Comparing Acne Scar Laser Treatments

Please compare Fraxel CO2 with Fraxel restore (erbium resurfacing) and laserbrasion (dermabrasion and CO2 resurfacing combo) for acne scars.  If cost was not an issue, I'd get Fraxel CO2, but Erbium and laserbrasion are much less expensive, and I'm wondering how the downtime, risks, and benefits compare.

Doctor Answers 2

Have an expert evaluate your skin first

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Fraxel Re:store resurfacing is usually done a multiple number of times so the final cost can be greater than one dermabrasion or CO2 treatment. The latter two can cause marked thinning and whitening of the treated skin but Fraxel maintains the good skin texture and color. Fraxel Re:pair CO2 is usually done as one treatment and probably can’t give as good results as multiple Fraxel Re:store treaments. If the RE:pair is done at high energy settings there might be a lightening of skin color that can develop as was seen with the old CO2 treatments. This discussion pertains to depressed scars that are wider than ice-pick narrow and deep scars. The latter can be addressed by punch grafts prior to laser treatment. Off label use of fillers including silicone is done to raise some acne scars. Your skin needs to be evaluated by an expert as your condition must be treated specifically for you as no two people with acne scarring have the same exact needs.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Be careful when mixing modalities

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Some of the worst complications I have seen is when half measures are combined. In general, erbium:YAG ablative lasers do not go deep enough, nor coagulate the deeper skin levels to improve acne scars long term. They are better for pigment. Dermabrasion with a wire brush is an "oldie but goodie" but ONLY if done by a real pro. CO2 resurfacing with only two modalities: Deep FX and Fraxel Repair have the depth to effect acne scars with one session. Fraxel Restore (which is an erbium glass, NON-ablative laser) with aggressive energies over 5-6 sessions can be amazing, but all three can be expensive. I'd say save your money until you can get an experienced doctor to do one of the best treatments rather than throw away less money and receive little benefit. Good luck.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 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.