Which one's more effective? Microneedling or Fraxel Dual 1550/1927 for hyper-pigmentation on dark brown Indian skin?

Question

I visited two different Skin Laser Clinics explaining my goal which is to get rid of hyper-pigmentation from a 70% glycolic peel chemical burn that happened 6 years ago. Also I have hyper-pigmentation from acne and dark circles. The first clinic said I my skin's too dark and micro-needling would be best. The second suggested Fraxel Dual 1550/1927 OR Micro-needling. She said that they had been using fraxel successfully on dark skinned individuals. Which one's better for the results I want?

Monica Boen, MD · Answer

Thank you for your question. Both microneedling and Fraxel are excellent choices for hyperpigmentation. In my office, we offer RF microneedling, which adds radiofrequency heating to the microneedling process to enhance the results. We also provide more than 45 laser devices so that we can customize treatments to the unique needs of our patients. In the case of patients with a darker skin tone, this ability to tailor treatments is invaluable. I encourage you to schedule a consultation with a board-certified dermatologist who is an expert in both of these technologies. Through an in-person assessment and discussion of your concerns and goals, your doctor should be able to create a personalized treatment plan that will work best for you.

Jason Emer, MD · Answer

Hyperpigmentation of any kind needs a combination approach of peels like Cosmelan; lasers like Clear + Brilliant, Aerolase or Laser Genesis; radiofrequency like Venus Viva; and constant skin care and sun protection. Bimonthly facials with SilkPeel DermalInfusion are 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. Hypopigmentation will need more of an evaluation and possibly additional lasers to get improvement. I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

Dmitriy Schwarzburg, MD · Answer

Fraxel is ideal for hyperpigmentation. While micro needling can help, it may require several sessions to see desired results. Depending on the energy settings, Fraxel can be a successful option for you.

Laura Riehm, MD · Answer

Thank you for your question.  It sounds like you might have Post Inflammatory Hyperpigmentation (PIH).  You can start by looking for prescription strength 4% Hydroquinone (HQ) to reduce the pigment.  Do not buy it over the counter or off the internet.  Laws vary by state.  In Texas, physicians can prescribe and dispense in office.  We have been very successful using the PicoSure laser with the FOCUS and / or Flat Lenses eliminating hyperpigmentation with a series of treatments.  
FOCUS lens treatments have the extra benefit of reducing the underlying scar tissue.  This is one of our go to treatments for patients older than 40 and worried about the signs of aging.  This laser is safe for all skin types.  Start with sunscreen every day!  Once you have treated your hyperpigmentation to your satisfaction, you will probably need a follow treatment every 6 to 12 months depending your level of re-pigmentation.  Best of luck.

Which one's more effective? Microneedling or Fraxel Dual 1550/1927 for hyper-pigmentation on dark brown Indian skin?

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