Fraxel Vs Photodynamic Therapy: Which is Better for Acne or Acne Scars?

I'm a 38-year-old Mexican female suffering from cystic acne since 2 years ago. I was given cortisone injections, but it left some wide pits. Doxycycline and spironalacton are currently keeping the cysts at bay, but I'm still getting occasional pimples and blackheads. Photodynamic Therapy and Fraxel were recommended to me; which of these will help me get rid of acne and get off the meds?

Doctor Answers 8

Photodynamic Therapy for Active Acne, Fraxel re:pair for acne scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Aunty,

For active acne photodynamic therapy is best, and it will help with scarring. Fraxel re:pair is better for the treatment of acne scarring. Good luck and be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Acne and photodynamic therapy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Photodynamic therapy is used for active acne.  Although it does stimulate a bit of collagen, it is not a treatment for acne scars.  Depending on your skin type, a fractional non-ablative laser such Fraxel Re:store or the fractional ablative Re:pair would help with acne scars.  Please consult a board certified dermatologist for treatment.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

PDT vs. Fraxel for Acne and Acne Scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Photodynamic Therapy (or PDT) is mostly aimed at active inflammatory acne.  While the Fraxel is mostly aimed at acne scars. 

But just to be clear:  "Scars" are the indentations left by acne.  "Blemishes" are the red marks left by acne.  Some patients call all of this "scarring".   PDT may help with some of the redness and "blemishes" left by acne, but will do little to address the indented "scars" of acne.

Neither of these treatments are effective in everyone.  Some people will only get a partial response. I have used both lasers for many years in select patients and I am careful to give realistic expectations.

Todd Minars, MD
Miami Dermatologist

You might also like...

You may need additional therapy for the cortisone pits

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree with everything that has already been written above: photodynamic therapy is good for active acne while the CO2 laser will help more with scars. The areas where you had the cortisone injections may need some type of soft tissue filler to build up the indentations. I like radiesse for such dents. I also like the DeepFX fractionated laser for treating acne scars. Just remember-there is no real cure for acne scars only treatments that improve them.

Hope this helps...

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 63 reviews

PDT for acne and Fractional CO2 laser for acne scarring

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Photodynamic therapy (PDT) can be a very useful adjunctive therapy in addition to topical and oral prescription acne medication, under supervision of a board-certified dermatologist. You want to make sure that your acne is relatively quiet prior to acne scar revision. Fractional CO2 laser would be most efficacious but should be done by a board-certified dermatologist or plastic surgeon who has performed greater than 50 cases of your skin type who can customize pre-op and post-op skin care routine to maximize clinical outcome and minimize potential complications such as pigmentation.

Fraxel for scars and PDT for acne

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

These two devices are both very good for what they do, but they do not do the same things.

PDT (photodynamic therapy) kills the bacteria that causes acne. It does this through a rather unique and clever mechanism. Bacteria naturally release a compound called porphyrins. With PDT a chemical is applied to the skin which wends its way down into the follicle where the bacteria are. The porphyrins take up this chemical. Light of a certain wavelength (Blu-light) is attracted to the porphyrins. This light zaps the porphyrins and at the same time kills the bacteria.

Fraxel is not meant for acne treatment, but it will improve scarring by causing the remodeling of collagen. This evens out the skin and may diminish scar formation.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Acne scar and acne treatment options at different stages

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I use a number of technologies for acne and acne scars. Of the two you asked about, I see Fraxel as best for acne scars because it targets collagen and is best when the active acne is controlled.

I see PDT for active acne because it targets the bacteria. Another option is Cooltouch laser which uses laser energy to target both the collagen and the oil gland to improve both acne and scars. It is great for all skin types. Finally, Isolaz uses pnuematic suction to debride the oils and dead skin cells out of the pores, blue light to kill bacteria, and IPL to improve redness. Please speak to an experience board certified dermatologist who uses and understands these technologies for best results.

PDT and Fraxel for acne and acne scars, respectively.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

PDT (photodynamic therapy) is an excellent treatment for active acne that has not responded to standard medical care with creams and antibiotics. Fraxel is a laser treatment that offers significant improvement and smoothening of acne scars. Fraxel is not used to treat active acne.

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.