Fraxel Restore or Repair for Acne Scars After PIH from Fractional CO2?

I am Chinese and got significant PIH from Fractional CO2 (with unknown machine) done in May this year. Luckily, the PIH is almost recovered now, and so I am considering Fraxel Restore or Fraxel Repair. The major concern for me is NOT to get any PIH again during acne scar treatment from Fraxel. My doctor told me that doing 5-8 treatments for Fraxel Restore equal to one Fraxel Repair, and Restore has less chance for PIH. Any advice?

Doctor Answers 3

Fraxel restore or repair for Acne Scars in Asian Patient with History of PIH


Post inflammatory hyperpigmentation is an increased risk in Asian patients treated with fractionated CO2 for acne scars.

As you have already experienced, the PIH will eventually fade over time. What you need to decide is whether putting up with the PIH is worth the improvement in skin tone and texture or your acne scarring. Both Fraxel restore and Fraxel repair will help with the scars. Your treating physician will need to decide which is better in your individual case. My experience has led me to use repair in those patients who desire aggressive treatment of their acne scars.

I am unaware of any peels that treat acne scars better than Fraxel

Good luck and be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Don't do it! Lasers are terrible for PIH and this is a scam. Use Obagi instead

Lasers are not a good idea for pigmentation in Asian skin or skin of color in general. If your doctor is suggesting this as a treatment after you have already suffered pigmentation from another laser you need to RUN, not WALK away from this doctor's office.

Sadly, you are a very common example of people going to someone with a laser that wants to do any procedure they can to make money off patients and doesn't care what happens. While I own BOTH of these lasers, I can tell you that there is no way in the world that I would ever consider doing either of them on an Asian individual. It is way too risky and alternatives like Obagi ( are just way too good and effective.

Believe me, this is a bad idea and doesn't work all that well even in caucasian individuals, let alone in folks with skin of color. Glad you asked!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.8 out of 5 stars 40 reviews

Fraxel re:store and re:pair

Although the re:store does have less risk of creating hyperpigmentation in your skin than the re:pair, there can never be a guarantee that it won’t happen. Some patients continue to derive excellent scar treatment results from re:store and have many more than 8 treatments. This continual treatment which is more gentle than the re:pair, may allow for more collagen production because multiple treatments are possible.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 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.