Non-ablative Fractional Laser After Accutane?

Hi, I am 24 years old and finally free of acne thanks to Accutane, but I have some moderate rolling and box-scars on my cheeks. When I asked about the scars, my dermatologist said that I could actually go for non-ablative fractional laser 2 months later if my skin was producing enough oil again. He says the post-Accutane risks are only for ablative procedures. My doctor has decades of laser experience, but I'm wondering if he is correct. Should I just leave my skin alone after Accutane?

Doctor Answers 3

Fractional Laser Safe and Effective for Acne Scars

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Non-ablative fractional laser is definitely an option to treat many types of acne scars, but if you have just completed a course of Accutane, I would wait the recommended 6 months.  Many of us in practice know that non-ablative laser 2 months after Accutane is unlikely to cause unwanted side effects, but you have come this far in improving your complexion.  Why take the risk?  As one previous comment mentioned, your scars will also continue to improve on their own for months after a course of accutane. After 6 months, you could pursue almost any treatment for acne scars.  Why not wait and choose the most effective one for your situation?

Summit Dermatologic Surgeon

Scar revision for acne scars after Accutane

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The recommendations by the FDA and guidelines for most resurfacing systems is to wait 6 months after Accutane course is completed.  Scars will continue to improve as well after treatment has stopped.  I think there is confusion about ablative vs non-ablative.   Fraxel, Profractional, Profractional FX, Deka, and anything erbium or CO2 are all ablative meaning that there is destruction of tissue whether it be in layers or in deep penetration of the skin.  Don't go there for the first 6 months.   Nonablative techniques refer to light energy, RF energy or laser entering the skin but doing no visible destruction of,  or removal of skin.  There is in effect, no visible wound being made.   The effect of these is to remove pigment, vascularity and induce collagen production over time.  Although the potential scarring risk from these is less than ablative technology I still would encourage you to wait as long as possible before looking into nonablative techniques as well.   Hang in there!

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

There is no evidence that Accutane interferes with wound healing

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Although it has become the standard of care to wait 6 months following Accutane for ablative resurfacing based on legal cases, there is no clinical or animal data that has shown that Accutane interferes with wound healing in any manner. Certainly a period of 2-3 months would be considered safe for non-ablative procedures. Fraxel Re:Store is a nonablative laser.I have done a number of cases of Fraxel Re:Store while on Accutane.I don't mean to sound cavalier, but I don't see a specific risk in this situation.

Richard Fitzpatrick, MD (in memoriam)
San Diego Dermatologic Surgeon

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