In your opinion, is CO2 worth it for my scars? (Photo)

Question

I've had PRP miconeedling, baby fraxel and possibly other non ablative laser treatments w/little to no improvement. I tried to show my skin in different lighting and angles in the pics.

Monika Kiripolsky, MD · Answer

Dear FightingTheScarring,
  Yes, CO2 laser would help with your scars. But, you will likely need more than one treatment (spaced 6-12 months apart). And, you would benefit most from subscission in combination with the CO2 laser to free up areas that are tethered down. Also, make sure your provider is board-certified and has a lot of experience with lasers (and has a powerful CO2 laser. . . they are not all created equally). 
Hope this helps!
Dr. Monika Kiripolsky

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

Jason Emer, MD · Answer

CO2 is the best laser for scars, but Erbium and Halo with Profractional are great alternatives. It may take a series of treatments to see improvements and to maintain. Keep in mind that a tailored combination approach will give you the most improvement with acne scars. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer. ​

Theresa M. Jarmuz, MD · Answer

I personally think that you would have a good response to CO2 Laser. It could take 1-3 treatment, hopefully no more than 2. A combination approach to scars is very effective. CO2 appears to be needed, as lesser invasive options are not reaching the result that you would hope for regarding your facial scars. The depth of CO2 for controlled injury and remodeling of tissue is what you will obtain results with- I hope this helps. 
J Scaljon

Nelson Lee Novick, MD · Answer

Regular followers of my answers would hardly be surprised by the lack of success with fraxels, RF treatments, and PRP, since all of these "bells and whistles," heavily marketed "next big thing" devices and treatments are much more heavily supported by the hype than any hard science. So sorry. On the other hand, simple, relatively inexpensive treatments, such as subcision for elevating and smoothing rolling and boxcar scars, and TCA CROSS for ice pick scars and dilated pores each are supported by decades of safety and efficacy data in all skin types. You would be wise to consult with an experienced, board certified dermatologist. Hope this helps. Best of luck.

Anshul Gambhir, MD · Answer

Hello there, 
I would recommend consulting with an experienced facility to address your concerns. In most cases multiple treatments of microneedling paired with PRP would be recommended to achieve optimal results. Additionally CO2 is a reasonable treatment, for the right candidate. It could help in the over all texture of the skin. I hope this helps you!

Richard Ort, MD · Answer

I would likely recommend subcision plus fillers for the scars on your cheeks. I would need to see you in person to provide a definitive recommendation. Subcision combined with filler releases, lifts, and fills sunken scars. 
Best,
Dr. Ort

In your opinion, is CO2 worth it for my scars? (Photo)

Answers (7)

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