Laser Resurfacing or Dermabrasion for Uneven Skin, Premature Fine Lines and Acne Scarring?

I am 25 years old and have been in search of a treatment for uneven skin, premature fine lines, and some acne scarring. I still have some mild comedonal acne that has persisted since adolescence, but am pretty depressed with how my face now looks. I am 2 years post accutane and i think my skin is pretty sensitive. I really want to fix this as it is very depressing but am unsure of what the best route to go actually is. I figure dermabrasion or laser resurfacing are best, but am pretty scared

Doctor Answers 6

Treatments for Acne Scarring, Fine Lines and Uneven Skin

As mentioned by another physician, this is a very difficult question to answer without doing a physical exam.  We have many different treatment modalities for acne scarring, fine lines, uneven skin, some of which work well individually or in combination with others.  However, the choice really depends on a patient's areas of concern, their skin type, their willingness and/or ability to have downtime, their healing, and their affordability.  In our office we have different lasers and dermabrasion-like machines (ie. Silkpeel Dermalinfusion) which we utilize very often for fine lines and uneven skin.  We also use liquid injectable silicone for a lot of acne scars, which gives great results.  I recommend you consult with a board-certified dermatologist or facial plastic surgeon for evaluation and discussion of best treatment options for you.

New York Dermatologist
4.1 out of 5 stars 8 reviews

Dermabrasion or laser for acne scarring

Unfortunatelt this is a very difficult question to answer without an exam.  However, a few generalizations can be made.

1.)  Deep ice pick scars likely will require removal with small grafts from behind the ear for maximial improvement followed by some resurfacing (dermabrasion vs. laser).

2.)  Lasers are very good to soften margins on discoid acne scars (think of moon craters).

3.)  Atrophic acne scars often will need lifting with some filler.  Fat can be used.  Also any of the availalble market fillers work quite nicely.

Bottom line:  All scars are not the same.  Many times a combination of therapies is necessary to resurface the skin, remove irregular surfaces, and plump the undersurface to improve contour.

Hope that helps.

Dr. Todd Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
5.0 out of 5 stars 53 reviews

Skin resurfacing for acne scarring

I have seen some very impressive improvements in the skin of my patients after treating them with fractional CO2 laser resurfacing. However, it is important to try and stabilize your acne before being treated. In some of my young adult patients with acne scarring, you can see mild flare-ups afterwards, but these often respond to antibiotics and skin care. If you feel that your skin is sensitive, then I feel that the fractional CO2 laser is much less stressful on your skin than dermabrasion or full strength ablative laser resurfacing. However, you may want more than one treatment to see optimal results. Additionally, I would recommend having a test spot performed prior to having your full face treated.

Gregory J. Vipond, MD, FRCSC
Inland Empire Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Acne scarring and persistent comedonal acne despite Accutane

I would not suggest you undergo any resurfacing treatment, whether dermabrasion or laser resurfacing with Fraxel, if you have whiteheads or blackheads currently. The healing process can create a flare of acne that is caused by a disruption of the preexisting blackheads or whiteheads.  You should see a dermatologist to determine if you need a stronger strength of the vitamin A medication, and then you would have to wait a year afterwards before having the resurfacing (the standard of care is to wait a year in case [not proven] there is an increased risk of scarring from the Accutane). You may need a topical therapeutic to decrease the whiteheads or blackheads.  When the acne is under better control, then seek a referral for an evaluation of Fraxel Restore laser treatment for the scars.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Fractional laser resurfacing is generally safer than dermabrasion for creating facial rejuvenation

Fractional laser resurfacing is generally safer than dermabrasion for creating facial rejuvenation. Healing is faster and controlled depth makes performing the procedure more accurate.

Edward Lack, MD
Chicago Dermatologist
2.8 out of 5 stars 5 reviews

Laser Resurfacing or Dermabrasion for Uneven Skin, Acne Scarring in 25yo Post Accutane

I highly recommend that you consult with a practitioner that is well experienced with both modalities you are considering. It will be important to perform a health and skin assessment and discuss the risks and benefits of both procedure as well as review anticipated outcomes. It may be necessary, given your mention that your skin is "sensitive", to treat a small area to see how your skin reacts.

Anifat Balogun, MD
Seattle Otolaryngologist

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.