Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
blairlikescats

Choice between microneedling or erbium laser with Dr. Rullan?

Recommended Posts

I have rolling scars and a couple of ice pick scars. I can take time off, so down-time isn't a big deal for me.

In the first picture, I increased the contrast and definition of the photo so you can see what my scars look like. I'm also wearing foundation in the first picture, and sometimes I think foundation makes my scars more visible. The other two photos are without editing, but I think my skin looks worse in real life, lol.

I scheduled my first treatment with Dr. Rullan (in a few weeks).

The package he recommended was "Subcision, Cross Carbolic, Microneedling or Erbium Laser." I'm not sure which to choose between (microneedling or erbium laser). I told them microneedling for now, but I can change it to the laser. It's the same price either way. Should I go with the Erbium Laser, instead?

 

20180620_ThePerfectHeadshot.com_2018_06_20_Sophia_Tinsley100.jpg

DSC00456.JPG

DSC00402.JPG

Link to post
Share on other sites

Frankly, I don't think it would matter either way. Most of the improvement will come from subcision and phenol anyway. Ask Rullan if you could get a filler instead.

Edited by Sirius Lee
Link to post
Share on other sites

agreed with sirius lee. i've done both. erbium was a lot more tolerable for me (pain wise) compared to microneedling but I feel microneedling is more effective (since needles are actually puncturing your skin). if you never done either, go with microneedling.

Link to post
Share on other sites
On 7/1/2020 at 3:10 PM, Sirius Lee said:

Frankly, I don't think it would matter either way. Most of the improvement will come from subcision and phenol anyway. Ask Rullan if you could get a filler instead.

Hm, well there are some mixed reviews on Rullan's fillers so I would probably get that done somewhere else, if I feel that I need it. I will likely do one or two more subcisions with Rullan before I do a filler. I'm trying not to rush into something like that.

On 7/2/2020 at 12:09 AM, gynoscar said:

agreed with sirius lee. i've done both. erbium was a lot more tolerable for me (pain wise) compared to microneedling but I feel microneedling is more effective (since needles are actually puncturing your skin). if you never done either, go with microneedling.

Yeah, a lot of times people suggest hand methods before going to lasers. I was just second-guessing my decision to go with microneedling because I feel like I can get that done anywhere; however, a laser is expensive on it's own, so I was thinking that maybe the laser was better bang-for-buck type of thing.

$1750. It seems to be his new price. I read that his price jumped quite a bit because he used to only charge ~$1250 for the package.

Link to post
Share on other sites

If I had to choose between those two, I would go with microneedling. It seems that most people feel that lasers should be reserved for the very end of the scar journey. BA has mentioned that Dr. Rullan is not the best with lasers.

If it were me, I'm not sure if I would even get microneedling there. I'd rather save the money for another round of subcision and Cross. You can get the Derminator and microneedle yourself. Or you can use the money for fillers.

By the way, Phenol/carbolic Cross may widen and deepen your scars just like TCA Cross. Dr. Rullan mentioned in a few videos that it doesn't but I did not find this to be true. I had several sessions with him. After my first visit, I didn't see changes with my scars. After my second, I noticed that several scars looked worse while a few got slightly better. 

 

Link to post
Share on other sites
1 hour ago, Amanda Hall said:

If I had to choose between those two, I would go with microneedling. It seems that most people feel that lasers should be reserved for the very end of the scar journey. BA has mentioned that Dr. Rullan is not the best with lasers.

If it were me, I'm not sure if I would even get microneedling there. I'd rather save the money for another round of subcision and Cross. You can get the Derminator and microneedle yourself. Or you can use the money for fillers.

By the way, Phenol/carbolic Cross may widen and deepen your scars just like TCA Cross. Dr. Rullan mentioned in a few videos that it doesn't but I did not find this to be true. I had several sessions with him. After my first visit, I didn't see changes with my scars. After my second, I noticed that several scars looked worse while a few got slightly better. 

 

Dude I have the same experience with phenol cross. I wrote in a post about observing a few scars appearing deeper/wider.

Could you elaborate on changes to your scars in response to the treatments you've received?

