Thank you for your question.
You submitted your question without a photo and you are essentially trying to understand
how the inflammation that could be associated with a treatment related to microneedling
can be somehow aggravated by the use of platelet-rich plasma (PRP).
And certainly, I can see how you are using appropriate logic to define the skin condition
such as rosacea, such as wrinkling and pigmentation issues as having some degree of inflammation
and so why would platelet-rich plasma (PRP) would be useful compared to other potential
modalities.
Well, I can certainly share with you a general broad explanation of the role of inflammation
when it comes to different treatments.
A little bit of background, I'm a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
I've been using PRP for many years and I have in fact developed a hair treatment for
male and female pattern hair loss using PRP and a material called extracellular matrix.
Part of everything we do in medicine and the aesthetic field can be argued to have some
type of inflammation.
So I would first start by asking you to maybe take a step back and look at the skin conditions
that you want to treat and determine if microneedling is the right treatment for you.
Microneedling is based on a principle known as collagen induction therapy.
And what you are essentially doing with the microneedling process is a controlled injury.
By definition, that injury causes inflammation.
When you look at the process of wound healing and everything from a simple cut to extensive
surgery or laser procedures, there are four phases: there's an initial hemostatic phase
which is the sealing of vessels so that there's no bleeding, then there's the inflammatory
phase, then there is the proliferative phase which is the wound healing response where
there is collagen production and blood vessel formation and then there's the remodeling
phase where all of this tissue is remodeled.
The goal of any treatment we do is to see improvement.
Now I can certainly tell you that understanding that microneedling can also be controlled
in terms of depth and aggressiveness and thereby have different levels of inflammation.
An expert in this area will always be mindful of staying on that line where there is a certain
amount of inflammation which is necessary and will not result in worsening of the condition
and that's the line.
The line is staying on the side where you get benefit as opposed to getting damage.
And this challenge occurs in microneedling, occurs in lasers, occurs in a lot of different
things that we do as aesthetic specialists.
So it's about the judgement.
And as far as PRP is concerned, I can certainly attest to the value of PRP with microneedling
as well as many other treatments.
When I do any type of laser treatment like a fractional CO2 or I should say an ablative
laser treatment, I use PRP to expedite the healing process.
With microneedling, I do exactly the same.
PRP will not cause worsening of inflammation.
PRP will help recruit the wound healing factors in your skin to help expedite healing.
So understanding that the conditions that you describe like rosacea, rosacea is an inflammatory
condition that leads to very sensitive skin.
Generally speaking, I don't usually recommend any kind of aggressive microneedling in the
areas where rosacea is active.
And that's a situation where you would not want to add inflammation to an area that's
already actively inflamed.
However, you can use lasers such as lasers for vessels to help improve the appearance
of skin that is flushed and has little vessels called telangiectasias.
Now in that situation, you are using laser that is inducing a certain amount of inflammation
but you are targeting vessels.
And so you are using that inflammation in a way that is helpful.
So it goes back to the understanding of judgment of what is right for your skin and so microneedling
being one option.
And if you are dealing with aging changes such as dyschromias or brown discolorations
as well as wrinkling well you have a wide range of options in addition to microneedling.
And as far as the role of PRP in these conditions, I can certainly say that PRP has only been
a useful tool to help expedite and improve the benefits of any treatment that I do in
a lot of different scenarios.
For example, when you do a treatment such as an injectable filler and you want to not
only add volume but then you want to improve skin quality well then you can inject PRP.
You can deliver PRP through different devices and the skin benefits.
So I think that it's important for you to of course always be educated and learn about
the science and principles but when it comes to a treatment plan, I think you should consult
with an expert.
Consult with a physician, a physician who can guide you with what it is you want to
solve before you decide that microneedling is the right thing for you.
A lot of times, people learn about different modalities and they come in wanting that modality,
not appreciating the wide range of options there can be and often missing the forest
for the trees.
So it is very important to find a doctor who can educate you.
And as is often the case in my practice, I've become the primary care doctor for beauty
for my patients and so we deal with a lot of facial aging issues and skin issues.
And so very often, when I evaluate my patients, I first take pictures, I review the photos
with them and then I talk about options to help them see benefit.
And I essentially use a very straightforward approach.
We start with the foundation which is the bone structure and volume and then work my
way outward to the skin.
So meet with someone with expertise with these areas that you are interested of or course
such as PRP and microneedling and see what's their take on this.
And understand, there are many variables at play in terms of managing inflammation but
certainly, I would not be concerned about the inflammatory effect of PRP but rather
the many benefits of PRP but also understand the limitation and find a strategy that works
best for you.
So I hope that was helpful, I wish you the best of luck and thank you for your question.
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