Fraxel isn't doing the job, need some other solution. What should I do and how much would it cost? (Photo)
Doctor Answers 3
A new & alternative laser treatment (to Fraxel) for deeper acne scars in darker skin types
Deeper acne scarring is best treated via a combination of subcision and aggressive CO2 fractionated laser resurfacing (i.e. Fraxel Repair). The problem with darker skin types is that they are at a greater risk for hyper, and even worse, hypopigmentation and scarring after such resurfacing. This leaves the option of non ablative skin resurfacing, at lower settings, often 10 to 15 monthly treatments to achieve dramatic results over time. Filler injections would also help some of the deeper scars.
There is however a new treatment on the horizon, using the Precision Tx laser from Cynosure. Its the same laser that is used for the Cellulaze procedure to permanently reduce cellulite. Cellulite is similar to acne scars in that its caused by vertical contracture bands pulling the skin inward requiring subcision of these bands and thinning of the skin dermal layer. A small puncture is made in the cheek or temple the size of the tip of pencil, The Precsion Tx 800 laser, which is side firing, can be introduced under local anesthesia thru this opening, so it can be used to subcase the acne scar and also heat the dermal layer directly by firing the laser upward without burning the skin. There is minimal to no downtime.
There is a plastic surgeon in NJ who was instrumental in developing the Cellulaze laser who has been using the same technology to treat patients with moderate to severe acne with darker skin types with dramatic results. I have also started using this on my patients and this may turn out to become the preferred treatment choice in darker skinned individuals in conjunction with non ablative skin resurfacing.
Good luck in your search and don't give up.
Ran Y. Rubinstein, MD
200 Stony Brook Court, Newburgh, New York
Board Certified Facial Plastic Surgeon (ABFPRS)
American Society forLaser Medicine & Surgery (ASLMS)
Clinical Professor New York Presbyterian Hospital
National Education Faculty (physician trainer) for:
Allergan (Botox, Juvederm, Voluma), Galderma (Scultpra, Restylane, Silk),
Cynosure (Cellulaze, Precision Laser Lift) & Solta (Fraxel, Thermage)
Fraxel and deep acne scars
When you have severe acne scars the Fraxel and the eMatrix are the best treatments for these acne scars. Since you have had five treatments you may need to have some of the scars plumped up with fillers or Sculptra and/or dermabrasion to complete the process. Please consult an expert in scar treatments for the best results.
Fraxel isn't doing the job
I don't think your dark complexion is an issue as I have a lot of success in treating patients similar to yourself. see the bottom of the web reference page for photos. Good Luck!
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