Thank you for your question!
You’re asking is micro-needling with PRP equal to micro-needling with hyaluronic acid
and you’re basically looking to improve acne scars, fine lines, skin tone and texture.
Well, I can certainly give you some information based on my experience.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon practicing in Manhattan and Long Island for over 20 years.
The use of micro-needling, platelet-rich plasma is something that I have a lot of experience
with, hyaluronic acid fillers as well.
In fact, I am a member of the network of vampire facelifts physicians and I’ve actually been
featured in the media a few times in regards to PRP and the vampire facial treatment and
some celebrities who have used it.
So I think that, first of all, whenever you start asking questions about procedures and
you’ve already kind of decided that you want to do micro-needling or for example combining
what combinations are ideal, you always have to go back to what is the core issue of the
skin that has to be addressed and then you can do some comparison.
Acne scars for example is one of the areas where there are a lot of different treatments
that can be combined in different ways to address this challenge of acne scarring.
To understand acne scarring, you have to think about the inflammation that resulted in acne
cysts that ultimately resolved in the skin healing with scar tissue and there being,
a majority of the time, indentations or depressions.
Now, in our practice, my approach to acne scars is typically about addressing them from
the inside first.
I understand that from the concept of micro-needling, you’re creating multiple little openings
and you try to get the skin to tighten but it has been my experience particularly for
more wide or deep acne scars that combine an approach where I’m actually using PRP
and hyaluronic acid but probably in a way that’s different than what you’re considering.
I actually do subcision and release the acne scars and I’ll combine the hyaluronic acid
filler such as Juvederm, Restylane with platelet-rich plasma to stimulate tissue growth on the inside
at the deeper levels.
A lot of times, acne scars get treated by superficial treatment or working for the outside
in.
This includes the use of laser or something like micro-needling.
And when you’re thinking about micro-needling, you’re asking will PRP be necessary when
you apply it at the top of the skin versus hyaluronic acid.
Well, I think PRP is better as far as from the surface perspective even though the actual
penetration and effect to the PRP can be up for debate but I would say that if you’re
doing something that is stimulating the dermis, if you think about it, the wound healing material
that is concentrated in platelet-rich plasma will probably stimulate more of a collagen
response or a healthy skin healing response more if you’re applying it from the top
in comparison to hyaluronic acid.
Hyaluronic acid is not necessarily the same as Juvederm in terms of the thickness but
there are manufacturers who offer hyaluronic acid topical to be combined with micro-needling.
But I would say, from my experience, injection with platelet-rich plasma, subcision with
acne scars and then as a finishing touch, doing something on the surface such as micro-needling
have been more successful for me in my practice.
Instead of working from the outside in, I work from the inside out.
And the rehabilitation of the skin from acne scarring using platelet-rich plasma in an
injection form rather in a micro-needling superficial form, I feel works very well.
Very often, I’ll do a combination where I’ll do the injection and treatment from
the outside and I will do something like Hydrafacial which is a glycolic acid and water based treatment
of the skin that is like a microdermabrasion but using water with infusion of glycolic
acid.
That way, we do deal with the superficial which is not to be neglected but I feel I
get a really nice result without having to make so many penetrating openings in the skin
with micro-needling.
micro-needling is great but it has to be used strategically.
Understand that acne scars treatment and skin treatment, textural treatment lines, etc.
is not a onetime event.
It’s always an overall treatment plan that I discuss with my patients to understand that
you can’t get always everything at once and to figure out a way to strategize things
so that you get the most value with every time you actually go to a procedure.
So I hope that was helpful, I wish you the best of luck and thank you for your question!