I want to address acne scars, larger pores and fine lines. Am I a good candidate for CO2 laser? (Photos)

Question

Hi! 32 y/o female, with mild to moderate rolling Acne scars around chin and cheeks. I would love to smooth these out as well as address some larger pores and fine lines. I’m not sure what lasers to look into as my scarring Is pretty shallow but very evident in bad lighting. I want to treat it aggressively and have the best improvement in just 1-3 sessions ideally.. Open to other treatments as well!

Anil R. Shah, MD · Answer

Hello my name is Ranen and I am an aesthetic nurse at Aesthetic Skin in Chicago.You’ve described your situation really clearly, which helps a lot. I’ll walk through options and then suggest how I’d prioritize things if you were my friend asking what to look into. 32F, mild–moderate rolling acne scars on chin/cheeks, shallow but obvious in bad lighting + larger pores + fine lines.Microneedling (non-RF).  Good for very mild scarring, texture, and pores. Often needs 4–6 sessions → so not ideal if you want max change in 1–3. But can be nice maintenance after more aggressive procedures.TCA CROSS (for ice-pick or very small deep scars) Spot-treats deep, narrow scars with high-strength TCA acid.
Great for ice-pick scars; less useful for broad rolling scars. If you have a few deeper pits mixed in, this can be added to your plan.Radiofrequency microneedling (e.g., Morpheus8, Secret RF, Genius) Good for: Mild–moderate rolling scars, Pores + early fine lines + mild laxity (especially lower face/jawline).  All skin tones (safer than strong lasers for darker skin)

Mark Beaty, MD · Answer

CO2 laser resurfacing is often considered the gold standard for improving acne scarring, especially when you’re looking for more significant results in fewer sessions. Based on your photos and the shallow nature of your scars, I would expect you to see a noticeable improvement after a single treatment as you seem to be an ideal candidate. However, it’s important to remember that achieving completely smooth skin is rarely possible—realistic expectations are key.

Once you’ve fully healed from the CO2 laser, a maintenance plan that includes a series of microneedling treatments (with or without growth factors) and 1–3 pigment-targeted chemical peels can further refine your texture and tone.

I recommend seeking care from a reputable, experienced provider—especially for the CO2 laser treatment—to ensure optimal results and safety.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nick Slenkovich, MD · Answer

Hello! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center.  Laser CO2 laser works well for mild to moderate rolling acne scars, enlarged pores, and fine lines. It’s considered one of the most effective treatments for resurfacing and smoothing skin, especially if you're looking for noticeable results in fewer sessions.

Stefan Weiss, MD · Answer

CO2 would be an excellent choice and bring you the results that you seek. Most importantly, choose a physician who has expertise in the use of CO2.

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