Which CO2 Fractional Laser is Better for Superficial Acne Scars? SmartSkin or Pixel CO2?

I'm a 33yr old white female with mainly superficial acne scars that are really only noticeable close up!I would like to get a CO2 fractional laser treatment soon but am not sure which is the better laser,the SmartSkin CO2 or the Pixel CO2.I am willing to go more aggressive for 1 treatment to avoid having to do it again.I am planning on taking 5 days off from work to rest and recover.Does anyone have any advice for which laser would yield the best results with 1 aggressive treatment? Thank you!!!

Doctor Answers 7

Laser treatment for acne scarring

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As has been said, it isnt about the laser as much as the operator.  That said, the lasers you mentioned have not been on the market as long as some others that are well known to be superbly engineered.  Remember also that acne scars almost always require surgical intervention such as subcision, punch excision, dermal grafting, etc.  In my experience laser therapy alone is seldom sufficient to achieve best results when treating acne scars.

Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

It depends on the skill and expertise of the Specialist and not just the laser machine itself...

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Here is the real deal - it really depends on several factors as to what is THE best laser-
1. The laser itself. The most power laser is probably the Active/ Deep FX
2. Laser settings, you may not require the most powerful laser, but the correct settings, such as power, density, coverage, etc. 
3. The skill of the operator or specialist is THE most important aspect. 

I always treat scars on their merits, some scars do well with TCA CROSS or fillers, other do well with Fractional laser, other respond best to eMatrix RF, others to ePrime needle RF. 

Sounds confusing? The bottom line is that it is not the machine, its the type of scar you have, and the skill of the Specialist to find a treatment for YOUR particular scars. In many cases, multiple treatment modalities are needed as patients often have different scars. 


Dr Davin Lim 
Cosmetic and Laser Dermatologist
Brisbane and Gold Coast

Fractional CO2 laser for acne scars

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There are several fractional CO2 lasers that can give very similar results.  It is the skill of the physician performing the treatment that determines the outcome.  Consult a board certified dermatologist or plastic surgeon who has experience with the CO2 laser to ensure the best result.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Best CO2 laser: Pixel vs SmartSkin

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My favorite CO2 laser is the Active Fx / Deep Fx by Lumenis.  It is pretty much the gold standard so I am very comfortable with it.  What may be a more important factor in deciding what procedure to have is the skill and reputation of the person doing the procedure. Research the doctor and you won't go wrong.

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 36 reviews

Fractional CO2 lasers for acne scarring

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One should not limit their options by selecting two lasers, especially those that have been on the market less than the original devices. I have no personal experience in using either the Pixela CO2 or Smart Skin laser but they both appear to utilize fractional ablative therapy but I have vast experience utilizing the Fraxel Restore erbium 1550nm. laser with deep settings and get good results with acne scar treatment as well as the Fraxel Repair fractional CO2 laser.  Seek consultation with an experienced laser surgeon not a device.  In this way, you will get the best recommendation for treatment of YOUR skin.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Best Fractional CO2 Laser for Treatment of Acne Scarring

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Hi Aimee,

I have used Fraxel repair laser for acne scarring for the past 4 years and have found it to be most effective in treating these scars.  There are many other lasers that are used.  It is most important to find a physician who is skilled and experienced with the laser that they use.  The laser is just a tool, your treating physician will determine the safety, effectiveness, and ultimate appearance of your face for the rest of your life.  Choose your treating physician most carefully.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Find a doctor that you trust

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I use the Active/Deep FX fractional CO2. Others swear by the Fraxel Repair. I think the doctor is more important than the machine. Find an experienced, board certified dermatologist or plastic surgeon (you would be amazed at how many doctors out there advertise themselves as such, but have no training and certification by the American Board of Medical Specialties). DO YOUR HOMEWORK!

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.