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So I was going through Dr.Rullan's website and couldn't help but notice a pop up that has the following info regarding rullan's combination regimen for acne scars in all skin types. Specifically, couldn't help but notice no mention of RF microneedling. Yes there is mention of microneedling but no RF... why do you guys think this is? Maybe patients of Dr.Rullan could shed some enlightenment? The quote is below for your reference:
QuoteQuoteWhen it comes to acne scars, Dr. Rullan emphasizes the concept of defect-oriented therapy, in which the choice of therapy depends on the specific type of scar. Ice pick scars are best treated with chemical reconstruction of skin scars (CROSS), which can be done with either trichloroacetic acid (TCA) 30-60-90-100% or carboxylic acid 88%. Dr. Rullan prefers the latter because it has less risk of scar widening. A cotton tip applicator or fine tip brush can be used for spot treatment of individual scars, and in his experience this treatment can be performed in all skin types with minimal risk of post-inflammatory hyperpigmentation. For rolling scars, he recommends subcision as the treatment of choice, with the goal of breaking the tethers under the skin. He uses an 18- or 22-gauge cannula rather than the Nokor needle. For boxcar scarring, multiple treatment options exist including CROSS, microneedling, fractionated erbium or CO2 laser resurfacing, and even 2-day phenol chemabrasion for more severe, generalized scarring. Finally, for atrophic scars, filler remains the preferred treatment.
Dr. Rullan shared his sequential combination regimen for acne scars in all skin types, as follows: 1) CROSS, 2) tumescent anesthesia (using 20-gauge spinal needle), 3) subcision, 4) microneedling or fractionated erbium or CO2 laser, and 5) fillers (after 2-4 sessions of steps 1-4). He repeats this regimen every 1-3 months, for a total of 2-4 treatments.
2 hours ago, anon09299 said:From my understanding the RF devices are still pretty new and expensive. I don't think it has anything to do with him not believing in the treatment or something like that.
Really though?hes one of the most successful acne scar specialists and laser companies are always giving physicians their machines for a discounted price, its hard for me to believe that RF micro needling isnt mentioned due to novelty or the price tag...
I was reading a few studies that found that CO2 had better results versus RF micro needling, see one here: https://www.journal.atmph-specialissues.org/uploads/179/8656_pdf.pdf
7 hours ago, Catharsis2018 said:Really though?hes one of the most successful acne scar specialists and laser companies are always giving physicians their machines for a discounted price, its hard for me to believe that RF micro needling isnt mentioned due to novelty or the price tag...
I was reading a few studies that found that CO2 had better results versus RF micro needling, see one here: https://www.journal.atmph-specialissues.org/uploads/179/8656_pdf.pdf
His treatments seem to be more focused on manual techniques especially acids. Every doctor has their specialty and you can't really expect them to be able to perform everything. For example he doesn't seem to do a lot with lasers either.
Those results do not surprise me. CO2 when it works seems to have the best result however carriesextremely high risk of hyperpigmentation especially with darker skin types. RF micro needling from my understanding is much safer, can be performed on darker skin types and gives decent results.
13 hours ago, Catharsis2018 said:Really though?hes one of the most successful acne scar specialists and laser companies are always giving physicians their machines for a discounted price, its hard for me to believe that RF micro needling isnt mentioned due to novelty or the price tag...
I was reading a few studies that found that CO2 had better results versus RF micro needling, see one here: https://www.journal.atmph-specialissues.org/uploads/179/8656_pdf.pdf
Co2 will always give more textural improvement than RFM simply due to the fact that youre coagulating the f*ckout of the upper layers of the skin
REMEMBER: coagulation is key to fixing skin whether its scars,wrinkles, laxity.
deeper scars need deep coag superficial scars need superficial coag
im a skin type 3/4 and have pushed the limit in terms of lasers and never got PIH thanks to hydroquinone
From Davin Lim's website, this is how he says about RFM:
QuoteRF is best suited forearly onset mild to moderate acne scar.Early scarring can be defined as acne scars less than 3 months old. RF can be combined with anti-acne treatments. 3-5 treatments are ideally needed for optimal results. Fractional RF is the safest method of acne scar removal in darker skin types.