Microneedling with PRP or Microneedling with RF and PRP? (photos)

Question

I am considering microneedling to treat my acne scars. However I was uncertain about whether I should go with SkinPen or Vivace RF. Which of these options would be safer for my skin tone? The SkinPen costs $600 per treatment, while the Vivace is $1000; so I would be able to get more skinpen treatments done. Which is the better route to pursue?

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

Jack G. Bertolino, MD · Answer

PRP can be used with laser, RF, and microneedling. Remember the platelets are activated by the trauma of these different modalities. Miconeedling should do the job and the growth factors from the PRP should be very helpful in healing. Talk to a provider to find the best fit for you. Hope this is helpful. JB

Jason Emer, MD · Answer

I recommend microneedling with prp for acne scars, but keep in mind, acne scarring needs a combination approach to get improvement. For the best results, one should target the acne scar type.  As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision.  Subcision for depressed tethered scars.  Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring.  Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision.  All lasers are combined with microneedling and PRP to get even better results and improve healing times.   The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician.  It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome.  Scars cannot be cured and will need life-long treatments to maintain and build on the results.  Best, Dr. Emer.

Evangeline Specht, MD · Answer

Micro needling alone will stimulate your body to start the healing process since it is  purposeful micro-injuries to your skin which brings in a cascade of growth factors which helps build your collagen/elastin and blood vessels. The addition of radio-frequency which brings in volumetric healing of your deeper tissues adds further to the remodeling of your skin and maximizes tightening. The addition again  of PRP (which is your own concentrated growth factors) delivered into an area that has open micropores just allows for more growth factors to help accelerate healing and development of new tissue that can help soften wrinkles, resolve scarring and rejuvenate aging skin. The cost is most certainly higher when done all together but the result can be 3x better than either modality alone. The down time is similar; you can experience redness and swelling from a few hours to a few days. I do this in my practice - can be done every 3-4 weeks - improvement  continues over 4 months. Once scarring has resolved the effects are permanent.

Johnson C. Lee, MD · Answer

The skin pen is a microneedling device. VIvace RF adds radiofrequency technology to help add a stronger tightening affect to the skin. PRP improves collagen growth and the speed of healing. I actually prefer to do a combination of all three types of treatments to maximize all three aspects (collagen, tightening and healing). Costs are expectedly higher as you add more features to the microneedling but standard microneedling alone with the skinpen is great for boosting collagen and improving overall texture. The decision for you is whether you need the added benefit of tightening from the RF and collagen boost from the PRP. Hope this helps!Johnson C. Lee, MD 
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

Ladie Arana-Domondon, MD, FACP · Answer

Hi hd1234, Microneedling is effective if done in a series of treatments. I recommend that you start with the plain microneedling to get your money's worth. Expect not to have full results with just one treatment. My patients get a series of 4 - 6 treatments every 4-6 weeks. Hope this helps.
Ladie Arana-Domondon, MD FACP

Shaun Patel, MD · Answer

In my patients, I usually start with a series of microneedling sessions by themselves (No PRP) and combine with followup chemical peels and fractionated lasers as needed. Both microneedling and microneedling RF will help you, later will probably provide more improvement but also a little more downtime than traditional microneedling.

Linda Kelley, MD · Answer

We offer both procedures at our office. I have seen the best results with acne scars when using PRP (Platelet Rich Plasma) with either the Skin pen or Vivace RF Microneedling. You would probably see good results from either device. These are scars and require multiple sessions. We are finding that Vivace RF Microneedling works best when there is still some acne activity because the Blue LED light along with the Radiofrequency and Microneedling may kill the bacteria associated with acne. We are also seeing that fewer sessions are required with Vivace vs the Skin Pen. You should discuss all options at your Consultation. The consultant will be able to assess your skin more thoroughly in person.

Davin Lim, MBBS, FACD - Account Suspended · Answer

You have active acne and PIE. I would not treat your scars just yet- absolute control of you acne is recommended- see a medical specialist. Red 'scars' are called PIE or post inflammatory erythema- laser can help, as can sunscreen and time. Once your acne is in remission, target the scars accordingly. 
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.

Microneedling with PRP or Microneedling with RF and PRP? (photos)

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