Profractional Laser Spot Treatments for Isolated Cheek and Jawline Scars - Ontario, ON

I've tried professional dermarolling and 2 rounds...

I've tried professional dermarolling and 2 rounds of subcision and filler for isolated boxcar and rolling scars on my cheeks and jawline. I didn't see much improvement.
So now I'm on to spot treatments with the Sciton Profractional laser. Settings for my first treatment were 350 microns at 22% coverage. The procedure was painless thanks to the numbing cream. Afterwards it didn't burn, sting, etc but I bled a lot. 48 hours later I am still quite red (bleeding stopped awhile ago) but feeling good.
I will keep this updated as I go through more treatments over the next few months.


I'm very surprised that Profractional was painless for you. I had the MicroLaser Peel in early March 2014. I was supposed to have both the MLP and Profractional at that time. However, the doctor wanted to do 3 passes of 50 microns deep over both of my cheeks as that is where I have acne scarring (don't know about any other settings, just depth). The MLP was actually so painful at 50 microns that I told her to skip any Profractional treatment this time around. I've had two other separate laser treatments with a different doctor than the one in March, using a fractional Erbium (not sure if it was Profractional) as well as other lasers and it was not nearly this painful. All of my treatments involved only application of topical numbing cream, but my first laser treatment I was given Tylenol. I'm not sure if that is what made the difference. Thank you so much for your post. Please do keep us updated. I am interested in having spot treatments of Profractional as well. P.S. What is "TDC?"
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3 passes at 50 microns each sounds intense. I'm pretty sure you're well into the dermis at that point. How long did it take to heal? Did you get any results? I just had numbing cream. I felt a bit shocked by the laser but the brief pain was very tolerable. I do remember wondering if I could take a whole face procedure though. TDC is a dermatology centre in Toronto.
Welcome, glad you took the time to share your journey with us. Would you be willing to post before, after, and progress photos?
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Pictures Added

It's been a week since the treatment. My skin is still red but easily covered with makeup. Still peeling a bit too.


Did I see your pics on as well? It was intense, indeed. The 3 passes were just done across both cheeks. The lower jawline and chin had only one pass of 50 microns. The forehead was at 20 microns - far less painful, but still painful. I think numbing cream can have differing degrees of potency. I healed pretty nicely. It took about 4 days to peel off entirely. My forehead at 20 microns never changed color. It looked exactly as if I had never had any lasering done on the forehead. The cheeks remained pink for a good 2-3 weeks, fading gradually over the course of that time. I noticed some immediate improvement (by "immediate" I mean after the peeling stage, and upon close inspection a week or two later) in some large pores. While I do still have many large pores interspersed throughout the area in which I have scarring, I definitely saw a disappearance of pores. In the past, I only noticed drastic improvement after lasering after the end of the 4th month. I guess that is just my collagen remodeling cycle. I'll need to wait until then to let you know. I think, though, that if I had known that I would only be able to tolerate only one of the two lasers because of the pain, I would have chosen to do Profractional. I think Profractional alone might be better for acne scarring than the Micro Laser Peel. I have heard doctors on this forum say two different things regarding the use of multiple passes when lasering. One doctor stated that "stacking" has the effect of having a deeper treatment, another said that more than one pass does not have the same effect as having a deeper treatment. I don't know which is correct. It would seem that if a laser beam can only go as deep as 50 microns under the skin, it can only ever go as deep as 50 microns. I can imagine that multiple passes over the same area of skin will cover more surface area and create better results (remember, with a fractional laser, you're only treating about 20% of the skin with those dots of laser with spaces in between). But how can passing over the skin 3x at 50 microns equate to using a laser that is capable of penetrating 150 microns? Maybe I'll post that as a question for one of the RealSelf doctors. I'd like to do a Profractional spot treatment just as you did.
Btw, I really can't see your scars much in the pictures - if that helps. Only large pores. Even though your pictures are fairly close up, I also know that pictures can be deceptive and not tell the whole story.
Yes, I'm on too. I think the Profractinal is supposed to be better for scars because it goes a lot deeper. It's only one pass (or it was for me) so that might be why it didn't hurt. I had the numbing cream on for quite some time too. Also, try to schedule your treatments after your period. It makes a huge difference in terms of pain. Don't know much about stacking sorry, but it seems to me that 3 passes at 50 microns can't = one pass at 150 microns unless the laser hits the exact same holes every time. Not likely is it? Best to ask the docs in RealSelf...although I find such a variation in answers it sometimes makes me more confused!! So far I'm happy with the treatment. There is one shallow scar that really bothers me and I've seen a lot of improvement already. The other scars not so much but I'm staying positive.

