Fraxel Laser Treatment Dangers

I am considering getting Fraxel laser surgery done to reduce the appearance of acne scars. You mentioned that there are a higher chance of side effects with a higher intensity laser beam. Is scarring one of these side effects?

Doctor Answers 12

Scarring can occur

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Yes. Scarring can occur with either the Fraxel Re:store or Re:pair laser but there is a higher chance with the latter. Scarring may be red thick raised or depressed scars. This is rare but no physician can guarantee that scarring won’t occur with chemical peels, dermabrasion or laser resurfacing of any kind.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Fraxel Laser Treatment and Scarring

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Thank you for your question. I can understand you concerns, however scarring is always a side effect with any laser. That is why we always recommend you to see an expert physician with any treatment you undergo, especially in laser surgery. Normally it takes more than 1 treatment to reduce acne scars and you can expect to see 50% of improvement with each treatment and the percentage rises with each treatment. I recommend having a consultation with an expert to determine the best treatment plan for you. Best of Luck!

Hardik Soni, MD (not currently practicing)
Summit Emergency Medicine Physician

Fraxel safe in the right hands

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There are two Fraxel lasers commonly in use:  Fraxel Repair, a carbon dioxide laser, and Fraxel Dual, a thulium and erbium laser.  Acne scars are generally treated with either the Fraxel Repair or the Fraxel Dual erbium.  These devices deliver a 'fractionated' laser beam which means that skip areas of untreated skin are left between the microthermal heated zones of treatment.  That speeds healing and reduces the risk of complications.  

However, every treatment can carry risks including scarring.  It is critical that you see a physician with training and experience, ideally a board certified dermatologist or plastic/facial plastic surgeon.  The Fraxel is not a procedure appropriate for an aesthetician, medical assistant or nurse.  You physician should discuss with you the possible complications, your personal risk of infection (generally patients with a history of herpes virus/cold sores are pretreated with valcyclovir to avoid an outbreak), and what to expect during healing.  If anything occurs that is not part of the normal expected healing described, you must call your treating physician.  Blistering or extensive scabbing can cause scarring if not treated appropriately.

Regarding dosage, your physician will pick the treatment parameters based on your condition and skin color.  Acne scarring invariably takes multiple treatments with either Fraxel so physicians often start with the gentlest dosing they think will be effective and increase as tolerated for subsequent treatments as indicated.

I hope this answer was helpful. Best wishes.

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 10 reviews

No Dangers With Fraxel

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Both Fraxel Re:Pair and Fraxel Re:Store can do an excellent job of smoothing out scars, making them less noticeable or even invisible. They have very few side effects and have been proven safe by the FDA and by years of use. Re:Pair is a stronger, ablative CO2 laser and will work in one session. Re:Store is gentler, non-ablative and will probably take several sessions to remove your scars. 

In the hands of an expert, neither Fraxel laser should cause scarring. During your consultation with a board-certified dermatologist, your skin will be evaluated for texture, tone and color so that the correct laser and settings can be determined. Side effects for Re:Pair include a reddened face that may feel tight for up to two weeks. Re:Store generally has no side effects at all. Some peeling or dryness may occur for some patients with either laser. Please find a board-certified dermatologist to find out which Fraxel will work best for you.

William Groff, DO
San Diego Dermatologist
4.9 out of 5 stars 51 reviews

Fraxel possible side effects

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Common side effects or reactons to fractional ablative laser treatments such as the Fraxel Laser or the Sciton HALO Laser include swelling, redness, skin flaking. The incidence of these is dramatically reduced with the HALO’s unique hybrid synchronous fractional/ full-field energy delivery mechanism. Patients do have some stinging during the treatment and for about an hour or two afterwards. By day three most patients get a bronzed or tan look. Every patient should be asked prior to treatment if they are susceptible to cold sores and pre-treated if necessary. Side effects also depend on the intensity and depth of the treatment. The stronger the settings the more downtime you can expect.

Marco Ellis, MD
Chicago Plastic Surgeon

Fraxel Laser Treatment

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If Fraxel Laser Treatment done properly for acne scars, Fraxel Laser Treatment should work great and shows good result. 

Jhonny Salomon, MD
Miami Plastic Surgeon

Fraxel Laser Treatment and Scarring

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The benefit of Fraxel Re:store is its relatively low side effect profile.  By leaving the outer layers of the skin less affected, most of the initial reaction is limited to mild-to-moderate redness and swelling for 1-2 days after the treatment.  This accounts for the minimal social downtime.   After the swelling and redness resolves, fine dandruff like flaking can occur, which may last 1 week.  Like other laser devices, burning, scarring, and post-inflammatory hyperpigmentation can occur, but the risks are minimized with the fractionation of energy.  These uncommon side effects, but real risks are the reason why it is important to have your Fraxel treatment performed in a physician's office.

Fraxel laser can cause scarring so go to an expert in laser surgery

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Scarring is ALWAYS a side effect with ANY laser. That is why it is VERY important to go to a physician who is an expert in laser surgery. Reducung the appearance of acne scars usually takes more than one treatment. We have found that patient’s can expect a 50% improvement with each treatment so that 1 treatment gives you a 50% improvement , 2 treatments give you a 75% improvement, 3 treatments gives you a 87.5% improvement, etc.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 26 reviews

Risk of Scarring with Fraxel Repair for Acne Scars

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With Fraxel Repair, we are using fractionated CO2 laser which has much more dramatic results but there is more downtime.  With the energy we use to improve acne scars, there are open areas of healing skin that require meticulous attention to pre and post care including finishing all medications since not following these can lead to infection and thereby scarring.  We have not seen any cases of scarring even on the top energy of the machine but we extensively counsel our patients and follow them closely after to monitor for side effects.


Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 52 reviews

Risk of scarring is less with Fractionated lasers

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Although there is a chance of scarring with any form of laser treatments with Fraxels Restore or CO2 Repair it is less likely to get a scar on the face.

I have seen scarring on necks however, so one should be careful with off the face treatment with the Fraxel Repair.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 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.