CO2 Laser on Entire Face for Acne Scars on Left Cheek?

I have shallow acne scarring on my left cheek. I've had numerous treatments (TCA 35%, Erbium Laser, as well as fillers. The scarring bothers me enough and interferes with my life. I'm 25 years old. Treating acne since 16, scarring since 20. I only have this one area. Would I need to have CO2 over my entire face? I do have skin textures issues but I wouldn't do CO2 to address them. I'd rather concentrate on my scarring. Although it's shallow, Erbium doesn't seem to be enough. Thanks so much.

Doctor Answers 1

There are options for acne scars

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Dear Battlescarred

Treating acne scars requires an individualized treatment protocol to obtain maximal results. Some scars are deep, some are shallow, some are wide and some are narrow.

Treating a patient with a variety of scars, therefore often requires a variety of techniques. These can range from:

  • Excision of scars
  • Use of high concentration TCA (85-90%) applied directly to the scar ONLY
  • Non-ablative fractional lasers, such as Fraxel or Affirm
  • Fractionated CO2 lasers, such as Total FX
  • Full CO2 ablation
  • Occasionally, even fillers can be helpful to minimize scars

In order to accurately answer your question, a close up photo or actual exam would be required. In general, however you might be looking at some sort of laser resurfacing treatments to improve your scars.

The non-ablative fractionated lasers provide very good results. These usually require 4-6 treatments, and have only 1-2 days of redness after each treatment.

A significant step up from this is the fractionated CO2 lasers, Total FX by Lumenis. This laser goes deeper, ablates more tissue and stimulates more collagen to plump and repair skin. Usually only one treatment is needed, but some patients may opt for a second.

Depending upon the depth of the scars, I often pretreat patients with 1-2 sessions of concentrated TCA or a Deep FX laser to the scars only, followed by a whole face treatment or regional treatment.

So, yes, to answer your other question... in many cases you can treat portions of the face so long as your skin type, skin quality are amenable and will not show any difference between the areas treated and not treated.

Appropriate laser settings are also important to make sure there is no obvious difference between areas.

Hope this was helpful.

Beverly Hills Dermatologic 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.