Which co2 setting would deliver results and minimize acne scarring on middle eastern skin? 40 y/o (photos)

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars.
- Subcision for depressed, tethered scars.
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars.
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring.
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Hello SP. Unfortunately, quoting settings for laser treatments is not meaningful. The reason is that tissue reaction is what we are looking for. For example, if we perform fractional resurfacing on a patient like yourself and get no pinpoint bleeding., we know we have not reached the dermis, which is where most of the acne scar tissue resides. This means results will be subpar. So while one laser may require a particular setting and another laser a different one, pinpoint bleeding needs to be observed for best results and is more important than what the setting is. Tissue reaction always rules. We use Erbium fractional (see link for photos) rather than CO2 as it has a lower expectancy for hypopigmentation with darker skin types. We would recommend a deep fractional followed by dermal fillers for the larger indented areas. Sculptra may also be useful.