Confused about acne scarring procedures. Is Halo considered an ablative procedure, non-ablative, or both? (Photos)

Question

I am confused about acne scarring procedures and trying to decide which one's right for me. Is Halo considered an ablative procedure, non-ablative, or both? I have acne scarring, so is it worthwhile to do HALO & will it produce similar results to say a CO2 laser? Or would I be better off with non-laser treatments, like TCA cross or subscision? I am hoping the HALO laser will be a good solution for clearing up acne scars and a general refresh.

Promila Banerjee, MD · Answer

Hi there, Would like to put your confusion to rest. Halo procedure is the first and only FDA approved hybrid procedure with both wave lengths for ablative and non ablative treatment procedures. Depending on the type of treatment, the treatment can be tuned to higher or lower settings depending on tolerance. Depending on how deep your scars are, it could probably take 2-3 treatments to get rid of most of the scars. Micro needling with PRP treatments are some of the other treatments you could potentially look into but that takes 8-10 treatments before you could see any results on the same.

Omeed Sani, MD · Answer

Hello,
Halo is considered the first hybrid laser in aesthetic industry. It is both ablative and non ablative. This is an excellent laser in a sense that allow clinicians to perform an accurate and predictable treatment with only a few days of downtime. The ablative part targets the shallow part of the skin like discoloration, age spots, sun damage and certain type of melasma. The non ablative wave length penetrate into the deeper layer and addresses conditions like scars, improve pores and texture, collagen stimulation,  and overall skin rejuvenation. In some cases Halo might be a good option to improve acne scars. Especially the darker skin type patients with shallow scars. In contrary patients with lighter skin type who suffer from deeper scars as a result of acne or rosacea, might expect a better outcome with other form of laser treatment like resurfacing. Compared to Halo, laser resurfacing considered an aggressive treatment with longer down time. Other treatment options like micro needling, subcision, chemical peel and filler may considered in other patients.
Best of luck

David A. Sieber, MD, FACS · Answer

Thanks for the great question! Halo is both ablative and non-ablative. There are two lasers in the device which fire at the same time to help improve sun damage, pore size, acne scarring, skin tone and texture, and fine lines. The non-ablative portion of the laser is what treats deeply in the skin to help form new collagen which can diminish the appearance of acne scars. Just like with any laser, it takes multiple treatments to really see a noticeable improvement in the scars. I would make an appointment to see someone in your area for an in person consultation to see if Halo is a good option for you. Best of luck!~Dr. Sieber

Rebecca Gelber, MD · Answer

Great question! Halo is actually the only laser which is both ablative and non-ablative. We were fortunate enough to receive the very first Halo prototype, so have been researching its benefits in scars for years. It is great in that you can dial up or down both the ablative and non-ablative components depending on goals, skin type and downtime tolerance. I would personally never use any form of CO2 in your darker skin type due to much higher risk of permanent hypo pigmentation.
I have had my best results with addition of subscision, punch biopsy scar resection, Halo and micro needling with Prp. Whatever treatment you do, prepare yourself for a series of treatments - good improvement with acne scars unfortunately is hard and takes time.

Paul J. Leahy, MD · Answer

Thanks for your question. It sounds like you have been doing a lot of research. The Halo is both ablative and non-ablative at the same time, but the beauty is that it is tunable for each patient based on his/her needs. Our Halo device is being used all day long and we've really been happy with the results we are seeing. To get the best possible result with acne scarring, you may need a comprehensive approach (laser resurfacing, microneedling, fillers, and skin care products). I hope that helps a little.

Harpreet Lotay, MD · Answer

Halo is considered a hybrid laser that has both ablative and nonablative components.  Both wavelengths are fractional and delivered in a varied and even pattern. The depth of treatment can be varied which is unique to this laser.  CO2 can be fractional or fully ablative and there is no nonablative component.  Depending on the type of acne scarring that is present, subcision may be helpful.  At our clinic we often combine subcision with Halo.  Halo is great for a general refresh of the skin in all skin types and is our preferred laser because of a shorter downtime and it's safety profile with darker skin types.  It is important to work with a physician who understands your goals, tolerance for downtime and your timeline.  Hope this helps.

Davin Lim, MBBS, FACD - Account Suspended · Answer

As above. Why? Because the ablative portion of the laser is only superficial. HALO is designed to be a low downtime laser for spots, dots, sun pigmentation, freckles and surface imperfections. Scars lie DEEP in the dermal lay of the skin. Many better METHODS to tackle scars. HALO IS a good hybrid laser, but other hybrid laser such as the YOU LASER are much better devices for scars, but not as good as HALO for the other things. Acne scar revision is a sub-specialised field. For the best results, one should target the acne scar type with ideal treatments and not just one device. The web reference below will take you to a resource to help you understand acne scar revision at a specialist level. I embedded all the videos in one page to help. 
  
For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars. 
  
The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best, 
  
Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.

Confused about acne scarring procedures. Is Halo considered an ablative procedure, non-ablative, or both? (Photos)

Answers (7)

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