Link to post
Share on other sites
2 hours ago, Amanda Hall said:

By the way, Phenol/carbolic Cross may widen and deepen your scars just like TCA Cross. Dr. Rullan mentioned in a few videos that it doesn't but I did not find this to be true. I had several sessions with him. After my first visit, I didn't see changes with my scars. After my second, I noticed that several scars looked worse while a few got slightly better. 

Can't speak for Phenol, but sometimes scars do widen with TCA. But, at the same time, they tend to get shallower.

Regardless, there are inherent risks involved with any invasive treatment. Don't naively think everything will turn out to be rosy. Moreover, don't expect hand-holding from the doctors. Once the treatment is over, that's it. They're done with you. That's the sad fact of today's world of medicine. I won't say they're unethical, but I can't help but question what their priority is: patient or money?

Link to post
Share on other sites

I'd go with the erbium if I had to choose between the microneedling and erbium. Microneedling wrecked my skin. I had it done by a professional, and it did nothing for my scars. Maybe if you are under 30 years of age, your skin might regenerate better, but I wouldn't recommend it based on my experience especially if you are over 30 years of age. The erbium should help with your discoloration. An erbium or ND Yag would help more with the discoloration than for the indented acne scar. I can see some slight redness or brown areas where the acne scars are located... by removing the color will help with the overall appearance. Prolonged redness can lead to deeper indents. Microneedling might make the discoloration worse

Link to post
Share on other sites

Is there an option to do neither?  Microneedling is not worth it to me because I haven't seen much compelling evidence it truly helps scarring.  There's tons of conjecture and marketing pushing it, but I still have not seen anything worth writing home about.  

If possible, I think you should just save money because the subcision will be doing the heavy lifting anyway.

Link to post
Share on other sites

walkietalkie - The ones that I noticed negative changes to were flatter and wider boxcar scars that I had. But I also had an ice pick type of scar that also widened and got deeper. Because of some of the videos I saw on YouTube with Dr. Rullan, I thought Phenol/carbolic Cross was much safer than TCA Cross (one of the main reasons I went down to SD to see him) so that's why I thought treating boxcars wasn't that much of a risk. I think Cross does work but most people don't have shallow scars; rather, they have deeper scars which can't get worse so Cross can only be positive. Also, for some scars, redness persists longer than others... I'm talking about a month at least.

Serius Lee - You are right. Dr. Rullan was such a sweetheart during my first visit. He took care of me and my appointment was a good amount of time. But not only did his rates spike, I didn't get the results that other people got. I thought that based on some YouTube videos, I would be closer to ending my scar journey. I guess I didn't have the luck that Elaine After Accutane got. Also, I didn't like the appointment process. You have go to through Amy but she drops the ball on most things.  If you want to make an appointment, email her (write again if you don't hear back). Make sure you get the quote in writing.

acnescarcure - Microneedling can ruin your skin. Yes! I've had bad results from microneedling (scarring and hyperpigmentation) but I think it depends on the device and depth. There was a video of Dr. Rullan doing microneedling and he doesn't go as aggressively as other people which is good, but can't you do this yourself for much cheaper?  Lasers do and can work but are much more expensive and have risks as well.

dazzed - I was convinced to get microneedling done because some people said it helped. Didn't help me (it gave me more scars) but all our scars and healing powers are different, right? It's also a long-term process. That's why I decided to do it myself and save the money. Subcision seems to help people with rolling scars but I didn't have lots of those - mainly boxcar scars. I got subcision done during my first treatment with Dr. Rullan and my face looked great when it was swollen, but that was just temporary. I decided that boxcars are best treated by other modalities. 

 

 

 

Link to post
Share on other sites
21 hours ago, acnescarcure said:

I'd go with the erbium if I had to choose between the microneedling and erbium. Microneedling wrecked my skin. I had it done by a professional, and it did nothing for my scars. Maybe if you are under 30 years of age, your skin might regenerate better, but I wouldn't recommend it based on my experience especially if you are over 30 years of age. The erbium should help with your discoloration. An erbium or ND Yag would help more with the discoloration than for the indented acne scar. I can see some slight redness or brown areas where the acne scars are located... by removing the color will help with the overall appearance. Prolonged redness can lead to deeper indents. Microneedling might make the discoloration worse

That’s interesting. I thought that microneedling would be the safer option than laser. I know there are a lot of risks associated with laser like hyperpigmentation, but I guess microneedling does as well. Can you explain further how microneedling ruined your skin?

