Microneedling with Platelet-rich fibrin (PRF) and IPL Combined vs. Active FX alone for wrinkles and fine lines. Which is better?

 Microneedling (a procedure I have been using for over twenty years), as a stand-alone treatment, is a tried and true approach for smoothing very fine lines and skin crepeyness. Unfortunately, despite the hype that surrounds it,  PRP, which adds anywhere from 800-1000 to the bill in my neck of the woods, in a recent November, 2018 JAMA Dermatology study on its effects on skin texture, was shown to be "nominally, but not significantly better than saline injections."  So, I'm not sure whether it really makes any difference if PRP is added--whether applied, sprayed on, or injected mesotherapy style. In my experience, medical microneedling performed to the point of achieve pinpoint bleeding and then covered with an occlusive dressing for up to twelve hours can provide any of the necessary growth factors and wound healing factors purported for PRP without the unecessary inconvenience and expense. As to the IPL, fraxels, etc., just be aware that most relatively expensive, so-called "bells and whistles" devices appear to be far more backed by device manufacturer supported marketing hype than hard science. So be cautious when considering these. Make certain that you are consulting with a board certified aesthetic physician and, once again, be sure to do your due diligence when vetting so much of the currently hyped and relatively expensive devices and techniques, like fraxels and PRP, that have not as yet stood the test of time. Best of luck.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon