What laser treatments should I have for acne scars: CO2 or Icon? (Photos)

CO2 fractional laser for acne and other scarring generally works very well. However, I find that in most patients, the results may take a few to several months to take effect since we are trying to stimulate collagen to help fill in the indentations. Sometimes the scars can be "bound down" by fibrous scar tissue and in this case, it is necessary to release the fibrous tissue with a procedure called subcision to prevent the scar from being tethered. The scarring was caused by the acne itself and not the Accutane so it is important to control your acne in the future. I would suggest consultation with a physician who is experienced in treating acne scars with the above methods to help your scars get the most improvement.  Best wishes, Mary Beth Mudd

Ideally, neither. Icon is not powerful enough to break down scar tissue in YOUR case. It can be effective if you have Mild and EARLY scars. Co2 can be use, in low density. Ideally the treatment of choice is mixture of procedures aimed at your scar type. Acne scar revision comprises of specialised procedures. For the best results, one should target the acne scar type with ideal treatments METHODS. Using one device is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one.  The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. 

As an example deep ice pick scars, and narrow box car scars are best treated with TCA CROSS. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat grafts, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations. 

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combination that give you best results, and everyone is unique! It is never about the device, its about the specialist behind the equipment that will deliver the best outcomes. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.