Should I opt for CO2 fractional laser for my scars or continue with RF microneedling? (photos)

Question

My scars are old and had done many chemical peels including TCA cross. Even dermarolling but very less results. Recently i have done RF microneedling 1 session but not happy with the results. Should i opt for co2 laser for my scars. I think its not deep now its more on surface and uneven skin texture. But my doc suggested for RF microneedling as he told it had same results but i dont think so.

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

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jeff Angobaldo, MD · Answer

Thank you for your question. CO2 laser skin resurfacing treatment is very beneficial for making acne scars diminish. This is done by removing deeper layers of damaged skin and stimulating the regeneration of healthy skin underneath. This treatment is also beneficial for uneven pigmentation, photodamage, fine lines and wrinkles, precancerous spots, and a host of other skin imperfections and benign lesions. If you believe you may be a candidate for CO2 laser skin resurfacing treatment, a qualified cosmetic surgeon or dermatologist can carefully analyze your skin and determine if the procedure is right for you.

Jason Emer, MD · Answer

A combination approach will give the most improvement. These types of scars need a combination of lasers, microneedling/prp, subcision and fillers. Co2 is the best laser for scars, but Erbium is a great alternative. 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

Jimmy C. Sung, MD · Answer

Hello! Through the photos you have posted I would suggest you either try ResurFX Laser OR CO2. ResurFX laser is a non ablative fractional laser, while CO2 is a fractional more aggressive laser completely making the a new layer of skin cells. With CO2 laser you only need 1 treatment but you will have downtime to heal, with ResurFX you have zero downtime but you do need more than 1 treatment to get the best results. Both are noticeably amazing results. I would suggest consulting with your dermatologist, or doctor to see which one would be best for you. sending you the kindest regards.

John J. O'Brien, MD · Answer

Hello, and thank you for your question and photos. Although we utilized microneedling in our practice, I believe in this instance your would get a better result using a Co2 laser resurfacing procedure. I would recommend that you seek out a qualified plastic surgeon or dermatologist in your area with expertise in this procedure.Best of luck.

Jonathan Zelken, MD · Answer

Thank you for your question and photo! Microneedling is a great treatment option for acne scarring but it is important to keep in mind that you will need multiple treatments to achieve the desired effect.  CO2 laser is one of the best treatments for scars and is a great option for acne scarring. Based on your history, this treatment too may require a couple of treatments. If you are looking for something that has less downtime than a CO2 laser, there is a treatment known as ResurFX which is a non-ablative fractional laser. Although the downtime may be less than a CO2 laser, you will need multiple treatments to achieve the desired effect. I suggest that you consult with a Board Certified Plastic Surgeon or Dermatologist to see what treatment option would be best for you.

Should I opt for CO2 fractional laser for my scars or continue with RF microneedling? (photos)

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