Crepey arms - ultherapy vs ellacor vs microneedling. Would any of these options be effective? (Photo)

Hi! Dr. Peterson here —
Crepey skin on the arms can be tricky because it’s not just about laxity; it’s also about skin thinning and collagen loss. Of the options you mentioned: • Ultherapy: This can provide some mild lift and collagen stimulation, but results are subtle and usually limited for larger areas like the upper arms. • Ellacor: Uses micro-coring to remove tiny amounts of skin. It can improve texture and tighten skin a bit, but results are modest and not comparable to an arm lift. • Microneedling: Helps improve skin texture and stimulate collagen, but again, the improvement is usually mild and more noticeable on smaller areas or for surface-level issues.
The most reliable, long-term improvement for crepey arm skin is an arm lift (brachioplasty). Any non-surgical approach will provide only subtle improvement and won’t remove the excess skin.
Non-surgical treatments can be helpful if you want some texture improvement without scars, but it’s important to have realistic expectations about what they can achieve. A consultation with a board-certified dermatologist or dermatologic surgeon can help you decide the right approach based on your skin quality and goals.

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your thoughtful question. Crepey skin on the arms is a common concern, especially as we age or after weight loss, and while an arm lift provides the most dramatic results, it's understandable to want to avoid the scarring. Here’s how Ultherapy, Ellacor, and microneedling compare for your situation:

1. Ultherapy (Ultrasound Skin Tightening)
Effectiveness: Moderately effective for mild skin laxity, particularly in younger patients or early stages of crepiness.

Mechanism: Uses focused ultrasound to heat the deeper dermis and stimulate collagen.

Results: Gradual improvement over 2–3 months. May require repeat treatments.

Limitation: Less effective for moderate to severe crepiness or where there is significant volume loss.

2. Ellacor (Micro-Coring Technology)
Effectiveness: Most promising among the three for crepey skin.

Mechanism: Removes tiny cores of skin (without scarring) to stimulate skin tightening and collagen remodeling.

Results: Noticeable improvement in skin texture and tightness after 2–3 sessions.

Limitation: Currently FDA-approved for the face but has shown potential off-label for the body. Not yet widely used on arms, but emerging data is encouraging.

3. Microneedling (With or Without RF)
Effectiveness: Best when paired with radiofrequency (RF microneedling).

Mechanism: Creates micro-injuries that prompt collagen production; RF adds heat for deeper tightening.

Results: Gradual skin firmness and smoother texture after a series of treatments.

Limitation: Results are subtle and require maintenance. Most effective when crepiness is mild.

Recommendation Summary
If you're aiming for modest improvement and minimal downtime, RF microneedling is a good starting point.

For a more aggressive and innovative non-surgical option, Ellacor may offer the best results long-term—particularly if adapted for arms.

Ultherapy is a safe option but generally less impressive for arm crepiness compared to other areas like the face or neck.

It’s great that you’re exploring all your options—being realistic about results while prioritizing non-surgical solutions is the right approach.

You might wish to look into the use of injectable HA biomodulators, such as Profhilo or Skinvive, for the nonsurgical treatment of upper arm crepeyness. This simple approach ttypically requires a series of about three or four treatment sessions. You would be wise to consider consulting with an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and hope you have a great holiday weekend.

Based on the photo and your concerns you can consider Morpheus8 treatments to improve crepey skin. The treatment combines RF technology with microneedling to improve overall skin tone and texture. If you are wanting contoured arms and the laxity addressed you will need to consider an arm lift. I've included a video I hope you find helpful.

I would not suggest any of those options. None of them will be very effective . If you do not want a brachioplasty , Renuvion ( J plasma) offers a nice alternative for moderate skin laxity . This is minimally invasive and performed under local anesthesia and will not have any large incisional scars. The 2 incision sites are about 3 mm and heal up without leaving any noticeable marks. I usually perform several on a weekly basis