Are the Traditional CO2/Erbium Lasers Better Than Fraxel Repair for Scars?

I have quite a lot of scattered ice pick and boxcar scarring. I went to see a dermatologist and he told me fraxel repair would only get rid of 30% of my scarring. He said he could reduce 80% of my scarring through the use of both the erbium/CO2 lasers in a single treatment for $7000. He no longer keeps before and after pictures as he said it was counterproductive. A lot of people seem unimpressed with a full face full CO2 laser treatments. Am I wrong to question his advice? Any help would be really great.

Doctor Answers (2)

Ablative or Fractionated lasers for scars

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Fractionated lasers preserve healing elements in the skin called pilosebaceous units. This allows the fractionated laser to penetrate more deeply into the tissue than fully ablative lasers which penetrate only to the superficial dermis. Scars are full thickness injury meaning that they involve the entire epidermis and dermis.

For this reason, the fractionated lasers can penetrate the scarred skin more effectively than fully ablative lasers. However, in practice neither of these alternatives will completely get rid of scars and can only improve them. In my practice I prefer to use the fractionated laser (Fraxel Repair) for scars as I think it is more effective.


Dallas Plastic Surgeon
4.0 out of 5 stars 12 reviews

Treatment of ice pick scars

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In my experience ice pick scars are very difficult to treat with laser, fractional or otherwise. I do not think you can get more than a 30 to 40% improvement in icepick scars using conventional non-fractional CO2 or erbium lasers alone. If the physician tells you that it can get more improvement than that especially if he/she says after one treatment you should forego that treatment. You are not wrong to question the advice. You are 100% correct to do so.

Aaron Stone, MD
Los Angeles Plastic 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.