Most non-commercial dermatologists & plastic surgeons would agree that platelet rich plasma does not contribute to the improvement of scars as compared with saline (normal saline, or salt water). Personally I believe it gives marginal improvement in healing times. It is also associated with a high patient satisfaction rate as we are sprinkling ‘growth factors & goodness’ extracted from your blood. There are many conflicting studies demonstrating the efficacy & in some cases the effectiveness of PRP. Base your decision on the interpretation of the data.

So what are my recommendations? If you would like a cost-effective DIY, try microneedling at home with sensible settings. I do use microneedling in my practice, however my indication is to gain access into the upper & mid papillary layers of the skin in order to deliver proper pharmacologically active drugs, most commonly corticosteroids.

In the context of acne scars, the team @cliniccutis can provide you with microneedling, however in the context of acne scars there are better solutions including vascular lasers for red scars, lasers, & energy based microneedling, known as RFM or radiofrequency microneedling. We still do provide PRP, however we are not keen to sell this treatment in the context of scarring & rejuvenation. PRP is effective in the management of hair loss (stronger evidence).

This treatment ranks as one of the worst treatments for melasma as it can lead to melanin drop out, leading to post inflammatory dermal hyperpigmentation. The logic behind this treatment is the most illogical reasoning for the treatment of melasma. Yes, I get it, the basement membrane separating the dermis & epidermis is compromised. Yes, this can be due to photoageing & restoring BM function seems logical, but to do this with trauma, often reaching the mid to lower papillary dermis is skin suicide. We are not addressing the actual pathological process with microneedling PRP. I do agree that this treatment can improve or restore photoaging, but in the context of melasma, there are far, far, far better & safer treatments. 

Subcellular settings on nano lasers, low fluence picos, or conservative Thulium laser together with vascular modification, & tyrosinase inhibitors with adequate UV protection is Gold Standard. Stabbing skin with needles then sprinkling platelet extract most often leads to rebound, but also makes our job much harder as pigment is pushed deeper into the dermis.

No. Despite the popularity of this treatment, microneedling PRP is not a good choice for treating dark circles. Why? Because in many cases it can make dark circles worse! The action of microneedling breaks skin, in turn causing bleeding. This causes bruising also known as post procedure purpura. This leaves more pigmentation known as post inflammatory hyperpigmentation or PIH. The logic of microneedling PRP in the management of dark circles is illogical. As clinicians we should address the actual cause of dark circles, namely, to diagnose before treatment.

Dark circles can be due to atrophic (thin) skin, vasculature, genetics, irritant or allergic contact dermatitis or many more disorders. Diagnosis & targeted treatment should be the Gold Standard of practice.

In some cases, it can be effective, in other cases it makes enlarged pores worse. If the needle is bigger than the pore, the latter is possible. Always find a solution that is smaller than the problem itself. For large pores (diameter wise), skin needling, large diameter lasers, RFM & TCA or Phenol are appropriate. 

For small diameter pores my preferred treatment is with 1927 Thulium laser via the LaseMD system, Fraxel Dual or even Clear & Brilliant. I also employ NdYag nano lasers & occasionally Pico lasers if appropriate.

At Clinic Cutis we base treatments on clinical findings and match this with appropriate treatments. We are not limited by equipment levels nor skill sets. To understand what is the ideal method to treat your pores, book an appointment with my clinical team. 

Yes, microneedling can help stretch marks. Because the skin is so atrophic, you do not need to go so deep. DIY simple roller at home with a 0.25 mm ‘Dermaroller’ from eBay can help. See my posts @101.skin & @drdavinlim to understand how to safely perform this treatment at home. Counter traction can help. This treatment is best for old stretch marks, namely white, silvery or papery.

New stretch marks are pink, red or purple. The use of a vascular laser is preferable over microneedling as the former targets the vessels under the skin, without breaking skin. I use the V BEAM Prima & Perfecta for this job, other lasers that we employ include the 1064 Nd Yag millisecond PD in the context of laser genesis.

For cases of old stretch marks, I also employ Tixel, LaseMD, Fraxel 1927-1550 & a whole lot of other lasers & energy devices.  For more information on how we approach stretch marks, book an appointment with my nurses or dermal therapists @cliniccutis

This is where microneedling & PRP can be highly effective as adjunctive treatments for both male & female pattern hair loss. It works by stimulation of hair germ cells via the release of growth factors & cytokines.

A standard protocol consists of one session every month for three months, followed by maintenance therapy every 3 to 6 months. For more information review the dedicated page on PRP Microneedling & hair loss on this site.

Yes, if conducted appropriately. The first step is the indication. For example, microneedling & PRP can be effective in the management of hair loss, wrinkles & in some cases acne scarring. It should not be used to treat melasma or dark circles.

Needle depths are typically between 0.25 to 1.5 mm. Device selection is important. A strong high Hz motor is required to facilitate gliding & not dragging. Technique is critical to prevent idiosyncratic scars- most frequently seen if needles are ‘dragged.’

The optimal concentration of PRP is required to ensure correct delivery of cytokines, growth factors & platelets. Too little & it is useless, too much & it could be counterproductive.

Can you cut grass with a pair of scissors? Yes, you can but there are far better solutions than a pair of scissors. Same applies to microneedling. I employ this treatment based upon the job. I do not employ a treatment based upon the limitations of equipment & skill sets. As stated microneedling is my preferred option for managing some scar types including thin hypertrophic scars as I want uninterrupted dermal delivery of corticosteroid in the upper and mid dermal layers.

At Clinic Cutis my team & I employ over 25 types of lasers & EBD or energy-based devices from powerful CO2 lasers to gentle Tixel, Fraxel, Clear & Brilliant, & LaseMD Ultra fractional laser systems. We add newer equipment monthly, keeping on the best & most effective solutions.

Book an appointment with my clinical team to understand what is the ideal solution for your skin concerns.