I have a severe acne scar and to remove it, I have done a fractional CO2 laser resurfacing 1 month ago. However, I did not see any dramatic improvement as it is promised and the result of the laser is rather disappointing. Based on my knowledge, I will be able to see the full result of the laser in 2-3 months after the collagen stops remodeling. My question is: How well the collagen remodeling phase improve my acne scar? Will it be noticeable or just a little improvement?
Fractional CO2 Laser Resurfacing Collagen Remodelling?
Doctor Answers 3
Collagen remodeling after fractional laser
It takes about a month to start seeing results from any fractional laser because that is how long it takes for collagen to actual being remodeling itself. Depending on the treatment done you should see apparent results and changes in the coming months, for about up to six months after the treatment and then things should plateau. I don't know which laser was used, or how bad the scarring was, so it's hard to tell you if it will improve it enormously. It should definitely improve, but to say it will be drastic, I can't confirm.
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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.
Fractional Laser resurfacing for Acne scarring
Fractional CO2 laser resurfacing is certainly helpful for improvement in facial scarring. Typically some results are seen shortly after the treatment, but collagen remodeling can continue for 3-4 months following the treatment. You should see some improvement in the coming months but repeating the laser is common in my practice, sometimes 3-4 times spaced out by about 3 months. Other treatments that may help include micro-needling, topical retin-A and chemical peels. A fractional Erbium laser is also a good choice for texture improvements.