Microneedling with PRP for Asian skin? Safe for history of hyperpigmentation? (photos)

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

Hello and thank you for your questionMicroneedling with PRp is safe for all skin types including those with a tendency for PIH. This is best combined with pre-treatment with hydroquinone or Lytera.  Best wishes and good luck! Andrew Lhis M.D. FACS

The best treatment is cosmelan and clear + brilliant laser , micro needling and PRP can enhance t he outcome but typically alone is not he best primary treatment. you need skin care and peels for maintenance.  Best, Dr. Emer.

Thank you for your question. Microneedling is an effective way to treat acne scars, uneven complexion, fine lines and wrinkles, larger pores and more, and it appears from your photo that you may benefit from this treatment. I recommend coupling microneedling with PRP for best results, but you should also consult with your board-certified dermatologist to be sure that this treatment is right for you. 

Yes Microneedling is safe with darker skin types even with a history of hyperpigmentation.  PRP is completely safe and fine also.  This is why I love it, especially in Houston!

Hello and thank you for your question and photos.Microneedling + PRP is great for all skin types, including a patient who is prone to PIH. For my patients I prepare their skin prior with a ZO Medical protocol, then during the microneedling + PRP, once the skin is open we add an additional product to lighten the pigmentated areas. After your treatment you will continue to use the products. Following this protocol or your providers protocol will help prevent PIH.Best to you,

I treat at least 8 Ethnic skin patients per day with all modalities including microneedling, PRP, energy based RF , insulated and non-insulated. The LOWEST risk of not developing PIH is with pre treatment with HQ or Meladerm, SPF, and the gentle use of non energy based systems. Other methods include INSULATED RF devices, to a depth beyond 2.5 mm - this still carries a risk despite company guidelines. For patients where I do need to use an energy device, Infini is my preferred choice over Intracel or Intensif. As for lasers, I tend to stay clear of erbium or Fraxel Non ablative, I do however use short PD Co2 in very low density. If PIH occurs, I either use my Pico or nano in the usual low fluency 1064 setting along with tyrosinase inhibitors and SPF. I suspect you may have rebound melasma from IPL. Present yourself to a dermatologist for a diagnosis in real time. If this was the case, microneedling is NOT recommended, as it can worsen this- breaking the BM of your skin results in pigment drop out and dermal pigmentation- makes treatments a lot harder. Remember always a diagnosis before treatment, and in this case microneedling may not be your BEST option.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. 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.

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