How many CO2 fractional laser treatments are required? (Photo)

The CO2 laser can be more effective depending on the strength and number of passes. I'm not sure how deep your provider is going but this could be part of the reason why it is not working as well. The deeper you, the higher risk of burns, so you have to find a good medium. If they are already doing high settings and you have had 4 treatments, you may want to try a different treatment.

In my opinion, if you are not seeing improvement after 4 CO2 treatments, you should consider switching to another treatment.  I prefer a series of microneedling treatments combined with topical PRP (protein rich plasma).  I do counsel my scar clients that nothing is available which will make all the scars go completely away.  However, 3-4 microneedling treatments should considerably minimize and improve the scars.I recommend a consultation with a physician experienced in aesthetic medicine.

Hello Sam.2017,
There are many different type of CO2 fractional lasers out there..  The strength of the laser depends on how deep it will go and what percentage of the skin is treated.  The strength will also be dictated by the skin type of the patient- Fitzpatrick types 1-3 can endure stronger settings. More pigmented skin types have more chances of complications such as hyperpigmentation and hypopigmentation.  The number of treatments depends on the skin color (type) and what type of laser and setting the doctor will be using.  

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. After 4 sessions and IF the actual before and after photos show no difference, you MUST take a different approach - treat the scar type. If you are in PJ, take a trip to Singapore to see Prof CL Goh, as I know he is the leading dermatologist for acne scarring in this region. I do not know of any one in Malaysia.  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.