What is difference between ablative and fraxel laser? Which one is better for ice pick acne marks?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thanks for your query. Fraxel is better for ice pick scar as I give the quality of ablative laser in a non ablative way which decreases the downtime and the results are also better. Hope it helps.All The Best

ablative lasers "burn" the skin, they are erbium or co2 and they have scabs and require wound healing.  where fraxel is a gold standard non ablative that only heats the skin, has no wound healing or scabs.  Please see an expert to consult your concerns.  Best, Dr. Emer.

Fraxel is a brand of lasers and they have a line of lasers that are different, that are ablative or non-ablative.Fractional CO2 Fraxel is non-ablative laser. On the other hand, Fraxel Re:Pair is ablative laser.Ablative means is that it is more invasive but can deliver improved results when it comes to aging to serious scarring. Fraxel Re:pair which is a fractionated CO2 laser is standard for ice pick acne scars. I would suggest you to find a provider with experience who can tell you what type of laser will work the best for you. Good luck! 

Laser skin resurfacing can be ablative or non ablative. Ablative usually involves the use of a CO2 or Erbium laser. The laser in the case of ablation "burns" the skin or heats it so that it evaporates. This creates a surface wound which requires healing. Non ablative lasers usually work deeper in the skin while the most superficial layer remains intact. Ablative lasers are associated with more downtime and considered more aggressive then non ablative lasers. The Fraxel Dual is a non ablative laser while Fraxel Repair is an ablative laser. These days, the term "Fraxel" usually refers to the non ablative treatment but of course it is always important to ask that you are intact getting a Fraxel Dual treatment. 

Ice pick acne scars are difficult to treat. Therefore, of the two choice you provided, ablative would be more helpful than a non ablative laser for this indication. However, I think the best treatment option for ice pick scar is probably punch biopsy removal or TCA cross peel. 

Resurfacing lasers are 2 types, ablative and nonablative. The Fraxel actually has both. The re:pair is fractional ablative CO2. The Fraxel Dual and Clear and Brilliance are fractional nonablative lasers. In general, the ablative lasers are more aggressive and have more downtime and more risk. So the CO2 will be better for ice pick scars. Another type of ablative lasers is Erbium. Other ways to treat ice pick scars are TCA Cross and Infini (my preference).