Fraxel Repair Vs Pearl Laser for Acne Scars?

Which is better for acne scars, Fraxel Re:pair fractional CO2, or the new Pearl fractional laser?

Doctor Answers 8

Fractional CO2 will always give more collagen coagulation

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While there are no definite answers that can be made regarding your specific case, in general, fractional CO2 using RePair, Lumenis Encore Active/Deep FX, and Ellipse Juvia can give more results with fewer treatments due to the better dermal protein coagulation. I have not used other fractional CO2 devices, but they may work as well.

The wavelength of Pearl, while better than traditional erbium YAG lasers in this mid-infrared laser light range, still does not duplicate the results of CO2. I am sure that results will be seen, however, but more treatments will be needed, just as Fraxel Restore works for acne scars with more sessions.

Good luck and please see a board certified physician. Real lists board certification on the right of the doctor's name.

Laser resurfacing for acne scarring

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The treatment of acne scars will ultimately depend on the depth and type of scarring you have.  More superficial scars may respond well to a series of chemical peels, although deeper scarring will require laser treatments. I have used the Pearl by Cutera, The newer Fraxel Dual by Solta as well as the Active and DeepFX by Lumenis.  I have acne patients that have treated with both the Fraxel and the FX laser and feel that the fractionated CO2 laser treatments with the FX laser were more effective in treating their acne scarring.  The Fraxel is non-ablative so has less downtime, but patients will need 4-5 treatments to see a change as their collagen is remodeling.  I did not feel that the Pearl went deep enough to effect a change.  Good luck!

Mona Salem Foad, MD
Cincinnati Dermatologist

Fractional CO2 best

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I agree that the best laser is that of CO2, in fractional mode. Deep FX or CORE will give a better result than PEARL. 

In fact, if you have suitable skin type, erbium full resurfacing, followed by CO2 in the same session can give outstanding results - especially for box car, and rolling scars. 


Dr Davin Lim
Dermatologist, Cosmetic and Laser

Acne Scar Lasers

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Often Fraxel laser is best for acne scars. 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 - Account Suspended
New York Dermatologic Surgeon

Fraxel For Acne Scars

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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.

Pearl Laser not for acne scars

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I use the Pearl laser but not on acne scars. The depth of treatment delivered simply has no effect on depressed scars which are caused by cystic acne. Although I don't use fractionated CO2, I have seen many patients who are dissatisfied with the results. I ocasionally use a conventional CO2, but only in carefully selected cases because of the collateral changes that are sometimes unwanted.

Acne Scars, Is Fraxel re:pair or Pearl a Better Treatment?

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Hi Truckg,

Fractionated CO2 lasers are more effective on acne scarring than non-ablative, superficial lasers such as Pearl. Fraxel re:pair, Deep FX, mixto, and eCO2 are fractionated CO2 laser technologies. I have had very good experiences with using Fraxel re:pair on acne scarring.

Good luck and happy holidays.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

The Fraxel Repair laser is the most power fractionated Co2 laser on the market

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The Fraxel repair is the deepest penetrating coe laser system there is on the market.  You can penetrate as deep as 1.5 mm deep into a scar.  This means that you can treat deeper scars more successfully.  Since it is fractionated the downtime is less compared to traditional co2 lasers.

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon

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.