Which Kind of Resurfacing for Acne Scarring, Sun Damage, and Large Pores?

I have been on so many consultations! Laser, mid-depth TCA, dermabrasion. I know they all work differently, but they seem to have similar healing profiles, downtime, cost, etc. I have mild acne scarring, sun damage, and large pores. I know I need a resurfacing, but which one should I choose?

Doctor Answers 5

Combination therapy for acne scarring, sun damage, and large pores

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The treatment of acne scarring, sun damage, and large pores does not have a one best answer approach.  In general, there are many factors that come into play when choosing the appropriate treatment for a particular patient's current skin issues.   Given that you have multiple skin issues, I would consider a multi-modality approach in order to give you the best possible cosmetic result while still maintaining your natural beauty.   Lasers, chemical peels, and other cosmetic procedures all have their place for various conditions and should be given fair consideration when putting together a treatment program. 

Arlington Dermatologic Surgeon

Laser is best overall choice for rejuvenation.

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I strongly favor laser resurfacing over mid depth TCA (unpredictable) or dermabrasion (messy and almost a lost art). Laser resurfacing is easily adjusted to the proper depth and aggressiveness. Which laser and how aggressive would be determined after an evaluation of your particular issues.

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 36 reviews

Total FX for Sun Damage and Acne Scarring

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If your skin type is 1, 2 or 3 then fractionated resurfacing with Total FX would provide the best result for sun damage (Active FX) and acne scarring (Deep FX). To maintain the result and improve pore size, you should follow this laser treatment with a good skincare regimen that includes a topical retinoid (example: retin-a, renova, or skinmedica retinol complex).

Daniel Levy, MD
Bellevue Dermatologic Surgeon
4.8 out of 5 stars 44 reviews

Acne Scarring

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Acne scars treatment depend on your skin color. The Gold Standard, is CO2 laser resurfacing if you can give the time to heal, and understand what to expect during the healing process.Dermaberasion is an old proven method, CO2 lase is more accurate.

Tca peel will give mild improvement. Fraxel Laser is WORTHLESS, Thermage is WORTHLESS in treating acne scars of any depth.

Proceed with caution, There are many claims but few methods that do the job well. Consult a Board Certified Plastic Surgeon or Dermatologist for CO2 Laser resurfacing and what to expect

Samir Shureih, MD
Baltimore Plastic Surgeon

Fraxel for Acne Scarring, Sun Damage, and Pores

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With all due respect to Dr. Shureih's opinion regarding his disdain for Fraxel laser treatments, I and many other laser experts have found Fraxel to be MOST EFFECTIVE at treating acne scars as well as most other types of scars.  It does take the combination of Fraxel technology along with a physician who is dedicated and experienced to obtain the optimal results with the treatment. (See web reference below, photos 5,6,&7).

Although I do not personally use Thermage in my practice, in the past few years many patients (including fellow physicians) have achieved very nice results.  It may be unpredictable in some patients, but certainly not "worthless".

Fraxel repair is an ideal treatment for your skin.  Acne scarring and sun damage respond very well, pores respond less predictably.   Fraxel restore is a less aggressive, less effective alternative.  Choose your treating physician carefully.  You may also consult with a board certified facial plastic surgeon in addition to dermatologist and general plastic surgeons as recommended by Dr. Shureih.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 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.