My doctor told me to use isotretinoin for 4 weeks before Co2 Laser scar treatment. Why is this?

Question

I'm a dark skinned individual with acne scars. My Doctor said I need to use isotretinoin for 4 weeks and stop it for a week before beginning Co2 Laser treatment for acne scar. Why is this? I heard isotretinoin is not recommended before Co2 treatment.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

If you have darker skin, I'd recommend a nonablative laser like fraxel or a fractional radiofrequency treatment like VIVA/Skinfinity/Intensif.  Isotretinoin is safe with lasers if used properly. I suggest seeing an expert. Best, Dr. Emer.

Dean L. Johnston, MD (retired) · Answer

Isotretinoin is a prescription drug used to treat severe acne.  A patient should wait at least 6 months to a year before considering CO2 Laser treatments.  Your history of dark skinned individual makes you at risk for pigment issues secondary to the laser treatment.  Consider several opinions prior to undergoing this aggressive treatment and ask to see or talk with others of similar skin type to be better prepared.

My doctor told me to use isotretinoin for 4 weeks before Co2 Laser scar treatment. Why is this?

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My doctor told me to use isotretinoin for 4 weeks before Co2 Laser scar treatment. Why is this?

Answers (3)

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.