 

17 hours ago, Amanda Hall said:

acnescarcure - Microneedling can ruin your skin. Yes! I've had bad results from microneedling (scarring and hyperpigmentation) but I think it depends on the device and depth. There was a video of Dr. Rullan doing microneedling and he doesn't go as aggressively as other people which is good, but can't you do this yourself for much cheaper? Lasers do and can work but are much more expensive and have risks as well.

There are some microneedling products out there. Banish may be a name you’ve heard. These devices aren’t as aggressive on the skin because the length of the needles is very short. These results are normally not as good as doctors’ devices, but it can be great to do if your acne scars are minor or you just want some regular, inexpensive upkeep. There are benefits to at-home microneedling, but they are not as noticeable as doctor-performed microneedling.

 

Also, I’m only speaking for the US. I’m pretty sure that in some other countries, you can get microneedling products that go beyond 0.5mm. Be cautious though when using these products. Microneedling with longer lengths is a more aggressive treatment so the risks of doing damage are much higher.

Link to post
Share on other sites

squeezeMcQueen - Both microneedling and Erbium have risks and there are lots of factors so one could be riskier than the other depending on the settings.

When I got microneedling done for the first time, I went to a med spa. I read reviews about microneedling, watched YouTube videos, and read some articles online. It seemed much safer than lasers. However, I ended up with more scarring. Maybe it was due to the nurse who went really deep or aggressive. I remember her making many passes (too many?) - they felt aggressive but that could just be the depth of the needles (too deep?). It could have been that my face wasn't properly moisturized during recovery. Maybe it's that my skin is more sensitive than others. I'm not sure. But I got new scarring and hyperpigmentation. No bueno.

 

I've only had Erbium used on me a few times but that was for some spots after surgery so I can't say I'm experienced with this treatment. When I got zapped, it was like nothing. There was no blood, no swelling, no marks. I think the PS who lasered that spot didn't go deep at all. From what I know and have seen (reference Dr. Lim's YouTube videos) Erbium can go deep, but it depends on the operator. Light Erbiu will probably not do much for scars and can be safe. But if you go deeper, it's riskier, and probably as risky or riskier than microneedling. So all in all, it depends.

Link to post
Share on other sites
6 hours ago, squeezeMcQueen said:

That’s interesting. I thought that microneedling would be the safer option than laser. I know there are a lot of risks associated with laser like hyperpigmentation, but I guess microneedling does as well. Can you explain further how microneedling ruined your skin?

 

There are some microneedling products out there. Banish may be a name you’ve heard. These devices aren’t as aggressive on the skin because the length of the needles is very short. These results are normally not as good as doctors’ devices, but it can be great to do if your acne scars are minor or you just want some regular, inexpensive upkeep. There are benefits to at-home microneedling, but they are not as noticeable as doctor-performed microneedling.

 

Also, I’m only speaking for the US. I’m pretty sure that in some other countries, you can get microneedling products that go beyond 0.5mm. Be cautious though when using these products. Microneedling with longer lengths is a more aggressive treatment so the risks of doing damage are much higher.

I had microneedling with PRP done on my entire face. The good or smooth areas of my skin healed up fine. But the areas that had sun damage, the areas that had redness, and some areas that had shallow indents were affected by it. Some of the red / discolored areas became slightly indented after the procedure and I was in shock and in disbelief. I took many photos of my skin before the procedure and some of these discolored areas were once smooth and some had only very slightly shallow indents. But after the procedure, some of the discolored areas and shallow scars became more indented. I took photos of my skin after the procedure and definitely noticed the difference. Plus the texture of the skin became worse... the redness and discoloration became slightly worse and looked like I had some type of dermatitis and it gave an orange-peel type texture with lots of micro-wrinkles and large pores. While the rest of the smooth skin healed up, the areas that had discoloration had prolonged and looked like some fresh new red marks. When I look close-up at my skin in the mirror with light reflecting on the surface of my skin, I can see a few new indentations after the procedure, and plus the shallow indentations had gotten slightly deeper. Even after about 2 months after the procedure, it looked like a whole area of my face was covered in scars due to the discoloration, the enlarged pores, and the indents... it just didn't look like it did before. The older scars that I had maybe 20 years ago weren't affected by it, and it didn't help with those scars either. If someone has lots of a mix of deep and severe scars, maybe they can take a chance to slightly smoothen it out if it would work. But for those who have shallow or minor scars, I think the risks will outweigh the possible gains. About 4 months after the procedure, my skin texture has gotten a bit better after some basic skincare and letting the skin rest, but it hasn't retuned back to its previous state.

