What Kind of Results Can Profractional Laser Give Without Coagulation? (photo)

I'm a type IV-V skin colour, my background is west indian, and I'm looking into profractional laser, all the dermatologists I've talked to have recommended around 4-5 treatments of profractional. The only concern I have is that, I have already used the dermaroller for 4 months, penetrating up to 2mm into the skin but didn't see much results. My scars are shallowly indented on the right side of my cheek. Dermatologists recommend to get it done without coagulation, is it worth it?

Doctor Answers 4

Profractional FX for scars on Type V skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Profractional treatments to your scars would definitely be beneficial and result in smoothing of the scar.  For your particular skin type you would not want nor need any coagulation as it will likely cause some persistent pigmentation.  You would also want to keep the total area treated in the 11% range, as higher percentages will result in a buildup of heat with the same risk.

Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Yes, but I would use a filler as well for your scars.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
To answer your question, my optimal treatment would be to use 5% CO2 laser, not profractional. I have both CO2 and Profractional Erbium, but for severe atrophic scars, use CO2 but not high coverage. 

If Profractional was to be used, I would go max depth ie. 1500 microns, 11% Pass, one pass only with 3+ Coag. 
You may get post laser darkening, but HQ or Lytera can reduce this (together with SPF). 

No matter what, you will require a dermal filler such as Juvaderm Volbella to fix up the atrophic scars. Combination treatments work best for acne scarring. 

Dr Davin Lim 
Laser and Cosmetic Dermatologist

Be Patient With Dermaroller

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Don’t give up on the Dermaroller just yet. Give it at least 6 months to see an improvement. I feel that it is a safe treatment option that will have minimal downtime and minimal side effects given your skin type. You should have 4 in office Dermaroller treatments and use a home roller between your sessions. Just remember, it takes approximately 2 months to see the results for the first Dermaroller treatment, therefore patience is key.

Modest scar improvement expected with Profractional laser

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree that Profractional laser could be helpful, but this will require more treatments than are typically used because of the gentler settings required to limit post-inflammatory pigmentation (5-8 range).  Also, I would consider alternating the Profractional laser with use of a non-ablative 1540 laser device (also with gentler settings).  Overall, though, I would expect maybe 50% improvement in the appearance of the scars at best.

Michael Contreras, MD
Greenwood Village Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.