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Fraxel Acne Scars- Does it Work?

I've heard a lot about Fraxel laser. Acne has always been a problem for me and I have the scars to prove it - can Fraxel treat acne scarring on my face?

Doctor Answers 36

Fraxel is very good for acne scars

I use the Fraxel restore for acne scarring routinely. The results can be variable. If the treatment settings used are the same as the settings for patients with sun damage and fine lines, then the results are very marginal. However, if settings such as 70mJ (a high setting) are used, then the results are much more impressive.

Acne scarring requires a higher intensity of treatment than other conditions. It is very important to seek out a very competent physician to perform the treatment. High settings can have higher side effects and longer "down-times," and are not suitable for all individuals. If you decide to use Fraxel for acne scarring, make sure to go to someone recommended on, have a consultation, make sure the physician does his/her own treatments, and then go for it.

Portland Plastic Surgeon

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Fraxel for Acne and Scars

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!

Shawn Allen, MD
Boulder Dermatologist
5.0 out of 5 stars 1 review

Fraxel for acne scarring doesn't work very well.

I see patients fairly often that have had Fraxel treament for acne scars or for skin "tightening" that are disappointed in the results.  RealSelf's poll shows a very low "worth it" percentage (50%).  I would be very careful before spending money on this painful treatment.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

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Fraxel repair for acne scarring

The Fraxel repair as well as most fractionated co2 devices ( Fraxel restore and Pixel among others) as well as Smooth Beam Laser can all effectively treat acne scarring . but you must identify which situation you fit into. 1)Namely, do you still have active acne? - you might consider smooth beam laser as it can put acne into remission for 4 to 12 months. 2) if you don't want any or hardly any down time but don't have active disease - or if you have darker skin color then the Fraxel may be best for you. 3) if downtime is not an issue and you are fair skinned individual then fractionated Co2 may be best.

Joshua L. Fox, MD
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Fraxel is the Solution for Acne Scars

If you want to successfully treat your acne scars, Fraxel is my preferred method of treatment. Fraxel will soften and smooth your skin reducing scarring to a noticeable degree. In order to achieve this, I tend to recommend 3-4 treatments to achieve the optimal results. In addition, there is no down time for healing. My goal when treating patients with Fraxel is to rejuvenate their face, chest and neck by reducing acne scars and wrinkles.

Joel E. Kopelman, MD, FACS
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Fraxel Is The Treatment of Choice For Acne Scars

There are 3 types of acne scars saddled with rather graphic names.: saucer shaped, boxcar, & ice-pick. The saucer scars have multiple answers since they are shallow: injectible fillers,ablative ( CO2;Erbium, & fraxelated ablatives ) lasers,subcision, & even dermabrasion. Because the latter 2 scar types can extend below the hair follicles ;ablative lasers cannot eradicate them since those lasers require intact hair follicles to supply epidermal cells to heal the wound surface. Fraxel, both the 750 & 1550 non-ablatves penetrate to the bottom of the scars ( below hair follicles ) with no need for surface healing. They are remakably effective in most cases in producing substantial improvement,evident within1-2 months.

Douglas Hamilton, MD
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Fraxel for acne scars

Fraxel is my treatment of choice for mild to moderate acne scars.  First, I always recommend to have your acne under relatively good control prior to Fraxel therapy.  Fraxel Re:store works through a mild resurfacing effect, combined with deep collagen stimulation.  Its really this deeper collagen stimulation that makes it effective for remodeling acne scars and sets this treatment apart from other devices.  Fraxel will not take away your scars completely, and it does not do much for deeper "ice pick" scars, but it can smooth out mild to moderate depressions.  In the right candidate, it can improve acne scarring by 50-75% after 4-5 treatments.

Fraxel is the treatment of choice for acne scars

Both Fraxel Re:Pair (CO2 Fraxel) and Fraxel Re:Store (nonablative Fraxel ) are very effective in treating acne scars.Fraxel Re:Store always requires a series of treatments (2-6) but has no downtime needed for healing.Both lasers have a very small beam that penetrates very deeply in the skin to get to the base of the scar and work by stimulating your body to make new collagen fibers. This basically rebuilds the skin that has been scarred by acne. Fraxel Re:Pair is more aggressive , requires 5-8 days downtime for initial healing but gives results equivalent to 3 or 4 treatments with Fraxel Re:Store.It can be repeated for even more dramatic improvement. The average amount of improvement is around 50% .

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon
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New Fraxel Re:pair treats skin the deepest, may be most effective on acne scars

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

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Fraxel and Acne

Fraxel Laser has become somewhat of the "gold standard" for treating acne scars.  It can, however, cause acne to flare.  My recommendation is to have your acne well controlled or cured prior to treating the scars.  The Fraxel Laser heats deep into the tissue which results in the production and remodeling of collagen.  The results can be somewhat unpredictable from person to person.

Jerome Potozkin, MD
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4.0 out of 5 stars 5 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.