Fraxel 1550 or Halo for these acne scars? (photo)

Question

I've had a few consults this week. Fraxel (multiple treatments I was told from one provider), Halo with PRP (at least two treatments). I've read that with Halo people have experienced volume loss. May consider TCA Cross in between sessions however, I am most concerned about which laser to pursue. Any thoughts?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Ron Shelton, MD · Answer

I have found during close to 20 years of using the 1550nm. I have not encountered many cases of post inflammatory hyperpigmentation. Granted, people prone to this condition or melasma, may develop darkening of their skin after any laser treatment including Fraxel, but there may be a greater chance of this by using the Halo laser.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

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, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, 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.

Andrew Campbell, MD · Answer

We have had great success with improving textural irregularities with the Halo laser. The combination of the non-ablative and ablative lasers work synergistically to create a lot of new dermal collagen. Several treatments will be necessary and the acne scars will never be completely gone, but they can be improved.Andrew Campbell, M.D.Quintessa

Jeff Rapaport, MD · Answer

Lasers  don't lift scars. In my opinion, your pits and ice pick scars should be raised prior to treatment with TCA cross or punch excision. They can then be lasered with either Halo or Fraxel. It's not the device that's as important as the physician who is performing the procedure.Jeff Rapaport MD FAADRealself Verified All-star

Michele S. Green, MD · Answer

I treat a ton of patients with acne scars and I would avoid Halo since this will leave you hyperpigmented.  Fraxel can also cause this same result depending on how much energy is used. The better alternative is to us the eMatrix for acne scars.  The eMatrix is a "color blind" laser and through radiofrequency heat it will decrease the acne scars and have the best results without the risk of hyperpigmentation.  Please consult an expert in acne scars for the best cosmetic results.  Best, Dr. Green

Erika Sato, MD, FACS · Answer

With the 1550 setting on the Fraxel laser, it will likely take 3-5 treatment spaced 4-6 weeks apart to get the best possible result from the Fraxel laser for acne scars. The number of treatments really varies depending on the setting chosen. At higher settings, you need less treatments, but higher setting means more pain during the procedure and also a little longer recovery. You may need a mixture of more than one type of procedure to really get the best result. You may consider the Fraxel laser but also can do micro needling  with PRP or Aquagold with a perfect mixture delivered to your skin.

Shaun Patel, MD · Answer

I would consider TCA CROSS for the ice pick scars and fractionated CO2 laser (CO2RE by Candela) for the remainder of the acne scars.

Fraxel 1550 or Halo for these acne scars? (photo)

Answers (8)

More Fraxel Laser Questions

WE SEND PRETTY
EMAILS

Answers (8)

More Fraxel Laser Questions

My chin has become quite pock marked this year. Can Fraxel smooth out the appearance? (photo)

Is PRP better in combination with Fraxel or micro-needling?

My face is highly scared after fraxel restore. What can I do? (photo)

What is the best laser for large pores on my nose? (Photo)

How to go about treating my ice pick scars via a more aggressive approach? (Photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS