Concerns are fine lines, acne scarring and jowls - am I candidate for CO2 Laser or something else? (photos)

Question

Had a consultation for CO2 laser for my 65 year old skin. The Dr. says he uses the old school CO2 laser (20 yrs.) and that it would give me at least a 50% improvement on my acne scaring and fine lines. I am concerned with the jowls as well. Did filler recently and it doesn't look good. Derm said laser waste of money and only look good for a short time because of the swelling. Dermatologist has done 2 Jessner Peels & 3 Microneedling with PRP. Had a facelift in 2015 and neck done in 2009.

Jason Emer, MD · Answer

"​Acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:
- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. 
- Subcision for depressed, tethered scars. 
- Vascular lasers like Yellow laser, Aerolase, excel V, BBL, or IPL for redness or thick acne scars. 
- Lasers such as Fraxel, Erbium, CO2, Halo or fractional radiofrequency (Venus Viva, Skinfinity, Morpheus, PiXel8, Fractora, Intensif microneedling RF) for textural issues and superficial scarring. 
- TCA CROSS and punch excision for deep ice pick scars and narrow box car scars.

All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​"

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Concerns are fine lines, acne scarring and jowls - am I candidate for CO2 Laser or something else? (photos)

Answers (2)

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Everything you need to know about CO2 Laser

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Concerns are fine lines, acne scarring and jowls - am I candidate for CO2 Laser or something else? (photos)

Answers (2)

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.