Does Fraxel work on acne scars?

Fraxel is effective for acne scars once the acne is no longer active.

You should consult with a board certified physician to deternine whether Fraxel or another treatment is more appropriate for your particular needs and lifestyle.

First of all your acne should be under control before embarking on laser treatments for acne scarring or you may:

1. Have acne breakouts from the treatment and post treatmnet wound care.
2. Continue to have scarring acne and need further treatments down the road with additional costs.

Secondly, the generic term Fraxel can be very misleading as there are 3 new "Fraxels" out there, none of which are created equal. 

• The original Fraxel is nonablative
• The next generation are re:store re:fine and re:pair, the last of which is abalative and as for the "Fraxel" family is clearly their best laser at treating acne scars. 
• The other great laser for treating acne scars in the Sciton Profractional laser. It is an erbium yag laser (not CO2), heals quicker and is less painful than the Fraxel re:pair CO2.

So, the technology is out there to treat scars quickly and safely with minimal downtime.  The only downside is the high likelihood of the need for more than one treatment with some of these devices, especially the non-ablative Fraxels.

Lastly, there is the gold standard full ablation lasers by Coherent CO2 or Sciton Erb Yag that will get great results in one treatment, but require wound care for 10-14 days. These results are far better than any of the other treatments discussed... when it comes to lasers, remember there is no "free lunch,"  i.e. more downtime = better results but higher chance of complications versus little to no downtime = need for multiple treatments and lower risk of complications. 

Ask your doctor what he or she thinks is best....and be weary that although the rolled scars may do great with lasers, the "ice pick" type scars do not do very well with any of these lasers; they often need small punch excisions with or without a stitch to fully improve their appearance. This can be done at the end of your laser treatment series. 

Good luck and be sure if acne is still active to get the acne under control with medications, etc. before starting any of these treatments!

Both Fraxel lasers can treat acne scarring very well. The newer Fraxel re:pair CO2 ablative laser penetrates up to 1600 nanometers (1.6mm) deep (as compared to 300nm (0.3) for Active FX, and 600nm (0.6mm) for Deep FX).

Good luck and be well.
Dr. P

Fraxel is quite effective in reducing acne scars; it is not very effective in treating active acne though.

The scars are not going to completely disappear, but they are usually going to be better. A higher power setting may be required. The results are not immediate either. It takes 6-9 month to get the full effect, so you must be patient.

Fraxel is probably the Gold-Standard Treatment for Acne Scars.

Our clinic has the Fraxel and the ActiveFx lasers. Fraxel, by far, has the most studies and the most experience with Acne Scars. ActiveFx MAY be an excellent alternative. We are using both lasers to treat Acne Scars and we are seeing nice results with both.

If someone wants one treatment with 4 days of downtime, we use the ActiveFx. If someone wants 1 day of downtime x 5, we use the Fraxel. ActiveFx gives more skin tightening and Fraxel is safer in patients with darker complexions (skin type 4-6).

Reliant (the makers of Fraxel) just came out with a new CO2 Laser which is like the ActiveFx but goes "deep" and Lumenis (the makers of ActiveFx) has just come out with a new attachment for their ActiveFx which makes it go deep. Deeper treatments may work better because more collagen is stimulated.

You can't go wrong with either laser for acne scars.

Fraxel is a very good treatment for acne scars. It does make a difference (how much of one really depends on the individual, but the difference is certainly noticeable after a few treatments) and that is more than I can say about any of the older technologies.

Currently, Fraxel is probably the standard of care for acne scars. That being said, I am not sure that it is the best treatment out there for acne scars. Fraxel hurts. Topical numbing cream and oral pain medication help a lot, but it is a hassle to get 5 or more monthly treatments that are uncomfortable.

There is some downtime with Fraxel - at least 3 days of redness, some swelling and some peeling. Then you look like you have a sunburn for a week. This can be covered with make-up, but it's also a hassle.

My biggest gripe with Fraxel, however, is that I do not think that the results are good enough. Even after 5 or more treatments, I still see the scars. Sure, the skin is smoother, but the scars are still noticeable. I think that we can do better.

I am looking at the Active Fx device for acne scarring. It is already good with fine lines and pores. The Deep Fx head should make this device excellent for acne scars. It is more aggressive than Fraxel, but it hurts a bit less. The downtime is a bit more, but perhaps by 1 day, not more than that. We still do not have a consensus opinion, but physicians outside the US who are using the Deep Fx and the few docs that have it in the US give it rave reviews for acne scars. I think that it is not going to be a one time procedure, but after a couple of treatments, the improvement should be better than Fraxel could ever do.

Fraxel works for acne scars. I use Fraxel daily in my office for acne scars. It works for the ice pick scars, box scars and rolled scars. I frequently see 60-80% improvement. I have achieved this by using high settings using the Fraxel machine. I generally use the maximum energy at 70 mJ. I have found with lower energies one needs more treatments and that tends to get expensive.

I find the biggest problem with using Fraxel with most patients is that they require good anesthesia. I combine blocks with topical as well. If you are interested in Fraxel treatments make sure the physician offers you good anesthesia as that lends itself to major success with the procedure.

For those patients who are prepared to put up with downtime I use Plasma PSR at level 3 and that works very well. However, there is associated downtime of about 5-7 days. However, they generally need only one treatment. Usually I find myself offering both treatments and usually people who have time to handle the down time tend to choose the plasma.