If you do a google search with these exact keywords: "Realself microneedling worse", you will see photos and stories of beautiful women's skin that was ruined by microneedling. I didn't think there was any truth to these reviews until it happened to me. But the results could be different for different people. But I highly doubt it would remove acne scars 

Link to post
Share on other sites

Hey everyone,  here's an update:

During my appointment with Dr. Rullan, he actually recommended the Erbium Laser instead of microneedling for my face. I didn't even need to mention my delimna, he just touch my skin and took a closer look in person, and then he suggested the laser for the type of scars/skin I have.

So, we did the package with the laser.

Now, it's been a little over a week since my appointment, and I see significant improvement in my scarring. I meannn... maybe 60% improvement so far ? Maybe even more than 60%... Idk how to gauge the percentage of improvement. Hopefully nothing retethers, though.

My face is a little yellow from the bruising, so it's still healing. The swelling is down, and I still have some scabs that will probably come off soon.

Link to post
Share on other sites
2 hours ago, blairlikescats said:

Now, it's been a little over a week since my appointment, and I see significant improvement in my scarring. I meannn... maybe 60% improvement so far ? Maybe even more than 60%... Idk how to gauge the percentage of improvement. Hopefully nothing retethers, though.

Most of that will be due to swelling, so it's advisable to assess after 1 month, preferably after 3 months.

Link to post
Share on other sites

Wow @ the people saying their scar got wider after cross.

I'll have to watch closely at mine then.

I had erbium pixel done last year and on the 4th month my skin got noticably better. But after the 8th month or so, it looked like it went back to the way it was before. Similar thing happen with rf genius. Are some scars just resistant to treatments? 

Link to post
Share on other sites
On 8/4/2020 at 2:13 PM, Sirius Lee said:

Most of that will be due to swelling, so it's advisable to assess after 1 month, preferably after 3 months.

Sirius is right. It's probably swelling. I've experienced this. Swelling stays for a good amount of weeks to months and you think you've gotten great results. Doctors know this and take "after" photos when there's still swelling so they can show future patients that the results are spectacular.

 

On 8/6/2020 at 10:14 PM, dirigo39 said:

Wow @ the people saying their scar got wider after cross.

I'll have to watch closely at mine then.

I had erbium pixel done last year and on the 4th month my skin got noticably better. But after the 8th month or so, it looked like it went back to the way it was before. Similar thing happen with rf genius. Are some scars just resistant to treatments? 

It depends on how deep your scars are. I've had shallow scars improved by Total FX (fractional CO2 laser). CO2 is more powerful than Erbium so you'll need a number of Erbium treatments to see results.

I've had a YAG laser zap my skin and that area instantly got plumped up, but it was only temporary. Had another Erbium treatment for a surgical scar and that did nothing.

Link to post
Share on other sites
On 8/7/2020 at 12:14 AM, dirigo39 said:

Wow @ the people saying their scar got wider after cross.

I'll have to watch closely at mine then.

I had erbium pixel done last year and on the 4th month my skin got noticably better. But after the 8th month or so, it looked like it went back to the way it was before. Similar thing happen with rf genius. Are some scars just resistant to treatments? 

Yeah, I have an ice pick scar on my cheek that seems to look bigger from the cross, but it looks more shallow.

Basically, it looks wider but more shallow than before. I imagine more crosses are needed to level it out.

Link to post
Share on other sites

Wow, can't believe Rullan is charging ~$1,700 for the package deal. It used to be under $1,000 a couple years ago. Even accounting for inflation, that's a ridiculous price jump. 

