Acne Scar Treatment Options After Fraxel?

I did several Fraxel treatment for my acne scars but didn't help my face. My face still looks horrible. What should I do next? Where should I go for a genuine doctor?

Doctor Answers 6

Acne scarring and Fraxel Laser

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Certainly, one of the most distressing issues that a young individual has to deal with is the presence of acne. The resultant scarring that can result from the acne that you had suffered from in your youth seems quite unfair. Laser therapy has had excellent success in diminishing the appearance of acne scarring. Fraxel laser is a less invasive modality to deliver the laser energy and still obtain excellent outcomes. Unfortunately, acne scarring takes on many forms. The most severe scars will likely need to be managed with surgical excision or subcision. A combination of several approaches may be necessary and total eradication is not likely.

Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 33 reviews

Your optimal treatment depends on your scar type, and skin type, and NOT a more

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I have 2 Fraxel machines, and use them extensively to treat APPROPRIATE scars, not all acne scars will respond to Fraxel. If you have rollling or atrophic scars that are severe, fillers may be the first choice, if you have ice pick scars, and deep scars, then TCA CROSS maybe better, if you have multiple box car scars, then full resurfacing is the way to go. If you have anchored or tethered scars, you should have subscision. 

Always, always treat the scar, and never ever use a 'laser machine' as the solution. All scar treatments should be tailored according to the scar type and skin type of the patient. 

See a good dermatologist in your area who has an interest in acne scars. For example, I see 8-14  acne scar patients daily, and perform laser and other scar treatments day in day out... 

Good luck.

Dr Davin Lim 
Laser and cosmetic dermatologist
Brisbane, Gold Coast

The tried and true method for acne scar treatment is dermabrasion

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The tried and true method for acne scar treatment is dermabrasion (not microdermabrasion which is a spa technique). This procedure works better if individual deeper scars are first treated with subcision, cross treatment, or excision. Dermabrasion has a completely different effect on scars than laser, whether fractionated or not.

William P. Coleman III, MD
Metairie Dermatologic Surgeon

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Best choice after Fraxel for acne scars

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Your choice of follow on treatments after Fraxel would depend on the type of acne scars you have. Before agreeing to any single type of laser or surgical method, you should try to evaluate as many as possible as some are more effective than others for certain types of scars. You will have a more complete picture when evaluating numerous options together Check these options out with local reputable practitioners.

  • Fractional CO2 Resurfacing (unless you had this already). The original Fraxel machines were not CO2.
  • Full CO2 resurfacing (not fractional, this is traditional CO2 resurfacing).
  • Erbium Resurfacing.

And surgical options:

  • Punch excision
  • Subcision
  • Dermabrasion

We're not a big proponent of injections for scars and advocate for trying to find something more lasting.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Acne scar treatment

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I find that combining laser resurfacing with surigcal treatment including subcision/excision of scars, possibly dermal grafts, and injections give the best results. Even under the best of circumstances it is reasonable to expect improvement and not perfection.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

Acne scar treatment.

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Acne scars a difficult problem and may require multiple modalities to obtain the best result. Realistically, it is better to expect a partial correction than than complete eradication of the scars.

Treatments may include active management of acne, as well as lasers, scar revision, punch grafting, fillers, fat injections, dermabrasion, chemical peels, etc.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.