Received a Dual Fraxel laser treatment without substantial results. Is another treatment best or a chemical peel?

I received a dual fractal laser treatment and was expecting much better results. I have mild acne scarring and a lot of post inflammatory hyper pigmentation from previous breakouts. I am looking for something that will give me good results. I have about a week for social downtime. I was wondering if I should stick with the laser and go for another treatment or do something else. Maybe a chemical peel?

Doctor Answers 6

Fraxel Dual and Acne Scars and Treatment

You asked an excellent question and perhaps they never explained the Fraxel process to you.  Fraxel is the gold standard for treating these acne scars but it takes many treatments, depending on the depth of the scars and your skin type.  In addition, the hyperpigmentation  or redness from acne scars may require a different course of treatment such as V-Beam for the redness or hydroquinones for the dark spots from old acne scars.  Please consult a board certified dermatologist with a great deal of experience with Fraxel and lasers.

Acne Scars – Combination or Multiple Treatments Needed

The best treatment for acne scars depends upon an individual’s skin type, age, ethnicity, sun exposure, overall health and most importantly, the type of acne scars present (ice pick scars, boxcar scars, rolling scars, hypertrophic scars and variable degrees of hyperpigmentation). In order to give you an accurate treatment plan, a consultation is required to properly assess your skin.

An important step for all skin types is sun protection including the use of daily sunscreen, sun hats and sunglasses, all of which help prevent aging and sunburns. 

When it comes to acne scar treatments, a combination of treatments are available including cosmeceuticals (medical grade skin care products specific for acne including ZO® Skin Health or ZO® Medical, Skinceuticals® or Glo-Minerals®), advanced laser resurfacing procedures (CO2 laser, Er:YAG laser, Fraxel DUAL®, PicoSure® FOCUS Lens Array), chemical peels (light, medium, deep including the blue peel), dermabrasion, augmentation/fillers, excision and/or subcision, punch techniques, microneedling/rolling, injections (corticosteroids, interferon, 5-FU), cryosurgery, electrodesiccation and microdermabrasion. 

These are advanced techniques so be sure to get an experienced dermatologist or plastic surgeon consultation for recommendations and treatment options.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
5.0 out of 5 stars 10 reviews

Multiple Fraxel Treatments Necessary

Fraxel Dual is currently the gold-standard for resurfacing, and is able to help improve the tone, texture and color of the skin. It is a fractionated laser, meaning a fraction of the skin is treated while leaving the remaining skin untouched, which accommodates for quick healing.

Depending on each patient’s skin and severity of their concerns, I generally recommend at least a series of three treatments 4-6 weeks apart. I would suggest you try at the very least one more treatment; you will likely be able to note a more significant change in your skin.

Although there are some deeper chemical peels that may have the potential to produce similar results to laser, there are several reasons why laser may be a better option: 1) Deep chemical peels will come with prolonged periods of downtime, 2) It is much harder to control and/or predict outcome with peels, 3) It will not result in nearly as much as collagen production as laser.

Consult with a board certified Dermatologist to see what option may be best for you. Best of luck!

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 17 reviews

InMode Fractora for acne scarring

Fraxel dual is a lower energy treatment so it requires many treatments to see results. I have found the InMode Fractora at high energies to be far superior. I have treated many patients successfully with this, and many of them had done other treatments prior without much success.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Acne Scarring -- Requires a Combination of Fractional Laser Resurfacing, Fillers Like Bellafill, Subcision and Eclipse Micropen

One fraxel treatment is not substantial enough to give results for acne scars or pigmentation.  You need a cosmetic dermatologist who specializes in acne scarring/pigmentation and does a combination of treatments including: surgery, subcision, or TCA cross for deep or pitted "ice pick" scars; fillers like Bellafill or Sculptra or Radiesse for broad "boxcar" or "rolling" scars; Eclipse Micropen for all types of scars and improvement in texture and tone; lasers such as co2 laser resurfacing or Fraxel/Clear+Brilliant or radiofrequency such as Sublative or Viva to improve the scars and give long term collagen production. There are many options but you want someone who can customize a regimen for your short and long term goals based on your individual situation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Fraxel for acne scarring

Fraxel dual requires multiple treatments, usually at least 5 treatments spaced one month apart. The final result will be seen six months after the last treatment. While you will see gradual improvement along the way, it is too soon to assess the results. Adding Sculptra to the Fraxel can improve and speed up results.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon
5.0 out of 5 stars 6 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.