CO2 or Infini for acne scars, which one has a better result? (Photos)

Acne scars need a combination approach for improvement. For the best results, one should target the acne scar type. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Typically you need fillers like bellafill and sculptra for atrophic indented type scars with or without subcision. Subcision for depressed tethered scars. Vascular lasers like yellow laser, aerolase, excel V or IPL for redness or thick scars. And lasers such as fraxel, erbium, co2 or fractional radiofrequency like venus viva, skinfinity, intensif microneedling RF for textural issues and superficial scarring. Deep ice pick scars and narrow box car scars are best treated with TCA CROSS and punch excision. All lasers are combined with microneedling and PRP to get even better results and improve healing times. The majority of patients will have a collection of different scar types, and hence a tailored treatment plan is needed by an expert physician. It is never about the laser or product that gives the results, its about the expert behind the equipment that gets you the outcome. Scars cannot be cured and will need life-long treatments to maintain and build on the results. Best, Dr. Emer.

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

Given the heavy advertising and the marketing out there, I am not surprised that you phrased your question as basically which device will be better for me, rather than which treatment or combination of treatments would be best for me. I have been writing for years cautioning readers about "bells and whistles," "next big thing" machines and products, like fraxels, radiofrequency devices, and PRP, which appear to be far more backed by device and product manufacturer supported marketing and advertising hype than any hard science. Subcision is an excellent means for elevating sunken (depressed, indented, atrophic) scars, but generally two to four treatment sessions are required per scar to achieve optimal improvement and done on multiple levels within the scars. Unfortunately, I need to emphasize that no scar older than three months, from any cause, including those from acne, can be completely eliminated with any current technology, although significant improvement is possible. Like you, the vast majority of people with acne scars typically have a combination of all the major types of acne scars, including boxcar scars, rolling scars, and pit scars. For best results, each type of scar requires its own treatment or combination of treatments.Less expensive tried and true treatments, on the other hand, such as "field subcision," for treating generalized facial atrophy;  individual subcisions wtih a biostimulatory filler (for deep rolling and boxcars);  TCA CROSS Technique for ice pick scars and very narrow boxcar scars; and medical microneedling for blending any residual, superficial color and texture problems that have followed these other treatments, have been shown to more consistently yield gratifying improvements. A series of superficial peels can help to fade and improve the postinflammatory pigmentary changes that may be present.  For more information on these, you may do an internet search under the above terms or check out the archives of RealSelf.com  Make sure that you do your due diligence in finding a good board certified aesthetic physician and not simply anyone or any place hawking its latest expensive fraxel or radiofrequency device purchase. Best of luck,

In  my opinion, both infini and CO2 fractionated laser are excellent for medium depth superficial scars. We utilize both in the same session. To get the deeper and tethered scars, subcision and PRP is performed. I believe the infini provides more "lift" than the CO2 fractionated laser, but not as much as the subcision with PRP. Acne scars are treated based upon their type and therefore you need to see an acne scar expert who will determined which treatment is appropriate.

I've used fractionated CO2 laser for many years for acne scars and I've also used Infini RF in recent years. I'm very impressed with Infini RF. In my experience Infini RF is far superior. But Infini is more for the mid to deep dermis and I also use LaseMD thulium laser simultaneously for more superficial coverage and find that this combination is very effective.