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Laser Treatment for Acne Scars

I am looking for a way to get rid of acne scars. Heard good things about some laser skin treatments but i don't know how to choose between them all because there are so many laser treatments that are said to work on lots of problems, but i really just want to know which one works the best on acne scars.

Doctor Answers 24

Laser or Dermabrasion?


If the question was what is the best laser for treatment of acne scarring? The answer would unequivocably be the CO2 laser. The reason for this is that the best results are typically obtained with the depth of injury and the extent of and depth of the thermal injury of the treatment.

CO2 laser creates a great degree of collateral thermal damage and consequently produces the most dramatic results when it comes to correcting acne scarring and/or effacement of lines and wrinkles. The problems with CO2 laser treatment are extended downtime, prolonged erythema (redness), and eventual loss of pigmentation that invariably occurs with this modality.

This leads to the next topic, a more old fashioned, but tried and true treatment for acne scarring and scar revision.


Dermbrasion (as opposed to microdermabrasion) is an older modality which uses a rotating diamond tipped fraise (wheel) to remove the epidermis and portion of the dermis. The extent of the injury to be corrected is determined by the depth of injury created, which is gauged by the Surgeon's eye and experience. A depth of injury comparable to CO2 laser treatment is feasible with Dermabrasion. However, several factors make Physicians less comfortable with Dermabrasion than they perhaps should be:

  1. It is a very technically dependent treatment,
  2. Wide availability of a variety of lasers which produce a fairly uniform depth of injury based on the individual laser and the laser settings.

The aesthetic problem with acne scarring is caused by topographical irregularities, catching shadow and light. The benefit of Dermabrasion is that scars can be selectively planed down to be less noticable. The benefit Dermabrasion carries over CO2 laser is less thermal injury, far less chance of hypopigmentation (loss of pigmentation), and a much smaller window of erythema (redness of the face).

Due to its benefits, I incorporate Dermabrasion regularly into my practice for purposes of acne scarring and scar revision.

Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 61 reviews

CO2 laser is the best for acne scars

I believe that the CO2 laser will give the best results for scars of the face. The best of these is the Fraxel re:pair Laser. This uses fractional technology, which has eliminated the risks of further scarring or hypopigmentation.

Nothing is going to remove all the scars, but with one or two treatments with the Fraxel re:pair, it should be significantly better.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Choice is less complicated with an experienced provider

The reason there are so many options for acne scar correction, is because there are different types of acne scars and there are relative strengths and weaknesses to all modalities to correct or improve acne scars. It is therefore very important to seek the advice of a board certified dermatologist with experience in all modalities in order to pick the one best for you.

  • Mild scars? Perhaps just SilkPeel or a series of peels is necessary.
  • Can't afford downtime? Cooltouch might be perfect.
  • Deeper scars? Fraxel Re:Store has been a true breakthrough, but does have 1-3 days of swelling that you must be prepared to experience.
  • Active acne? Isolaz may be for you.
  • Finally, severe scars may benefit from true resurfacing either with traditional dermabrasion, or a fractional CO2 laser device like Juvia or Fraxel Re:Pair. These procedures have at least one week of social downtime, but give the most dramatic result.

Please get the advice from someone familiar with the options and prepared to provide the one best for you.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 12 reviews

Acne Scarring

There are a few different lasers that can treat acne scarring. The most commonly used lasers are the Pixel and the Fraxel laser. The Pixel is a one time treatment but has about 7-10 days downtime after, the Fraxel has no downtime but needs to be repeated monthly for a series of 4-6 treatments. After either treatment you need to wear sunblock daily. Depending on the type of scars you have your doctor can suggest which treatment will work best.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Best laser for acne scars

The best laser to treat acne scars depends on the depth of the scar, your skin tone, the amount of downtime you can afford, your tolerance for discomfort during a procedure, and your budget. Ablative treatments like CO2 laser and dermabrasion give the most dramatic result, but there can be risks of pigmentation problems and a week of downtime. Fractionated lasers or IPL treatments have minimal downtime, but they may not give very dramatic results.
The only way to know for sure what the best treatment for you will be is to see a physician in person who treats acne scars routinely. I highly recommend getting more than one opinion so you can compare the approaches. If two or three plastic surgeons or dermatologists tell you the same thing, then you can be more confident that it's the best treatment for you.

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 24 reviews

Laser and Other Treatments for Acne Scars

Fractional CO2 Laser vs other treatments for Acne Scarring
As severe acne scars, isolated or generalized, involve a deep scar process that extends to the deep dermis and sometimes even deeper it would be unusual to see dramatic differences after a single Fractional CO2 laser treatment. Realistic expectations are important and one should expect improvment but not total correction with each treatment. In my own experience I have not found a significant difference in results between a Fractional CO2 treatment and the Obagi Blue Peel. Dermabrasion and Ablative lasers including confluent CO2 lasers are more helpful but have the significant increased risk of permanent hypopigmentation and post inflammatory hyperpigmentation. It takes several months to see the full effects of collagen remodelling.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 76 reviews

Many treatments for acne scars

There are many different treatments for acne scars and there is not one that works for every patient. The first step is to ensure that any active acne is under control. The next step is to determine the best course or courses of treatment. This may include lasers, dermabrasion, dermaroller, excision, fillers, or other options. Finding a facial plastic surgeon, dermatologic surgeon, or plastic surgeon who offers a variety of treatments is going to be your key. Don't be swayed by advertising pictures which promise miraculous results as most single treatments will get about a 50% improvement (there are some exceptions).

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

ProFractional Therapy

Acne scars are best treated with a fractionally ablative laser. Sciton's ProFractional Therapy is an Erbium: YAG laser that gives the physician very precise depth control and optional coagulation of the ablated tissue.  The wound-healing process produces fibroblasts that generate new collagen, plumping the skin and correcting skin imperfections. In fractional resurfacing, the laser removes pinpoint columns of skin, leaving the surrounding tissue intact to promote rapid healing. CO2 lasers come with a high risk of hypopigmentation and a longer downtime than Erbium. Hope this helps!

John W. Antonetti, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 3 reviews

Laser treatment for acne scars

The best results for improving acne scars on the face are achieved with fractionated CO2 laser resurfacing. Acne scars on non-facial areas can also be treated safely. The fractionated mode limits recovery time and side effects but necessitates multiple treatments. There are different fractionated CO2 laser systems available under different names. They have the same basic capabilities but there are some differences among the different lasers. Impressive results have been achieved at The Laser and Skin Surgery Center with the CO2RE laser made by Syneron/Candela. Multiple (4-6) treatments are usually needed, on average about 3-4 months apart. There are different kinds of acne scars. and other methods of treating acne scars are sometimes used in combination with or instead of fractionated CO2 laser resurfacing.

Laser Treatment for Acne Scars

TotalFX (a combination of ActiveFx (superficial) and DeepFx) is a type of laser resurfacing. Fractional lasers treat only a fraction of the skin, leaving bridges of untouched skin that aid in the healing process and reduce healing times. DeepFX, a subtype of TotalFx, is where the laser extends deeper into the dermis (relatively speaking). New collagen grows into channels from unaffected skin to improve the appearance of scars. I would suggest this if laser treatment is the way you want to go.
There are many other treatments besides lasers for acne scarring including: subcision for rolling and “box car” scars. Other treatments include “punch” or circular removal, microneedling, chemical peels, dermabrasions, and dermal fillers like bellafill or high grade sillicone. Consult with a board certified dermatologist for the best procedure for your condition.

David J. Myers, MD
Salt Lake City Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.