PRP w/Microneedling vs Laser? (Photo)

Question

Discussing w/my dermatologist on best ways to treat acne scaring and deep lines. He's offered either 1 CO2 laser w/PRP Microneedling the same day for 3k or multiple sessions of microneedling w/PRP under 3k.  Bc of Corona, downtime doesn't matter, although I've heard some experiences of sensitive skin in the cold for years later after laser.  Appreciate any feedback or recommendations in LA/SoCal

Jason Emer, MD · Answer

Microneedling will do almost nothing for you, you need fillers, submission, lasers.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly from emeragecosmetics.com) should be started now.  visit emeragecosmetics.com where we ship medical grade skincare all over the world AND do free virtual skincare consults daily.

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. see emeragecosmetics.com where we do free skincare consults daily and can send you peels and skincare. proceeds go to help BLM and LGBTQ+ non for profit organizations.

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, 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.

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.  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

Kristin J. Tarbet, MD, FACS · Answer

I would definitely go with the 1 CO2 laser with the PRP micro-needling. The CO2 is an ablative laser that will help with resurfacing and the PRP Micro-needling will help encourage collage growth.

Susan Fox, DO, RPVI · Answer

Hello, I would recommend treating this with a series of microneedling with radio frequency (we use vivace) plus PRP or stem cells to address the acne scarring and botox to address the lines.  Good luck!

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