When it comes to combination therapy, the question is not simply which procedures can be performed together. It is whether the skin is ready for the next step.

In MDPen’s Corrective Microneedling™ Combination Therapies webinar, Awilda “Willie” LaBonne, PhD, PA-C, outlined an approach to treatment planning centered on healing, patient selection, and sequencing. Her guiding principle: “Timing beats technique.

Begin With Healing

Microneedling initiates a wound-healing response that continues beyond the treatment appointment. Dr. LaBonne described four overlapping phases of repair: hemostasis, inflammation, proliferation, and remodeling.

Immediately after treatment, a clot forms and the healing cascade begins. Inflammation is discussed as occurring from the time of injury through approximately day five. Proliferation follows, with new blood vessels and collagen formation occurring from about day three through the first three weeks. Remodeling then continues from approximately week three to three months. To learn more about the role of angiogenesis and tissue perfusion in the healing process, explore our related article: “Harnessing Angiogenesis:  The Clinical Edge of High-Density Corrective Microneedling.” 

This timeline informs the decision to add, delay, or avoid another procedure. Rather than moving directly to a device or treatment modality, Dr. LaBonne advised clinicians to begin with the condition of the tissue. “What phase is this tissue in?” she asked. 

Supportive vs. Additional Trauma

Dr. LaBonne discussed several modalities she may use to support the post-microneedling healing period, including PRP, PRF, PDRN, hyaluronic acid, LED light therapy, topical growth factors, and copper peptides.

In her treatment approach, PRP, PRF, PDRN, topical growth factors, and hyaluronic acid may be incorporated on the same day as microneedling. She described LED as a modality that may be used immediately after treatment or during the first 72 hours. 

Radiofrequency microneedling may also be paired with corrective microneedling in the same visit. When both are performed, Dr. LaBonne’s sequence is RF microneedling first, followed by corrective microneedling.

The distinction, she explained, is whether the added treatment supports what the tissue is already doing or creates additional trauma during a period of healing. As Dr. LaBonne put it, “A therapy earns same-day status when it reinforces what the tissue is already doing.

When to Separate Treatments

Not every modality belongs in the same session as corrective microneedling. Dr. LaBonne advised against combining microneedling with ablative procedures, medium or deep chemical peels, or injections on the same day.

Dr. LaBonne also discussed how timing may vary when corrective microneedling is incorporated alongside modalities such as RF microneedling, LED light therapy, PRP, PRF, PDRN, neurotoxin, dermal filler, chemical peels, lasers, dermaplaning, and microdermabrasion. Rather than presenting a universal schedule, she emphasized evaluating healing, barrier recovery, treatment intensity, and the patient’s individual presentation before determining when to proceed. For a closer look at the timing considerations and sequencing discussed for each modality, watch the full Corrective Microneedling™ Combination Therapies webinar replay. 

Tissue Readiness Comes First

The pre-treatment consultation is where combination planning begins. Dr. LaBonne emphasized assessing skin-barrier health, recent procedures, current skincare, medical history, and the patient’s healing capacity.

She discussed deferring or modifying treatment in the presence of active infection, open lesions, active inflammatory skin disease, recent procedures, barrier disruption, active autoimmune disease, uncontrolled diabetes, a history of keloid formation, or recent isotretinoin use. 

Fitzpatrick skin type, melasma, rosacea, smoking, anticoagulant use, and diabetes were also discussed as factors that may warrant a more conservative approach. For patients with melasma or rosacea, Dr. LaBonne recommended reduced needle depth and longer intervals when appropriate. She also cautioned against same-day thermal-energy combinations for patients with melasma or rosacea. 

Her approach is not necessarily to rule out treatment entirely. In some cases, she may recommend addressing a skin concern or supporting barrier recovery first, then reassessing for corrective microneedling at a later date. For patients whose healing capacity or barrier status is uncertain, her guidance was direct: “When in doubt, extend, don’t shorten.

The Healing Timeline

Patients should understand that healing and remodeling take place over weeks, not hours. Dr. LaBonne outlined a practical post-treatment timeline:

• Immediately after treatment: The initial healing response begins. In her practice, supportive topical products such as PDRN, PRP, or exosomes may be used during or immediately after microneedling.
• Days 1–3: Redness, tenderness, and sensitivity may occur. She advises avoiding unnecessary heat exposure, including hot showers, hot tubs, and extended heat from cooking.
• Around day 5: The clinician can assess recovery before reintroducing active skincare ingredients, such as vitamin C, retinoids, or acids.
• Weeks 4–6: Depending on healing and the clinical goal, this may be an appropriate window for another microneedling session or other subsequent treatment.
• Around week 12: Remodeling continues, and treatment outcomes may become more visible over time 

Treatment intervals should be based on how an individual patient is healing, rather than on a predetermined schedule.

Patient Education Is Part of the Plan

Combination therapy is not limited to what happens in the treatment room. Dr. LaBonne repeatedly emphasized patient education, including discussions around expected healing, skincare use, treatment intervals, sun exposure, and realistic expectations.

She also described presenting treatment plans rather than isolated appointments. In her practice, she often recommends a series of microneedling treatments spaced four to six weeks apart, with maintenance considered later based on the patient’s needs and response. 

Dr. LaBonne encourages providers to frame treatment as an ongoing process. “This is actually a journey that you’re going to go through,” she said when discussing the need for realistic expectations and patient commitment. 

Before adding another modality, clinicians should assess healing, patient-specific risk factors, and the desired treatment outcome. As Dr. LaBonne framed it: “Should I combine today?”

Put It Into Practice

Ready to explore a more thoughtful approach to combination therapy? Watch the full Corrective Microneedling™ Combination Therapies webinar to hear Dr. LaBonne’s clinical insights, or book an appointment with MDPen to discuss how Corrective Microneedling™ may fit into your practice.

Frequently Asked Questions

1. What makes a treatment appropriate to combine with corrective microneedling?

Dr. LaBonne’s framework begins with tissue readiness. A treatment may be considered for the same visit when it supports what the skin is already doing during healing, rather than adding unnecessary trauma. She discussed modalities such as PRP, PRF, PDRN, hyaluronic acid, LED light therapy, and topical growth factors in the context of supportive care.

2. Can RF microneedling and corrective microneedling be performed in the same appointment?

In Dr. LaBonne’s practice approach, they may be performed during the same visit. When both treatments are used, she completes RF microneedling first, followed by corrective microneedling. Treatment decisions should still be based on the patient’s skin condition, history, goals, and healing capacity.

3. Which treatments should not be combined with microneedling on the same day?

During the webinar, Dr. LaBonne advised against pairing corrective microneedling with ablative procedures, medium or deep chemical peels, or injections during the same session. She also discussed evaluating recent laser treatments, peels, fillers, and neurotoxin before proceeding with microneedling.

4. When can patients resume active skincare after microneedling?

Dr. LaBonne discussed assessing the skin around day five before reintroducing active ingredients, including retinoids, vitamin C, and certain acids. The timing should be based on how the patient’s barrier has recovered rather than on a fixed schedule.

5. Who may need a modified or delayed treatment plan?

Patients with active infection, open lesions, active inflammatory skin disease, barrier disruption, recent procedures, uncontrolled diabetes, active autoimmune disease, recent isotretinoin use, or a history of keloid formation may require treatment to be delayed or modified. Melasma, rosacea, smoking, anticoagulant use, and Fitzpatrick skin type may also warrant a more conservative plan.

Watch the full Corrective Microneedling™ Combination Therapies webinar to hear Dr. LaBonne’s clinical insights, or book an appointment with MDPen to discuss how Corrective Microneedling™ may fit into your practice.