No Improvement to Acne Scar After Fractional CO2?

Question

Hello Doctor..I am 3 weeks POST fractional CO2 but do not find any improvement in my acne scars on face. Is this normal? I am scared all my hard earned money has wasted.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Julian De Silva, MD · Answer

Fractional laser resurfacing is an effective treatment for acne scarring. Key to an effective treatment are these considerations:

•      Avoid if treated with Roaccutane in the last 6-months

•      Postpone if active acne

•      Realistic expectations for improvement, several treatments may be required, each building on the last treatment

•      Use of test-patch of laser to avoid risk

•      An experienced doctor who has used laser resurfacing for many years with good results

•      State-of-the-art modern laser designed for safety and fast recovery

Michele S. Green, MD · Answer

Fractional lasers are a great tool to treat acne scars.  However, it can take several treatments to improve the appearance of deep acne scars.  It also can take up to six months to see the full effects from the treatment.  I would return to your treating physician to discuss your concerns.

Jeffrey Zwiren, MD · Answer

You are still early in your recovery period and active phase of healing from the CO2 laser. Give it a chance. Acne scarring is difficult to treat because it is a deep dermal problem. The fractional laser energy does a good job at smoothing out the superficial irregularities but it has a difficult time with these deeper scars. The Cynosure SmartXide laser has the capability of stacking the pulses to penetrated deeper into the scar. The deeper the treatment and the closer together the dots then the more prolonged the healing as well. Complete healing takes 4 - 6 months to achieve.

F. Victor Rueckl, MD (in memoriam) · Answer

Results will build over time. Do not panic. The purpose of fractional CO2 is to remove minimal surface skin, and have the effects be underneath, and bring those up. It simply takes time. 3 weeks isn't enough to evaluate it. It can take 6 months to fully see results from fractional CO2 because the purpose is to have you have minimal downtime, but results that build. As opposed to traditional CO2 which can take months to recover fully.

No Improvement to Acne Scar After Fractional CO2?

Answers (5)

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