Acne scarring and facial scars do need more intense treatment settings for better outcomes. Most of my acne scarring patients will have settings between 50-70 for the milli-joules. As already mentioned, it is NOT common to see a result after 2 treatments with the Fraxel restore. For scarring, it will take between 4-6 treatments for most patients. Even though most patients with facial scars need more intense treatment settings, there are patients that cannot tolerate those settings and will need to turn the settings down. These patients will likely not obtain optimal results and will likely need more treatments for better results.
I have had many patients start at 45 mJ on their first treatment and then I increase the settings on the subsequent treatments. It is hard to make a generalization that 45 mJ is bad for all patients, but it is a little low for scars.
The Fraxel repair laser can go deeper but will have a substantially longer "downtime." Good luck with your procedure.
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