What laser treatment would be the most effective for my acne scars? (Photos)

In my practice, we perform fully ablative CO2 laser resurfacing for acne scarring. Chemical peels work well, but the best one-time treatment is fully ablative CO2. We perform the procedure in the office with sedation anesthesia.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for sharing your question and photos. Based on the type and depth of your acne scarring, CO2 ablative laser resurfacing is often one of the most effective options for meaningful improvement. It is a more intensive treatment and does involve a recovery period, but it can significantly remodel the texture of the skin.

In many cases, the best results come from a combination approach. Pairing CO2 resurfacing with treatments like microneedling (traditional or RF) can help build collagen at multiple skin levels and optimize the overall outcome.

It’s important to set healthy expectations: improvement, sometimes substantial, is very realistic, but complete removal of acne scars is uncommon. A consultation with a qualified plastic surgeon, dermatologist, or aesthetic practitioner experienced in laser resurfacing can help tailor the treatment plan to your scars and your goals.

Hello, my name is Ranen and I am an aesthetic nurse here at Aesthetic skin. Acne scars can be treated by different modalities such as a resurfacing laser, rf needling and or cross tca. Depending on your history of treatments I will be able to help you with customizing a treatment plan to help reduce the appearance of your scars.

There are some simple treatments for addressing acne scars that have stood the test of time for both safety and efficacy. Consider subcision for elevating and smoothing indented boxcar and rolling scars, and TCA CROSS for addressing ice pick scars and dilated pores. I have personally been performing subcisions for this purpose for thirty years and TCA CROSS for ice pick scars for over twenty-five years, each with gratifying results.
When it comes to fraxel lasers and other expensive light and energy-based gizmos out there, exercise a great deal of "buyer beware" caution because the hard science to back up there use lags well behind the heavy marketing hype and social media buzz to promote them. Professionally performed manual microneedling (no need for the added expense or risks of RF microneedling) is best reserved for addressing and superficial, surface color or textural Irregularities. It is not particularly effective for treating acne scars, so no surprise that you did not see any benefit from your prior treatment.
You would be well advised to seek consultation with an experienced, board certified cosmetic dermatologist scar treatment specialist.

Hi there!
This is a great question - CO2 Laser is an amazing modality for lightening up acne scarring like yours. CO2 Laser is very user dependent, and a series of treatments likely would be required to achieve smoother texture.
With a skilled provider and combining with microneedling or radiofrequency microneedling like SecretPRO can be a great treatment option for you. The added collagen stimulation with the microneedling can really create a transformative result.
As always, an in person consultation is required for all patients in order to assess anatomy, goals, and formulate the correct treatment plan for you.
Sincerely,Eleni SgantzosCosmetic Dermatology PA-C