Have Been Advised With Fractional C02 But Am Very Scared

I am skin type 4 and have deep acne scars on my face, I was reading so much about Fraxel-Restore as that is only available in my country and had almost made up my mind about going for it. When surprisingly my Dermatologist Fraxel will not help so much for your scars as much a Fractional CO2 laser would do, because my scars are very deep indeed. Now I know the difference is Fraxel Restore is Non-Ablative and the latter being Ablative.I can go with Fractional C02, but I am most worried about PIH.

Doctor Answers 3

Deepa acne scarrring

Ablative lasers like the Fraxel may help improve the acne scarring. But it looks like LaViv a product using your own fibroblasts may be useful for acne scarrring to improve the contour.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Fraxel for acne scarring and use of the co2 laser

I personally do not think that fraxel is going to do a lot for you at all. You need laser resurfacing and even with that you are looking at milder improvement.  It is a lot of work for small improvements but acne scarring is hard. I would like to see pictures of your scars to know. But you will need things to elevate your current scars and then you will need co2 resurfacing to polish your scars more. A multilayered approach is better and then co2 will play a huge part.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Fraxel Repair/ Fractional CO2 Laser For Acne Scars

I am assuming that you are referring to Fitzpatrick skin type 4. This type  basically tans easily and rarely gets sunburned. This is because of the melanin pigment which is responsible for your skin color. 

Fractional CO2 lasers like Fraxel Repair are safest for patients with very fair skin. Melanin tends to absorb laser frequencies rather easily. So the more melanin you have, the greater is the risk for scars, burns and pigmentation issues. 

If you are a true type 4, then you should avoid fractional CO2 and opt for non ablative lasers such as Fraxel Dual instead

Fraxel Dual uses the 1550 and 1927nm wavelength which is unique in that they are not readily absorbed by melanin. This laser is non-ablative and heats the dermis causing it to produce new collagen fibers. The skin reacts to this heat as an injury and creates these new fibers to repair itself. In doing so it overrides the abnormal collagen of the scar tissue. 


Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 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.