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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 (19)

Laser or Dermabrasion?

+6

Laser

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.

Dermabrasion

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 32 reviews

CO2 laser is the best for acne scars

+4

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 7 reviews

Choice is less complicated with an experienced provider

+3

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 Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 8 reviews

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Acne Scarring

+2
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 8 reviews

Many treatments for acne scars

+2

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 12 reviews

Acne Scar Treatment with Microneedling

+1
There are many great lasers on the market that will improve the look of acne scars. The difficult part is finding a medical clinic that will give you the best laser advice. The best results I’ve seen in getting rid of acne scars would be with the DermaRoller micro needling device. This treatment has the least amount of side effects as well. You will have to go with the stronger lasers for acne scar reduction and that means much more downtime.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 54 reviews

Best laser for acne scars

+1
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 9 reviews

Laser and Other Treatments for Acne Scars

+1

Fractional CO2 Laser vs other treatments for Acne Scarring
+1
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 44 reviews

Treating Acne Scars

+1

Rather than trying to figure out what is the best laser for acne scars, it would be better to think about do you want a treatment that requires downtime for wound care and healing or would you rather have a series of treatments that don’t require significant healing time. We have 7 or more lasers that can be used for treating acne scars and we use all of them. It is important to be able to offer options and to understand the pros and cons of different approaches. My personal favorites are the Fraxel Re:Pair and the Fraxel Re:Store lasers. However I also use the Actve Fx ,Deep Fx, V-Beam, pulsed erbium, pulsed CO2, Alexandrite and Ruby lasers as well as various fillers and punch excisions. Speak with an expert San Diego dermatologist about your options.

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon
4.5 out of 5 stars 12 reviews

The best treatment for Acne Scars

+1

The best laser treatment for Acne Scars is Fractional CO2.  Fractional CO2 uses small columns of fractionated energy to ablate areas of damage- it offers mild improvement in wrinkles, discoloration, and scarring by stimulating collagen production.  Patients continue to see additional improvements as collagen builds over the next several months.  In many cases patients can achieve their optimal results in 1 to 2 treatments.   There is "down time" associated with this results driven treatment.  Expect to be red and peeling for 7 to 10 days.

Syed Amiry, DO
Virginia Dermatologic Surgeon

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.