Is Fractional laser or radio frequency better for fine lines and wrinkles? (Photo)

Question

I was told both laser and radio frequency are used to stimulate collagen. Which would be superior to treat wrinkles? Or do they do this in different ways so maybe they both can be combined? It also seems like radio frequency is more comfortable and with less downtime so I'm thinking of RF. If you had to choose one, which would it be?

Raffy Karamanoukian, MD, FACS · Answer

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. 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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

William Groff, DO · Answer

Fractional lasers and RF microneedling devices both work by creating tiny channels in the skin that trigger the body to produce more collagen. As collagen levels increase, the skin becomes smoother and firmer from the inside out. Lasers can be adjusted to work deeper than microneedling, making them a good choice for more severe signs of aging. However, there is some downtime required after these procedures. I recommend scheduling an assessment with an experienced, board-certified dermatologist who can evaluate you in person and create a customized treatment plan that meets your needs and goals best.

Jason Emer, MD · Answer

Fraxel and/or CO2 are best for resurfacing, but Erbium is a good alternative. I always combine lasers with microneedling/PRP for more robust outcomes. For skin tightening, I recommend a combination of Ultherapy with RF treatments and Sculptra for skin tightening. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Patrick Flaharty, MD FAACS · Answer

Fractional laser resurfacing using the CO2 laser offers better results for skin tightening and wrinkle reduction but does have downtime which can be 7 to 10 days. RF instruments are less invasive with some redness and swelling but minimal downtime however you will not get the same degree of skin tightening and wrinkle reduction.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question.  Both procedures might be helpful for wrinkles, but a lot depends on how much your budget allows, who is doing the procedures, and what their experience level is.  I would recommend seeing an experienced board certified dermatologist or plastic surgeon with excellent before and after pictures for you to review and a solid plan for how many treatments might be best for you.  Laser and radiofrequency are completely different types of energy and how many treatments you can afford, what your downtime capability is, and what your goals are will play into your physician's plan for you.  Best of luck and see an expert!

Edward H. Bedrossian, Jr., MD · Answer

Yes, both laser and radio frequency are used to stimulate collagen. Fractional CO2 laser settings can be adjusted to provide superficial or deep treatment depending on if your wrinkles are superficial or deep. Superficial CO2 laser treatments, like RF, are not painful with less downtime, but usually require multiple treatments.Either treatment is good for superficial wrinkles and often they are combined for deeper wrinkles. 
 If I had to choose one, it would be fractional CO2.  But best to seek consultation with a cosmetic Oculofacial plastic surgeon, or Dermatologist, experienced with the fractional CO2 laser. 
Best from Philadelphia
Edward H Bedrossian Jr. M.D. FACS

John Louis Ratz, MD · Answer

Wow both radio frequency and CO2 laser can give excellent results, I would choose the Doctor Who has the experience  and the expertise with the fractional CO2 laser.       jlr

Harrison C. Putman III, MD (retired) · Answer

You can accomplish the desired improvement with both procedures, but one fractional CO2 laser vs multiple RF microneedling treatments are necessary. Each has advantages and disadvantages, so consult a board certified surgeon who is knowledgeable.

Is Fractional laser or radio frequency better for fine lines and wrinkles? (Photo)

Answers (8)

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