Fractional and CO2 Lasers for acne scars on very dark southeast Asian? I'm about level V on Fitzpatrick (Photos)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

A combination approach will give the most improvement. Co2 is the best laser for scars, but Erbium is a great alternative for darker skin types. These types of scars need a combination of lasers, microneedling/prp, TCA cross, punch excision and fillers.  It may take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Given your Fitzpatrick Skin Type V I would suggest microneedling instead of CO2 laser resurfacing which is likely to result in post inflammatory hyperpigmentation.  I use the Dermapen 3 in combination with subcision and Bellafill to treat acne scars.