Microneedling

Five days before

• Stop all retinoids. Tretinoin, retinol, retinaldehyde, adapalene. They thin the barrier and raise irritation risk during needling.
• Stop exfoliating acids. AHAs such as glycolic and lactic, BHAs such as salicylic. No exfoliating toners, serums or masks.
• Stop benzoyl peroxide.

Three days before, for PRP

• Stop over-the-counter anti-inflammatories. Ibuprofen, naproxen, fish oil, vitamin E and flaxseed oil reduce platelet activity, which directly undermines PRP. This matters more here than for any other treatment.
• Do not stop prescribed blood thinners or anticoagulants. Speak to the doctor who prescribed them and contact us so we can plan around them.

Two weeks before

• No waxing, threading, laser hair removal or dermaplaning on the area.
• No peels, laser or other microneedling.

Tell us before your appointment

• Any active breakout, open wound, rash or skin infection on the area. Microneedling is not performed over active inflammation or broken skin.
• Any history of keloid or hypertrophic scarring.
• Any clotting or platelet condition, for PRP.
• If you are pregnant or breastfeeding. This treatment is not performed during pregnancy.
• Recent sun exposure or an active tan, which raises sensitivity and pigmentation risk.
• Current medications, particularly immunosuppressants or corticosteroids, which affect healing.
• Any history of cold sores. A preventive antiviral will be prescribed. In deeper skin an outbreak after needling can cause pigmentation out of proportion to the outbreak itself.

The day itself

• Clean, product-free skin. No moisturizer, SPF or makeup on the area.
• Eat beforehand, particularly for PRP, since blood is drawn first.
• Be well hydrated. It improves PRP quality and supports healing.

The micro-channels created by needling are open. That is why the infusion works, and it is also why what touches your skin in this window matters more than usual.

• Redness and warmth are normal. Expect it to look like a mild to moderate sunburn.
• Apply nothing except what we have given you or approved for the first 24 hours.
• Do not touch, rub or press the skin.
• No exercise or anything that makes you sweat for 24 hours. Sweat introduces bacteria into open channels.
• No makeup for 24 hours, 48 preferred.
• Avoid heat: hot showers, saunas, steam rooms, hot yoga.
• Avoid direct sun. In the first 24 hours a hat or scarf is better than putting SPF over open channels.
• Sleep on a clean pillowcase. Bacteria on fabric cause breakouts when the channels are open.

Days 2 to 3

• Redness begins to subside. Mild peeling or flaking is normal as the skin regenerates.
• A gentle fragrance-free moisturizer is now safe, morning and evening.
• SPF 50 every morning from day two. Essential for protecting new skin and preventing pigmentation.
• Small breakouts in the days afterwards are a normal purging response and resolve on their own.
• No retinoids, acids or actives.

Days 4 to 7

• Skin should feel close to normal by day four or five.
• Normal gentle skincare resumes. No actives until day seven.
• From day seven, reintroduce retinoids and actives gradually, every other night for the first week. They enhance collagen remodeling and complement the treatment.
• No facials, peels or laser for two weeks.

Weeks 2 to 12

• Collagen remodeling continues. Results build over weeks and months.
• Most people see texture and pore improvement at four to six weeks. Acne scarring generally needs a series of three before the change is clear.
• Daily SPF 50 throughout the series and afterwards.

PRP

Platelet-rich plasma concentrates your own growth factors from a small blood draw. Because it comes from your own blood, allergic reaction is not possible.

• The healing response is more robust than serum, so expect slightly more redness and warmth in the first 24 hours.
• Avoid anti-inflammatories for three days afterwards as well. They blunt the inflammatory response PRP relies on to stimulate collagen.
• Stay well hydrated in the days after.
• Initial glow at one to two weeks. Texture and collagen change at four to eight weeks. Full results from a series of three at three to six months.

Serums

Serum infusion targets a specific concern. Which one is chosen depends on what we are treating.

• Hyaluronic acid for hydration, plumping and barrier support.
• Vitamin C for brightening, antioxidant protection and collagen support.
• Growth factor serums for collagen and elastin stimulation.
• Brightening serums with niacinamide, kojic acid or tranexamic acid, for uneven tone and post-inflammatory darkening.

• Recovery is similar to or milder than PRP.
• Immediate glow from hydrating serums. Brightening and texture at two to four weeks. Full results from a series at six to eight weeks.
• Reactions are rare. If you get unusual burning, itching or a rash after the initial redness has settled, contact us.

For deeper skin tones the single biggest factor in the outcome is not the treatment, it is what happens before it. Inflammation going into the session is the main driver of pigmentation afterwards. The goal is calm, well-prepared skin on the day.

Four weeks before the first session

• Calm the barrier first. Bland fragrance-free moisturizers with ceramides and niacinamide, a gentle non-stripping cleanser, no scrubs or exfoliating devices. Stop acids and retinoids early, two weeks out rather than five days.
• Consider a tyrosinase inhibitor. Starting two to four weeks beforehand primes the skin to resist pigmentation afterwards, and it is the highest-yield preparation for Fitzpatrick IV to VI. Options include hydroquinone, cysteamine, azelaic acid, tranexamic acid, kojic acid and arbutin. Which one is a prescription decision made at consultation.
• A low-inflammation preparatory treatment before the first session improves the starting point without adding inflammatory burden. A hydrating facial, a calming enzyme facial, red light therapy or an oxygen facial.
• Active acne is treated first. Needling through inflamed acne markedly worsens pigmentation in deeper skin. Options include the Aerolase in acne mode, a gentle mandelic or lactic acid peel, or topical treatment.
• Antiviral cover if you have any cold sore history.

How treatment is adapted

• Shallower initial depth, adjusted as we see how your skin responds.
• Fewer passes. The goal is stimulation, not maximum trauma.
• No chasing pinpoint bleeding. Bleeding as an endpoint indicates more inflammation than is needed and raises pigmentation risk.
• Longer intervals, at least six weeks between sessions for Fitzpatrick V and VI, so healing and inflammation resolve completely.