Fractional CO2 Resurfacing for Acne Scars and Uneven Skin Tone?

Question

Can you tell me what is the best solution for uneven skin tone, redness and acne scarring?
I’m a 21 yo male with really fair skin, persistent redness (been using benzyl peroxide daily with a moisturiser for a few years), mild acne (pimples and blackheads) and a bit of light-medium scarring (had bad acne when younger).   Have found one place in Sydney on the North Shore that does it. They say Co2 will reduce scarring by around 30% and Erbium/co2 will be around 80%, however they wouldn’t show pics because they said it looks terrible!
I am planning to take a few weeks off in November and am considering getting fractional co2 done. I realise it wont do as much but seems safer.   I would absolutely love it if it worked all to plan, though am afraid of scarring from the heat or persistent redness or the possibility that it wont do anything at all.
Doctors do make it seem like a walk in the park. Was wondering if anyone can give any suggestions or possibility of an even better treatment?  I would really appreciate it if anyone could give me some advice and more than happy to keep you updated with any results, pics and text.   Thanks !

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Scott Trimas, MD · Answer

Bar none, the CO2 laser resurfacing is the best treatment for acne scarring. Unfortunately, if you reduce the effectiveness of the CO2 laser by fractionating the treatment, you will get substantially less improvement. If you can afford a 10 to 14 day downtime, you would see significantly more improvement in the skin with a deeper CO2 laser. 
Men typically heal faster and the pinkness is gone in about 6 weeks in males. With acne scarring, the skin is thicker and only mild degrees of improvement are achieved with fractionated treatments and multiple treatments of 3-5 sessions are required. 
Once again, this does not equate to even one normal CO2 laser resurfacing procedure and males do especially well with this treatment. I wouldn't waste my money on a fractionated treatment for acne scarring.

Jeffrey Zwiren, MD · Answer

I usually use a two step process for acne scarring. First any deep ice pick scar need to be treated with 90% TCA. I grind the TCA into the ice pick scar this creates a full thickness injury and allows the scar to fill in. Then the face can be resurfaced with a CO2 laser. There are many types of lasers available that work well. The SmartXide Dot therapy laser allows nice control over the depth of the treatment allowing treatment of deep dermal scarring.

Fractional CO2 Resurfacing for Acne Scars and Uneven Skin Tone?

Answers (3)