PicoSure + PRP. What schedule would be the best for me?

Thanks for your question.  The first question is how is the PRP going to be administered?  The PicoSure FOCUS is non-ablative (doesn't open the skin barrier).  If you apply PRP topically, it is just going to roll off and not soak in.  The PRP needs to be either microneedled or injected under the skin. Best of luck!

Thanks for your question.  The first question is how is the PRP going to be administered?  The PicoSure FOCUS is non-ablative (doesn't open the skin barrier).  If you apply PRP topically, it is just going to roll off and not soak in.  The PRP needs to be either microneedled or injected under the skin.Combination therapies often work better together.  We wouldn't recommend combining these 2 treatments.  They each offer excellent benefits on their own.  If you get great results, what would you attribute it to:  treatment #1, #2 or #1+#2.  I would suggest you pick one or the other and do a series of treatments.  Next wait 2-4 months to see the ultimate results.  If you are generating new, undamaged skin, it takes a while to see the final results.  I hope this helps.

You do not need PRP for PICO, you should have your scars treated first, then pico last. See the FAQ on acne scars to understand why. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments. 



I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’) 



In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher. 

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin. 



All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.