Link to post
Share on other sites
18 hours ago, kitsliv45 said:

Wow, can't believe Rullan is charging ~$1,700 for the package deal. It used to be under $1,000 a couple years ago. Even accounting for inflation, that's a ridiculous price jump. 

What is included in the package deal?

Link to post
Share on other sites
On 8/14/2020 at 7:03 AM, kitsliv45 said:

Wow, can't believe Rullan is charging ~$1,700 for the package deal. It used to be under $1,000 a couple years ago. Even accounting for inflation, that's a ridiculous price jump. 

The office has gotten much more demand. People on this forum discover Dr. Rullan through other members here and from some vloggers like [Removed]. Dr. Rullan has two things going for him: subcision and Phenol Cross.

A small percentage of doctors do subcision so he'll get business there. In addition, only a few doctors in the US do Phenol Cross so that's even more reason for people to see him.

I read a post on this forum that said it was due to inflation or expenses going up but we all know that's BS. The office knows that they're getting more demand so why not charge more? It sucks for scar patients because we need multiple treatments so that's a good amount of money out of our pocket for repeat visits. 

Are the treatments all worth the hype? It depends on your scarring, but so far enough people are saying yes to keep Dr. Rullan's revenue healthy. This lady said she got great results. https://www.acne.org/forums/topic/385160-carbolicphenol-cross-subcision-with-dr-rullan-journey-with-final-results/

I didn't see the same results but that's probably because of my scars (mostly boxcars). Subcision didn't make any noticeable changes to my scars but I wasn't that hopeful in the first place. Phenol Cross improved a few scars (I think) but it made several a little wider/deeper. But I'm just one person.

The bottom line is that you don't know unless you try, and there are document instances in which people have stated that his treatments work. Is the cost worth it? It's up to you. Compared to other doctors in LA (Dr. Ripoffs) he's affordable.

Edited by Ishayat
Removed promotional content
Link to post
Share on other sites
On 8/15/2020 at 3:11 AM, Amanda Hall said:

The office has gotten much more demand. People on this forum discover Dr. Rullan through other members here and from some vloggers like [Removed]. Dr. Rullan has two things going for him: subcision and Phenol Cross.

A small percentage of doctors do subcision so he'll get business there. In addition, only a few doctors in the US do Phenol Cross so that's even more reason for people to see him.

I read a post on this forum that said it was due to inflation or expenses going up but we all know that's BS. The office knows that they're getting more demand so why not charge more? It sucks for scar patients because we need multiple treatments so that's a good amount of money out of our pocket for repeat visits. 

Are the treatments all worth the hype? It depends on your scarring, but so far enough people are saying to keep Dr. Rullan's revenue healthy. This lady said she got great results. https://www.acne.org/forums/topic/385160-carbolicphenol-cross-subcision-with-dr-rullan-journey-with-final-results/

I didn't see the same results but that's probably because of my scars (mostly boxcars). Subcision didn't make any noticeable changes to my scars but I wasn't that hopeful in the first place. Phenol Cross improved a few scars (I think) but it made several a little wider/deeper. But I'm just one person.

The bottom line is that you don't know unless you try, and there are document instances in which people have stated that his treatments work. Is the cost worth it? It's up to you. Compared to other doctors in LA (Dr. Ripoffs) he's affordable.

I thought subcision helped with boxcars? How many subs have you had?

Boxcars is what I have and I'm 6 days post op and swelling has completely calmed down and the scars look exactly as they did before. 

Edited by Ishayat
Removed promotional content
Link to post
Share on other sites
4 hours ago, dirigo39 said:

I thought subcision helped with boxcars? How many subs have you had?

Boxcars is what I have and I'm 6 days post op and swelling has completely calmed down and the scars look exactly as they did before. 

I only had one subcision treatment. I did it just out of hope. Most people know that multiple sessions of subcision are needed to see optimal results but I don't want to spend more money getting marginal results. My scarring isn't as bad as other people's.

Rolling scars are the best for improvement with subcision. Ice pick scars won't be improved.

Look into lasers. There are risks but these are better for boxcars in my opinion.

Link to post
Share on other sites

For boxcars, forget about filling the holes. What you want is to sand down the edges as much as possible. It's the hard edge that give away your scar when the light bounces off of it. Laser is not as effective as TCA for this purpose IMO. 

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes


×