Can the fraxel laser be used to treat active acne? Are acne scars expected to increase on Accutane?

I know fraxel lasers are used to treat acne scars, but I'm not sure if they can be used (maybe a specific variation) on active acne. I have a great deal of acne scars and active acne and I am not sure whether I should pursue laser treatment now or later once my active acne has ceased. I am currently on Accutane (20mg) and I have found that all of my active acne seems to scar now; I find the emotional toll to be the worst. The pigmentation of my scars are very red.

Doctor Answers 3

Accutane and Fraxel laser- NOT a good idea

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Legally in the US, most Specialist will NOT perform Fraxel laser with active acne, especially if you are on Accutane. I personally will not treat old scars if you have active acne, as this can be frustrating for both yourself and the treating Specialist- namely we repair one scar, only to have a new one form due to active acne. If your scars are relatively new, gentle treatments such as Fraxel 1550 and low dose 20mg isotretinoin or even RF with eMatrix is safe. This is determined on a case by case basis. 

Regards, Dr Davin Lim. Brisbane. Australia. 

Fraxel and Acne

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A logical course of action for someone with active acne and scarring is to first treat the acne and get it cleared up.  If one is treating with "Acccutane" (isotretinoin) it is typically recommended that one wait 6 months after completing the course of medication before treating with laser.  This recommendation is based on older studies that showed a higher risk of scarring when Accutane patients were treated with dermabrasion.  Newer studies imply that one may not necessarily need to wait that long.  The Fraxel Laser is typically not used to treat active acne and in some patients can cause a flare.  If what is bothering you is redness you might be better served with the VBeam Laser or Intense Pulsed Light (IPL)

Jerome Potozkin, MD
Danville Dermatologic Surgeon
4.2 out of 5 stars 5 reviews

Accutane and acne scar lasers

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Hello there,

I recommend waiting at least 6 months after you finish a course of Accutane before receiving your Fraxel re:pair CO2 laser treatment. This is because Accutane affects the way your skin heals, and it takes about 6 months before it is safe for you to get your laser treatment. 

Also, it is important to make sure you have been clear of acne for at least 6 months before you receive your laser treatment. Sometimes Fraxel re:pair CO2 laser treatment can cause a worsening of acne after the treatment is performed. Having clear skin for at least 6 months can help prevent complications. 

I hope this helps!

Andrea Hui, MD
San Francisco Dermatologic Surgeon

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