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Microneedling vs. Laser Resurfacing: Which One is Right for You?


Microneedling has become a catch-all term to represent any type of treatment that involves puncturing the skin with tiny needles. The goal is to cause a medical “injury” to the skin, with the purpose of repair and regeneration, thus improving skin health and appearance. 

From DIY mechanical derma rollers to the most high-tech and advanced devices, some variation of microneedling is offered at most clinics worldwide. That’s because the science behind controlled micro-injury is conclusive. Evidence abounds that this popular procedure can dramatically improve skin texture, scarring, pigmentation and even reverse the signs of aging. 

Currently the most popular microneedling modality is an automated device, such as the SkinPen, that delivers thousands of micro-punctures per minute. It’s a versatile treatment that can be performed on all skin types, and anywhere on the body. Furthermore, the needle depth can be adjusted to target specific concerns and skin conditions. 

The biggest benefit of automated microneedling seems to be its ability to stimulate collagen production. For this reason it works exceptionally well to smooth acne scars, brighten a dull skin complexion and refine fine lines and wrinkles. Additionally, there’s very little downtime associated with microneedling and clients can return to work or regular activities almost immediately.

Perhaps the biggest drawback with microneedling is that a minimum of 3-5 sessions are generally required to achieve a satisfactory improvement. Furthermore, since there’s a limit to how deep the micro-needles can penetrate, the treatment may not be as effective on more mature patients or those with deeper scars and wrinkles.

RF Microneedling         

One step up from microneedling is RF Microneedling. This highly advanced treatment features a sophisticated hand-piece that projects microscopic needles into the skin while deploying a burst of radiofrequency heat energy. Some examples of RF Microneedling devices include the InfiniTM RF Microneedling, Genus® RF, Intensif® Microneedling RF and SecretTM RF. 

Combining microneedling with RF accomplishes a certain degree of tissue coagulation and neocollagenesis that microneedling alone does not. The needles act as tiny delivery vehicles for the RF energy to penetrate deep into the dermis, causing the collagen fibers to become denatured and then rebuilt. 

During the healing process, the denatured collagen fibers heal in a more structured and orderly manner, helping to dramatically improve the skin’s appearance. RF Microneedling is therefore indicated for the treatment of wrinkles, improving texture and pigmentation and minimizing many types of scars and skin imperfections.

The very reasons that make RF Microneedling so effective are the same reasons why it’s more risky for some patients. Anytime extreme heat is generated there’s a chance of developing rare but serious complications such as burning, scarring and PIH (post-inflammatory hyperpigmentation). For this reason RF Microneedling must be used with caution on those with darker skin tones.

There’s also the pain factor to consider. In most cases some type of anesthetic is required for pain management and to keep the patient comfortable during the procedure. There’s also a longer downtime with RF Microneedling. Recovery can take anywhere from 2-7 days, with patients experiencing some degree of swelling, redness and general discomfort.

Non-Ablative Resurfacing 

Lasers offer yet another advanced level of skin rejuvenation. There are two kinds: ablative a non-ablative, which means they either remove layers or skin or they do not. 

Laser treatment can also be fractional, which means heat energy, (such as Erbium gas for example), is deployed in a grid-like pattern, leaving tiny “columns” of the treatment area untouched.These include the Clear + Brilliant® and Pico fractional lasers. 

Non-ablative lasers tend to target and “heat up” the dermis, delivering a controlled “damage” deeper in the skin. The columns that have been heated up then undergo a rapid repair and regeneration process, causing old, damaged layers to slough away, revealing vibrant new skin underneath.

Depending on how they’re calibrated, non-ablative lasers can be superficial or go quite deep. Some require 5-6 sessions to achieve results while others can do the job in three treatments. In most cases, multiple sittings are required to improve skin concerns such as scars, wrinkles, pigmentation, sun damage and texture.

The biggest downside to non-ablative laser resurfacing is the risk of burning, scarring and hyperpigmentation. Those with extra pigment need to use extreme caution with this modality as intense heat generated by lasers can cause PIH (post-inflammatory hyperpigmentation). The pain factor is also very high, so a topical or local anesthetic is absolutely necessary. 

CO2 Ablative Resurfacing

As far as intensity goes, ablative lasers are the clear winners in this category. Instead of delivering heat energy deep into the dermis, ablative lasers essentially obliterate the top layers of skin. These are the original lasers, using CO2 gas as one example, and the ones you associate with extreme redness, blisters and peeling.

CO2 Ablative Resurfacing is now mostly used by plastic surgeons to smooth deep wrinkles and treat serious sun damage. Because of the extremely high pain factor, this procedure is often performed during plastic surgery, when the patient is under sedation. Luckily, full ablation is usually one-and-done, without additional sessions required.

There is some good news when it comes to fully ablative resurfacing. Most CO2 devices these days offer the less intense fractional option. Similar to its non-ablative counterpart, CO2 gas is deployed in microscopic columns.

Patients undergoing fractional CO2 enjoy many of the same benefits of CO2 ablation; however, the fractional nature of this treatment results in less pain and suffering, and a quicker recovery. Even so, there is still considerable downtime which can be anywhere from 7-10 days. During this time it’s normal to experience swelling, redness, peeling and itching.

Fractional Ablative Radio Frequency (RF) Resurfacing

As consumer demand moves away from highly invasive procedures with a long recovery, the industry has had to keep up. The challenge has been to create skin rejuvenation technology that’s not only comfortable and with a shorter recovery, but one that also produces noticeable results. Enter the Venus VivaTM skin resurfacing treatment. 

The Venus Viva uses dual applicator technology to achieve minimally-invasive skin rejuvenation. The first application directs controlled nano-fractional RF energy into the dermis using tiny pins. This results in controlled ablation and tissue coagulation, helping to improve the appearance of wrinkles, pigmentation and texture issues. 

The second application is the DiamondPolarTM feature (patented multi-polar RF with pulsed electromagnetic fields). It goes even deeper, triggering a cascade of powerful healing processes such as the production of fibroblasts, blood cells and growth factors. 

Such a healing response deep in the dermis produces an even more profound skin revitalization effect for patients, such as skin tightening and improvement in advanced lines and wrinkles.

The benefits of Venus Viva are numerous with few complications. For darker skin tones, it’s a much safer option than laser, yet produces excellent results. It’s highly controlled and customizable, and downtime is relatively short. Most people can resume their daily activities within 24 hours. 

Ready to rejuvenate your skin? Whether you're interested in microneedling, RF microneedling, non-ablative or CO2 ablative laser resurfacing, or the Venus Viva skin resurfacing treatment, we have a solution for you. Visit Spotless Laser today to schedule your consultation.