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

Doctor Answers 4

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

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


India Plastic Surgeon
4.9 out of 5 stars 132 reviews

Ablative versus non ablative lasers

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. 

Acne Scarring -- Lasers (Fraxel, Co2/Erbium, VIVA, Intensif); Microneedling/PRP, Fillers (Bellafill); Subcision; Punch Excision

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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

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Ablative lasers?

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).

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.