Is it safe to combine microneedling RF (Genius) with fractional CO2 or Erbium in the same session as subcision for acne scars?

Question

Should I separate them or is it safe to do together at once? Is risk of complications higher than if done separately? I don't seem to read about this same day combination very often but I've been told I could benefit from all 3 modalities.

Jason Emer, MD · Answer

we do MNRF and laser together all the time. see our examples. make sure to prevent PIH and do cosmelan or enlighten first 2 weeks before to prevent complications.

at home peels like cosmelan, enlighten and aerify along with dermarolling (Emerageskin roller with anteage MD AERIFY ampules weekly) should be started now (see link to emeragecosmetics).

if you have post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream.

Acne scar treatment needs a combination approach for 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, halo, maxi, pro fractional laser/erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif or fractora 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.  For those at high risk for hyperpigmentation (darker skin types or asian or hispanic or mixed ethnicities) we already pre-treat the skin with cosmelan or enlighten lightening peels to prevent complications from energy-based or chemical-based treatments.  Best, Dr. Emer.

Jeff Rapaport, MD · Answer

We routinely combine microneedle radio frequency,subcision and CO2 laser. It's helpful in acne scar treatment with multiple scar types. I recommend adding PRP injected into the subcision areas and to be used topically with a mask.

Jeff Rapaport MD FAAD
RealSelf Verified All Star

Jeff Rapaport MD FAAD
RealSelf Verified All Star

Is it safe to combine microneedling RF (Genius) with fractional CO2 or Erbium in the same session as subcision for acne scars?

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