Fractional CO2 and PRP: will it be effective against acne scars?

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

The the answer to this question is dependent upon your type of acne scars. CO2 fractionated laser is excellent at improving scars. Adding PRP will improve the healing and the repair process. However, lasers don't lift scars. If your scars are depressed, they will need to be raised prior to CO2 laser treatment. In experienced hands, CO2 laser is safe and usually will produce long lasting results.
Acne scar nj.com

A combination approach will give the most improvement. These types of scars need a combination of lasers, microneedling/prp, subcision and fillers. Co2 is the best laser for scars, but Erbium is a great alternative. It will take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Hi miracle22,
Accurate expert assessment of acne scars is critical. If the scars are depressed they should first be subcised and filled, or repaired surgically.
CO2 is the gold standard treatment for scars, after they are raised. Following CO2 treatment a yellow/brown crust forms on your face; this is rich in your platelets. Adding PRP or human growth factors immediately after treatment improves healing time and results.
Consider 2 or 3 treatments with CO2 over the course of 12 to 18 months. Some people are happy with 30% improvement after one treatment.
You may wish to add to your treatment plan erbium ablative, non ablative 1540, 1440, radio frequency ablative lasers or micro needling; these are all options that require less down time and would compliment your CO2 results.
PRP, skin boosters, and growth factors will benefit the quality of skin and improve overall results with all treatments.  
Before you start ensure there is a comprehensive plan in place that takes into account your expectations, schedule, down time, and finances.

Usually, a combination of treatments is needed to significantly improve acne scars.  I often recommend a series of microneedling with PRP, a fractional CO2 with PRP, subsicion and/or fillers.  Some people need only one of these treatments and some need all.  I do tell my patients that there is no one treatment or combination of treatments that will get completely rid of all the scars.  The goal is to soften and minimize a majority of the scars.  The improvement that is attained with CO2 or microneedling is permanent, because these procedures stimulate collagen production and actually "repair" the scar.  You are correct in stating that fillers are temporary.Without a picture showing your skin color and the depth/type of scars it is impossible to tell you what treatments will give you the best results.  The darker your skin color, the more risky a fractional CO2 laser is. I recommend a consultation with a physician who specializes in aesthetic medicine.

Acne scars should be treated upon their merits, if they are ice pick, TCA CROSS is best, if they are tethered, surgical subcsion. CO2 can help with rolling and box car scars. Treatments should be directed to your scar type. Each acne scar patient presents with different scars.