Remove Acne Scars with Dermabrasion or Laser?

I went to a Plastic Surgeon to inquire about having Dermabrasion for acne scars. The surgery was all set for March. After a month, the docter's office called me back saying that the Fractional Laser Treatment would be better. I've been doing a little research and it seems that with the laser treatment you have to go back after one treatment and pay more money. I can't afford this. Please tell me which treatment works better for the least money and the best results.

Doctor Answers 5

Consider waiting another year

Dermabrasion or carbon dioxide laser can improve scars from acne substantially in one treatment but there will still be scars. It does depend on what type of scars you have. Ice pick narrow scars that are deep respond differently than craterform shallow scars and deep and wide box car scars.

The new Fraxel Re:pair laser might improve the scars and add some tightness but this laser has only been out for a couple of years so long term results and delayed complications could still not be known compared with dermabrasion.

Deep dermabrasion certainly has more risk for scarring than the newer fractional lasers, but the results with one treatment might be better. You might do yourself a favor and sit back and wait one year to see what the medical community is learning about your situation.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Fractional lasers best for acne scars

Dermabrasion was once the Gold standard for treating acne scars. It does work, but it has been supplanted by better treatments. The major drawback with dermabrasion is that it can leave the treated area with hypopigmentation or permanent lightening of the skin. CO2 laser skin resurfacing was the next great thing, with as good or better results, but again left the skin with hypopigmentation.

Fractional type lasers have reduced/eliminated the hypopigmentation problem and still give excellent results with acne scarring. There is no one best machine. Each device has its advantages. The Fraxel machine was the first to introduce this technology, and now has three different devices to choose from. These work, so do all the other fractional type lasers. Also, some lasers can be adjusted to reduce the number of treatments needed, but are associated with a longer recovery.

I would ask your Plastic Surgeon, if he is willing to give you a package price, ie. how much for 3 or 4 treatments.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 40 reviews

I think Dermabrasion is best, but both can help

Unfortunately I have to disagree with Ms. Howard. Perhaps she is confusing micro-dermabrasion with surgical dermabrasion. Micro-dermabrasion is done by aestheticans and nurses etc, and it's a very mild form of dermabrasion. The deep of sanding goes only to the epitheilum and does not penentrate into the dermis, hence it is not good for acne scars, but is good for facials, and opening clogged pores. It does not cause bleeding.

Surgcial dermabrasion penetrates into the dermis. The face will actually bleed significantly if done to the proper level. It must go deep enough to cause the skin to have to regenerate (hopefully deep into the papillary layer of the dermis,) but not so deep that it penetrates the deep reticular layer of the dermis, or scar will form. The skin is then forced to heal and grow need skin, dermis, collagen, and elastin. It can be helpful for wrinkle and/or the deep pitts associated with acne.

If done properly, the results can be sometimes dramatic, because it levels out the deep pits and also because new skin grows. I do like it better than the Fraxel for various reasons that I really don't have time to go into here. However, recovery from aggressive surgical dermabrasion is much more intense then from repeated treatments with the Fraxel Laser.

Lane Smith, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 93 reviews

Laser .... has less side effects

This question is almost 4 years only, but lets re-explore it. Dermabrasion can be excellent for very severe and deep scars, and without doubt, was the best way to treat severe acne scars....10-20 years ago. With the event of Fraxel, Fractional lasers, combination Erbium and CO2 Fractional laser and longer lasting dermal fillers, dermabrasion should now be historical. 

Who knows what the future will hold in 20 years time. 

Dr Davin S. Lim
Cosmetic and Laser Dermatologist
Brisbane, Australia

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 75 reviews

Fraxel Laser

Often Fraxel laser is much more effective for acne scars. Patients may need to do multiple treatments, as with dermabrasion, which is possible but the effects are permanent and last longer. Cost wise it is most costly, but often has higherpatient satisfaction. 
The Fraxel laser treats a fraction of your skin’s tissue at a time to give you optimal results. The laser works by producing thousands of microscopic laser columns that penetrate deep into the layers of skin that stimulate your own natural healing process. The body then produces collagen to replace the damaged skin. The results are more youthful, smoother, and healthier appearing skin.

Eric Schweiger, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 13 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.