Does Picosure stimulate collagen and rejuvenate skin With the same effect as dermaneedling?

Question

Hello, I am 40 YO. I noticed that my pores got larger and I have crepey skin under my eyes despite having regular Botox and fillers. I also developed melasma. I was advised that Picosure was better than micro needling meaning it encourages type A collagen but without inflammation. It is a big investment and I would like to check that the advice given to me was correct. PS I have a history of keloids (earlobes and chest)

Lichun (Li) Huo, MD · Answer

Hi!  Yes, PicoSure works to target pigment and at the same time stimulate collagen and elastin production.  It is a fantastic laser that delivers results with very minimal downtime.  You may experience some redness in the first 24 hours, gritty skin texture that will resolve.  Some people also experience a bit of peeling.  Botox paralyzes muscle so that you cannot make facial expressions so that the lines soften.  Fillers are temporary (as you know).  I prefer PicoSure because it stimulates your own body to produce collagen and you still look like yourself!  Three treatments are recommended, then every 4 to 6 months for a one time maintenance.  Best of luck, Dr. Huo

Monika Soni, MD · Answer

Yes, PicoSure works to target pigment and at the same time stimulate collagen and elastin production.  It is a fantastic laser that delivers results with very minimal downtime.  You may experience some redness in the first 24 hours, gritty skin texture that will resolve.  Some people also experience a bit of peeling.  Botox paralyzes muscle so that you cannot make facial expressions so that the lines soften.  Fillers are temporary (as you know).  I prefer PicoSure because it stimulates your own body to produce collagen and you still look like yourself!  Three treatments are recommended, then every 4 to 6 months for a one time maintenance.  Best of luck

Craig Schwartz, DO · Answer

Actually, PicoSure will rejuvenate your skin with a much greater effect than micro-needling. The idea behind skin rejuvenation is to generate newer, fresher, healthier skin cells to provide a more youthful appearance. Understand that skin, as a structure, is composed of layers of cells - with the youngest, freshest cells at the bottom layer, and the oldest, most damaged cells at the surface, which will slowly slough off as you wash your face over time. Treatments for skin rejuvenation are designed to remove the outermost layer of cells and stimulate new growth of the fresher cells to rise to the surface. Therefore, treatments that go deeper into the skin layers will provide a much better effect. Things such as microdermabrasion or chemical peels are very superficial and will not give much effect. Micro-needling goes a little bit deeper, but is still very superficial and only provides limited effect. True laser treatments like PicoSure go much deeper into the skin layers, and thus provide much greater rejuvenation. You should see a cosmetic specialist who has multiple options for treatment available, so that the best choice for your particular case can be determined.

Davin Lim, MBBS, FACD - Account Suspended · Answer

In the correct skin type, yes it can stimulate collagen, however the settings need to be well over the company guidelines. The laser is excellent in skin type 3 and above and can be used in conjunction with medical therapy for melasma. The X factor is not the laser but your dermatologist or plastic surgeon performing this procedure. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’)

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher.

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.

David E. Berman, MD (retired) · Answer

you should plan at least 3 Picosure sessions, spaced a month apart. Use a good sunblock. It is the worlds best laser for melasma and evening up the skin discoloration from the sun. it can used on  the face, neck, chest and back of the hands. I have treated my wife, who had a lot of sun damage with great results. microneedling will also stimulate collagen production. the Picosure is probably better but I am not aware of any controlled studies between the two methods. david berman md

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