Hydroquinone as pre-treatment preparation to micro-needling treatment?

In our practice we always pretreat the skin with lightening creams and peels. Its essential you see an expert.Hyperpigmentation from any type needs a combination approach of peels like cosmelan,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimontly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

Microneedling should be done at a depth that does not cause PIH. That is one of the benefits of using microneedling compared to other traditional skin treatments such as laser or chemical peels. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon

I usually don't recommend pretreatment with hydroquinone prior to microneedling treatment. If there is a risk of PIH, then post procedure hydroquinone maybe used. 

There is no clinical evidence that preparing the skin with hydroquinone before laser or microneedling  will prevent possible pigmentations. Using hydroquinone after the procedure is definitely a good idea for those patients who are prone to postinflammatory pigmentations.

Lasers produce heat. Heat can lead to PIH, so can trauma. IF one micro needles aggressively, yes you can get PIH, PIH can also occur with generation 3 and 4 devices. Be guided by your specialist with HQ and pre-treatments. Microneedling has come a long way over the past few years and can help skin via several methods. Firstly it releases cytokines and growth factors in the epidermis and dermis- the top and bottom layers of your skin. This in turn remodels scars and the dermal layer of the skin. Additionally needles can break up scars themselves. This leads to new collagen formation, and in practice can provide limited skin rejuvenation. 



Microneedling is both user dependent and method driven. Simple needles can be used, growth factors can be added after the procedure, including PRP, or controlled heating during the procedure. This controlled heating is delivered via RF, and is called RF microneedling. RF can then be delivered via insulated or insulated needles. Even the energy level, depths, density, pulse duration and so many other variables can be controlled. This together with the added benefits of growth factor infusion makes this one of the most complex procedures in procedural dermatology. I use everything from Dermapen, though to newer generation insulated and non-insulated devices including INFINI micro-needling radiofrequency, Intensif and others. Newer generation devices can provide an added advantage in some, but not all patients. In my practice, I combine microneedling with many different forms of energy devices, depending on the expectations of the patient. Tailored microneedling combination will always give the best results. 



Like most procedures, its 80% skill level of the specialist and 20% dependent on the brand of the energy device- microneedling system. All the best, Dr Davin Lim. Brisbane. Australia. Realself Advisory Board Member