Fractora vs Fraxel for severe rolling acne scars?

Question

I have severe rolling acne scars. I have had a consultation with different dermatologists. I heard fraxel and fractora are great options for treatment. Which treatment is more effective?

Jason Emer, MD · Answer

"​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. ​"

Rebecca Fitzgerald, MD · Answer

Your ethnic background is going to impact the choices. White skin with little tendency to react with extra pigment can use any system with low risk. Skins with color, or skins that include a gene pool with pigmentation risk are generally steered toward a non-laser like Fractora or eMatrix, or even micro needling.Because we treat a wide variety of skin types and colors, we provide Fractora, Fraxel, eMatrix and micro needling - all of which can be used for improving acne scars specific to needs and risks and acceptance or rejection of downtime. Subcision and peels may be part of the process, but that would be determined by your treating physician.Lasers such as Fraxel erbium and ActiveFX CO2 "can" cause post treatment hyper pigmentation, so it's a good idea to see a doctor who has both laser and non laser so the appropriate choice can be made.

Raffy Karamanoukian, MD, FACS · Answer

We continue to see very positive results with our exclusive Hidef Acne Scar Protocol which uses subcision, Ematrix RF, fractional RF and laser, light chemical peels, and microneedling. Best, Dr. KaramanoukianLos Angeles

Jeff Rapaport, MD · Answer

In my opinion, the Fractora device would be superior to using the Fraxel laser for depressed acne scars. The Fractura is a type of micro needle radio frequency. It has the ability to volumize underneath the stars. I would suggest combining the Fractura  with subcision. The scars will not raise if they are being held down by tethers. The Fraxel device is a fractionated laser. Lasers do not have the ability to lift skin. They are excellent at smoothing out the edges. In my opinion, the Infini is a better device due to  the depth of penetration and control of volumization compared to the Fractora. Multiple sessions may be needed. I would seek a doctor who has experience in treating acne scars. Ask to see photos. Hope this helps. Good luck.

Johnson C. Lee, MD · Answer

In my opinion, Fractora would be the better of the two for rolling acne scars. Fractora uses radiofrequency microneedling to first physicially open up the top layer of skin with needles followed by transmitting radiofrequency energy between the needle tips of the device while under your skin. This has been shown in studies to increase the Type 1 collagen in the dermis which would help "fill in" the depressions from acne. Fraxel uses energy to create microscopic thermal burns direclty through your skin to stimulate the skin to produce collagen through injury. Both can improve collagen production, but Fractora seems to have more potential to augment the collagen beyond the skin's baseline to fill in the rolling scars.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Acne scar revision is a
specialised field. For the best results, one should target the acne scar type
with ideal treatments. For example deep ice pick scars, and narrow box car
scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic
scars treated with fractional devices such as Fraxel, fractional lasers, and
INFINI radiofrequency. Atrophic scars (depressions) can be treated with either
fat grafts, or with HA dermal fillers. Tethered and anchored scars are best
treated with surgery.

The majority of patients
will have a collection of different scar types, and hence a tailored treatment
METHOD will be best. Careful examination, especially under angled lighting with
scar mapping will give you an understanding of what are the best options for
your scars. Every acne scar patient is different, IMHO, you should see someone who has a variety of skill AND devices to give you the best result.  See my B and A for an understanding of bespoke treatments based upon YOUR scar type. Both 1550 Fraxel and the Fractora are great devices, but for targeted treatment always use a combination approach.

All the best,

Dr Davin Lim

Laser, surgical &
aesthetic dermatologist

Brisbane, Australia

Fractora vs Fraxel for severe rolling acne scars?

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