Fractional Co2 Vs. Fraxel Restore - Which is Better?

Although there are many "brands" of fractionated CO2 laser (eCO2, Deep FX, Fraxel Repair), you would be hard pressed to find any reliable data which showed one laser produced consistently better results.  There is no doubt, however, that fractionated CO2 lasers are able to produce more significant results than fractionated erbium lasers (Fraxel Restore).  The appropriate resurfacing modality used must be applied to treat the problem at hand.  Fractionated erbium lasers can help when the aging or sun related findings are minimal, but are less impressive as the indications are more significant.

Usually I do reserve fractional carbon dioxide laser (Fraxel Repair) for larger and deeper acne scars but there is more downtime and risk than with Fraxel Restore/Dual. For moderate scarring and large pores I have accomplished very good improvement in many patients over more than 15 years use of Fraxel Restore when done as a series of monthly treatments, usually 5 or 6, wait six months and then sometimes resume treatment. Icepick scars and some large pores are first removed with punch grafts or TCA CROSS.Scars are improved, not removed. There is always some evidence of remaining scars.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. 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. 

Both Fraxel Re:Pair ablative CO2 laser and Fraxel Re:Store non-ablative laser can do an excellent job in reducing acne scars and tightening pores. Which is best for you will depend partly on the evaluation your board-certified dermatologist makes of your skin and partly on your preferences. 
Re:Pair is a more heavy-duty treatment that can resurface your skin in only one session but will have up to two weeks or more of side effects, such as a reddened face and/or dryness. It is usually not appropriate for darker skinned individuals, as it may cause hyper- or hypopigmentation. 
Re:Store is gentle enough to resurface even extremely dark skin. It has no real side effects and is sometimes referred to as the “lunchtime laser,” as you can have a treatment during your break and go straight back to work. It takes several sessions to get results that are comparable to one treatment of Re:Pair. Please see a board-certified dermatologist with expertise in laser resurfacing to find out which Fraxel is best for you.

Hi Fed,
Fractional CO2 (Fraxel re:pair) is ablative and more powerful than the non-ablative erbium Fraxel re:store laser. In a 1-3 treatments acne scars are very much improved. Fraxel re:store is good for those patients unable or unwilling to undergo an ablative treatment. Good luck and be well.
Dr. P

Thank you for your question. At my practice, I have gotten excellent results for scarring with Fraxel. This treatment eliminates irregular skin discoloration, and stimulates new collagen production, tightening the skin without prolonged recovery. After a series of 2 to 4 Fraxel treatments, the cumulative cosmetic improvement is near more aggressive lasers, but unlike more aggressive lasers, redness and swelling eliminated within 2 to 4 days after each treatment. Fraxel is outstanding for fine wrinkles, mild skin laxity, irregular pigmentation, acne scars, surgical scars, enlarged pores, stretch marks, age spots and Rosacea. It can be used safely on the face, neck, hands, arms, and chest.

There are several different kind of fractional CO2 lasers now. Active/ Deep FX and Fraxel Repair are the ones that are best studied, and also the ones that will probably give you the best result, provided you are a good candidate. Fraxel Restore is not likely to give you much improvement for acne scars or large pores.