No Improvement After Subcision and Fraxel Laser?

Question

I'm a 32 year old female who had subcision and fraxel laser done for my acne scars almost 3 months ago with no results whatsoever. My dermatologist recommends now subcision and CO2 laser. What are the chances of having some improvement with this new laser if I had none with the previous one. Also I have undereye wrinkles that thought would improve after the laser but didn't, is there anything I can do for them?.

Michael B. Lyons, MD, FAACS · Answer

My most gratifying results for treatment of acne scars have been a combination of Subcision, Filler(my favorite is your own fat with stem cell concentration mixed with PRP), and CO2 Fractional Laser Resurfacing.

	As other physicians have reported this is a work in progress, the problem is a scar formation at multiple layers of your skin, therefore one must either work slowly from the outside using only Laserabrasion, Dermabrasion, or Chemabrasion or add additional steps.This method works slowly and must be repeated each 3 to 6 months in my experience to help prevent complications of hyperpigmentation & scar formtion from the treatment.

	When one adds subcision with the "Abrasions" there is an added benefit of releasing the scar and allowing your own blood to help form collagen.

	When this release is performed  at multiple layers of the skin, and the deep dermal or subcutaneous layers have a filler added, there is a synergistic effect. The results that one would usually see after 2 to 3 fractional CO2 Laser treatments, can be obtained after only one treatment with CO2, Subcision, and Filler. I hope this information helps. M.Lyons,MD

Channing R. Barnett, MD · Answer

There are many different treatments for acne scarring, some more effective than others. The treatment(s) used typically depends on the type of acne scarring being treated.  I genuinely think lasers are overrated for acne scarring. Subcision gives mediocre results at best and is often not necessary.  Most types of acne scars can be corrected with injectable fillers, electrosurgery and punch excision.  Click on the link below to review before and after photos of acne scars treated mostly with injectable filler (silicone) and some electrosurgery.

Peter J. Jenkin, MD, FAAD · Answer

Treating acne scars is always going to be a "work in progress".  What ever treatment you settle on, you will need multiple treatments to see appreciable results.  Fraxel laser for acne scars is usually going to require 3-6 treatments.  I am assuming that you mean a CO2 fractionated laser as the alternative.  The results will come faster with that laser at the cost of greater down time.  Still, I would expect more than one treatment to be necessary.  I hope that is helpful.  Good luck.

William M. Ramsdell, MD (retired) · Answer

Subcision and Fraxel are good ways to treat acne scarring (assuming that you have the appropriate type of scarring). The benefit of fractional CO2  - such as Active FX and Deep FX - is that many fewer treatments are necessary. Your results will be dependent of the severity of the scarring and how aggressively the laser is used. Hope this helps.

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No Improvement After Subcision and Fraxel Laser?

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