Radio frequency microneedling: contraindicated for extremely fair, sensitive skin, post Accutane?

Question

Is this procedure contraindicated for someone who might have extremely fair, sensitive skin, post accutane with some scarring and sun damage? I do not want to have a procedure that could further damage, or injure my skin. Can the heat generated do that to the skin? Also, is not the collagen formation permanent? I read somewhere that it is temporary, and micro needling needs to be done often to maintain the collagen formation.

Jason Emer, MD · Answer

I perform lasers, fillers, micro needling and PRP on all my accutane patients for years without issues. In face studies in Europe show that fraxel during accutane helps scars more than doing nothing.  There are no healing issues ever seen in my whole practice.  Best, Dr. Emer.

Neda Vanden Bosch, MD · Answer

RFMN is an amazing new technology that is safe on all skin types. However I am old school and do not treat someone who has been on Accutane with any lasers for at least 6 months. Having fair skin is actually in your favor as some RFMN devices have non insulated tips which can cause an issue on darker skin types. As for skin sensitivity, your practitioner should monitor your response during your treatment and adjust the settings accordingly. In fair skin types I commonly see a little bit more swelling and erythema for 2-3 days post treatment. In regards to scarring, in my opinion, RFMN is the BEST option on the market right now! It is not what I would recommend for sun damage, IPL is a better option for that.

Isobel Walker, MBBS · Answer

I am not a dermatologist but keep up with the recent revisions on Oratane, the new JAMA 2017 guidelines has confirmed the safety. This was a consensus decision made by US Dermatologist, wound care experts and Plastics, so bottom line- safe if performed correctly, Dr Isobel Walker. Brisbane. Australia. Fiori Institute.

Rafael Gottenger, MD · Answer

Good Morning and thank you for your inquiry. On my experience we recommend the patients to do laser at least 6 months after finishing accutane. On the case that you want to do Profound RF that combines microneedling and radiofrecuency we recommend to wait 12 months after finishing the treatment with accutane.

Davin Lim, MBBS, FACD - Account Suspended · Answer

No, this treatment is safe, as new guidelines have been developed last year regarding Accutane and energy devices. Dr Steve Weiner is one of the leading experts in this treatment, and he is in FL!Acne scar revision comprises of specialised procedures. For the best results, one should target the acne scar type with ideal treatments METHODS. Using one device is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. 
  
 
  
As an example deep ice pick scars, and narrow box car scars are best treated with TCA CROSS. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat grafts, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations. 
  
 
  
The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combination that give you best results, and everyone is unique! It is never about the device, its about the specialist behind the equipment that will deliver the best outcomes. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.

Radio frequency microneedling: contraindicated for extremely fair, sensitive skin, post Accutane?

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