2nd treatment

Just had my second treatment. Settings were 500 microns (800 in a few of the deepest scars), 2 passes at 11%. It hurt a lot more this time.
I haven't seen any improvement but it's still too early to pass judgement.


I also wanted to say that your skin looks great after it healed from the laser. I think you have lovely skin. Of course, when it is on one's own face the scar is all we see.
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Thank you for the kind words. You're right. All I see is the scars. They aren't severe but they're there nonetheless.
Thank you so very much for sharing this. I am in the very same situation, with trauma scars on each side of my mouth. They are tacked down, which make them much like depressed acne scars. I've had subcision -- at least three times each side -- and then filler with subcision, then the fraxel laser 1550 seven times a month apart each time. My last time I had gentler subcision with Sculptra, for its ability to create collagen. I can relate to how much you have gone through with such disappointment -- I've seen very little improvement despite how much financial cost and the strain of having procedures. My skin is otherwise good: I do my own 25 percent TCA peels and I don't have dynamic wrinkles just the creases where the scars are tacked down: they pull on the fascia below and that causes creases. I was going to have a consult with a Clearwater doctor who is promoting her Profractional laser just last week but after talking to them I did not make the appointment. I am searching for an experienced practitioner who does the Co2 laser fraxel, either the Deep FX or the Fraxel Repair. I have searched so much online, everything I've read shows these types of scars are best helped by these lasers or fat grafting. The problem with fat grafting is you cannot know how it will come out, how much you'll need, how much will stay and on the fact, you can get the cottage cheese appearance. I also got pitched having the needling with PRP -- platelet rich plasma. But I just can't afford to spend any more money on anything that might or might not work, I am trying to stick to procedures that are better known. I did read that the results from these fractional lasers will improve over months, so you may see a very good result in three to six months. Please keep us posted and God Bless.
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Recovery and Cold Sores

Recovery seems to be a lot quicker this time. The redness is reducing much faster and I'm done peeling.
Despite having taken anti-viral meds, I have managed to get a cold sore outbreak along my jawline. It hurts!


Stop doing these treatments! You will be scared even more. Unfortunately the scarring doesn't show up right away-trusts me.
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IceAge, did you ever have cold sores *before* having your first laser treatment? Are you sure it's a cold sore? I thought those only appeared on a person's lip....
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Yeah, I get them once in awhile. You can get them anywhere around the mouth, not just the lips. I rarely get them on my lips actually. I think the anti-viral did help though. The outbreak wasn't as severe as I've had in the past.

10 weeks since my last treatment...

Don't think I've seen much on terms of results. The scars seem the same. I'm disappointed so far.


So two things, once and for all, cold sores aren't "caused" by laser treatment. Nearly 90% of North Americans carry the HSV1 virus and many have no visible "out-breaks" but were still, at some point, infected. HSV1 looks like many things and it's not accurate that you can't have it inside the mouth, so I think it's important to clarify that as well. I took a heavy load of anti-virals before my laser surgery, 1,000 mgs, every day for three days prior and then kept going and had no issue. Won't hurt anyone to take this just in case either. Secondly, maybe it's just me, but for sure I wouldn't be doing any at-home acid peels on my face. That just seems like a recipe for disaster. Please be safe. You only get one face.
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So sorry you are not happy with your results so far :( Time really can make a difference, hopefully you will start to see some changes. 
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Thanks Eva.
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TDC. So far, so good.

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