The active FX fractional CO2 laser a good treatment method for more superficial problems. These include lesions in the epidermis or upper level of the skin, such as pigmentation changes and very fine wrinkles. 

To treat the deeper lines, wrinkles and acne scars, I will first treat with the Deep FX and then go over the areas again with the Active FX. I agree with the other physicians, that the manufacturer's recommendations for power settings are conservative and that in experienced hands, the laser is used more aggressively, yet being mindful of the areas being treated. 

I think with any medical procedure, it's important for the treating physician to be honest and realistic with the patient as to what to expect, in terms of postoperative recovery time, pain, and results.  There are many patients that I've treated with a single treatment and other patients such as those with acne scars, I explain that they will need multiple treatments.

As with most resurfacing procedures, whether they are chemical peels or laser resurfacing, the deeper one goes, the more effective the results, and the more downtime.