Will Infini RF or Fraxel be helpful for my scarring? (photos)

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

With acne scarring, the infini works better in my opinion. It's important to understand there will be only a 50% improvement in your appearance and usually 3 treatments are necessary for the best results.

Microneedle radiofrequency ( Infini) and fractionated low-density lasers should improve your acne scars. However, I believe that TCA Cross or punch excision would be a better starting point.Jeff Rapaport MD FAADRealself All-star

I your case, you have many ice pick scars which I would treat with TCA Cross. In general, Infini is a much better choice for acne scars than Fraxel. Infini goes deeper, has less downtime, and is safer on darker skin. I have upgraded to the Genius and this device is best RFM on the market. It has impedance feedback, sharper needles, better motor design, and energy delivered measurements. Sometimes clinics make recommendations based on what device they have purchased and not necessarily based on what is best for the patient. We have the Fraxel and we used to use for acne scars until the Infini was purchased. Our results are much better with the Infini.

How long you have had the scar will effect the outcome of any treatment. For example if you have had scar for a long time, such as 10 to 15 years, any of the treatments; ablative, fractional or microneedling, will result in approximately a  20 to 30% improvement.Studies show that the earlier you treat the scar the better the results will be.We find Combining microneedling with PRP (platelet rich plasma) results in  a much better outcome as the plasma is very rich in growth factors. If you choose a fraxel treatment, be sure that it is an ablative fraxel treatment as a non ablative procedure will not produce good results. 

Thanks for your question. There are many options for improvement. While radiofrequency is often or favourite option (efficacy vs downtime), many patients require more than one treatment to get the best results. I absolutely agree that punch excision and or TCA cross would be a great starting point for your type of scarring but having said that RF can improve the look of it as well. With your skin type you are at a higher risk of post inflammatory pigmentation changes and I would strongly recommend only seeing a board certified dermatologist to get this treated in order to minimize your risk. Good luck

Agree with Dr Weiner- this is primarily TCA, secondary with a narrow beam CO2 laser, or an energy device. TCA in the correct hands will give a far, far superior outcome compared to Fraxel or RF microneedling.  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. 
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 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.