What type of laser would be best to treat acne scars? (Photo)

Question

Had acne years ago and was left with these scars, they’re pretty shallow but tretinoin has done nothing for them. I am very self conscious about them and would like for them to be less noticeable.

Mark Beaty, MD · Answer

For shallow acne scars, there are several treatment options that can help improve skin texture and make the scars less noticeable. In general, a combination of treatments tends to provide the best results.

CO2 laser resurfacing is the more intensive laser option and can offer significant improvement in acne scarring and overall skin texture, although it typically involves more downtime and recovery. A series of Erbium laser treatments may also provide meaningful improvement with a different treatment intensity and recovery profile.

Microneedling and RF microneedling are additional options to consider. Although these are not lasers, they stimulate collagen production and can help improve the appearance of shallow acne scars over a series of treatments.

The best approach depends on the type and depth of your scarring, your skin type, and your tolerance for downtime. An in-person evaluation would help determine which treatment or combination of treatments is most appropriate for you. With the right treatment plan, meaningful improvement is often possible, although complete elimination of acne scars is not a realistic expectation.

Nelson Lee Novick, MD · Answer

First off, let me emphasize that the hard science to back up the use of exensive "bells and whistles" lasers lags well behind the heavy marketing hype and social media buzz to promote them.  What's more, laser treatments, particularly in skin of color poses risks for post-treatment dyspigmentation that can be difficult and costly to try to treat. 
You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist acne treatment specialist. There are stronger topical retinoids than ordinary tretinoin that may help. Additionally, a series of full strength superficial peels, such as beta hydroxyacid peels that may be used. 
For ice pick scars, there's TCA CROSS and subcision for indented boxcar and rolling scars. Unlike so many of the costly, here-today-gone-tomorrow gizmos, these treatments have stood the test of decades of time for both efficacy and safety. Hope this helps and best of luck.

What type of laser would be best to treat acne scars? (Photo)

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