial treatment of microneedling with exosomes for improving crepey aging skin and fine lines?

Answers (2)

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