What Would Be Better for Moderate Acne Scarring (Non-cystic): MixTo or DeepFX Laser?

I can only afford one treatment and would like to know which of these lasers goes deeper for better results. I am 34, and the scarring is all over my face. I also have a 2 inch scar in my right smile line. Please help me make a decision. Both of the doctors are very experienced.

Doctor Answers 4

Why a Single Laser Treatment May be "Not Enough" for Acne Scars

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Scars represent tissue loss. This means you need to somehow replace the lost tissue with new collagen. A single treatment of either MiXto or DeepFX won't be sufficient to get the job done.

Here's why:

Collagen response to laser is based on a controlled injury - fractional laser gives you a certain level of that injury to turn on collagen building. It is only through repeated treatments that you get the accumulated collagen build that you need to effectively smooth acne scars.

Depth is not the issue as much as frequency. Each treatment builds on the one before to eventually provide a smoothing effect for the repeated collagen production.

Your other options include

  • a dermal filler (temporary results and may not be as "smooth" as you desire)
  • subcision performed BEFORE a laser treatment (only by a qualified dermatologist who has the skill to do this properly). Subcision involves a special needle with sharp edging which cuts the scar floor from the tissue beneath. Ideally this should enhance the laser effect but there is no guarantee.

    Depending on the pigmentation levels of your skin, certain lasers will promote post-treatment Hyperpigmentation. Of recent note is eMatrix which is not laser, bur radio frequency and thus bypasses much of the post treatment pigmentation risks.

Keeping your skin hydrated, protected from the sun and clear with a good acne control regimen will be of some positive benefit.

Some physicians participate in training and/or clinical studies who may be willing to use you as a model. It might be worth checking in your area to see who may be involved in either training or trials.


Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Mixto vs. deep fx

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The question about which laser with which to be treated is not the correct one to ask.  What you should be asking is "which doctor operating the laser is most experienced"?  There is no single treatment that is likely to give you as much improvement as you need.  You need to work with a physician who treats a lot of acne scars.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

Fractional laser treatments must be repeated for acne scarring

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Fractional laser treatments must be repeated for acne scarring. There is no evidence that the depth of the treatment is as important as number of treatment sessions and per cent of surface covered by the laser. Therefore, technique with fracitonal lasers is more important than the name of the laser.

Edward Lack, MD
Chicago Dermatologist

Total FX for Acne Scarring

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Thank you for the question.

After evaluation your skin, I would suggest you undergo a Total FX treatment. This laser, in our hands, is unparalleled for management of moderate to severe acne scarring. 

Best of luck,

Glenn Vallecillos, M.D., F.A.C.S. 

Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

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.