Can I spot treat acne scars on my temples with CO2 laser?

Question

I have a lot of scars mostly boxcar and saucer scars. But they are all located on both sides of my temples only. There is literally no unscarred skin on my temples. I was wondering if I can get co2 laser done on ONLY my temples, I would hate to risk my good skin on the rest of my face for hyperpigmentation or even more scarring. Also I am Filipino with a light complexion.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Yes, you can have spot treatment with lasers in the scarred area. However, a combination approach will give the most improvement. These types of scars need a combination of lasers, microneedling/prp, subcision, Cosmelan and fillers. Co2 is the best laser for scars, but Erbium is a great alternative. It will take a series of treatments and may need some treatments to maintain. I recommend getting a formal evaluation with an acne scarring expert. Best, Dr. Emer

Victoria A. Cirillo-Hyland, MD · Answer

You might want to try Lutronic's Infini which is fractionated microneedling radiofrequency device.  It is less likely to cause pigmentation compared to CO2 laser.  You will typically need 3-4 treatments over time.  The good news is the downtime is minimal as the energy is delivered directly into the dermis, leaving the epidermis alone.  It has been a "game changer" in our practice for acne scarring.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Short answer is yes, but I always match the scar type to the best treatment. In your case it MAYBE Co2 laser. 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. 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.

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Can I spot treat acne scars on my temples with CO2 laser?

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Answer: CO2 laser vs manual scar removal vs microneedling RF

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