How to treat acne scars- NOT with Fraxel Laser


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How does the Fraxel laser treat acne scars?

Fraxel lasers, like other fractional lasers produces tiny columns of laser energy that penetrate the skin. Depending on the type of skin you have the depth of scars, and type of acne scarring, your Specialist will determine the depth and density of treatment. Laser energy is concentrated in the deeper dermal layers of the skin, and this breaks down acne scars. The skin responds to this breakdown of old collagen, and stimulates new collagen. This is the basis behind acne scar revision. Lasers are best for certain types of acne scars, remember, not all acne scars are best treated with lasers, and methods such as TCA PEELS, fillers, surgical subscision, PRP energy based microneedling and RF devices are needed for a targeted approach.

What is the success rate of Fraxel laser treatment for acne scars?

Over and over again I stress that acne scar management should be done at a specialist level, and tailored according to the patients skin type, acne scar type and downtime. Most patients who have acne scars will have a variety of scars including deep ice pick, rolling, box-car and atrophic scars. Fraxel in theory will improve all forms of acne scarring, however a targeted approach will give the best results. Acne scars can be treated with two types of Fraxel laser- the 1550, or dual, or the Fraxel RePair or Co2 laser.

How does Fraxel compare with other fractional laser machines?

Fraxel is FDA approved for the treatment of acne scars, however it is almost impossible to compare all our lasers at the same level. Why is this so? Well, because every patient with acne scars is unique. Scar types, depths and extent will differ for all acne scar patients, as well as their skin type and downtime. Importantly, cost can be a factor as well. As a guide I rate Fraxel as a modest treatment for acne scars. There are many other better lasers for acne scars. CO2 CORE Fractional using higher energy settings can be more effective in deeper scars, but the trade off is longer healing times and it should be used in caution on darker skin types. Fraxel 1550 in this case is safer. CO2 lasers made by DEKA and Lumenis have higher density levels, and more power. ‘With power comes responsibility- spiderman’- however these lasers outperform Fraxel CO2 by far. The future however is not solely in lasers, for now it lies in insulated micro needling energy devices, like INFINI RF, in combination with PRP. Lasers are not redundant, they still play a political role for rebates, and clinically for shallow box car scars. Remember, it is never about the device, but the method of scar revision that gives optimal results. Everyone will have a unique pattern of acne scars, and find the correct method will give the best results.

Can Fraxel be used in all skin types and skin colours?

Yes. Fraxel treatment is excellent treatment for acne scarring in all skin types, including darker skin scar patients. Asians, Latino, Greek and Middle Eastern patients can be treated with an excellent safety profile. In this setting, the 1550 Fraxel is the safer one, however this treatment, in my opinion is outdated with the even of insulated RF based microneedling systems such as INFINI in combination with Platelet Rich Plasma.

Dr Davin Lim
Laser and cosmetic dermatologist
Brisbane, Australia.

20 Responses to “ How to treat acne scars- NOT with Fraxel Laser ”

  1. Jay Park says:

    Thank you it was very informative.. by the way I got a answer from you at realself site,that hypopigmented cut scar should be used laseric method(or microneedling) plus latisse.how can that 'latisse' be used on that scar area??  I got no information about latisse ..

  2. Lovely Marie says:

    you have clinic manila?

  3. Lovely Marie says:

    how much Lazer acne

  4. Lovely Marie says:

    ohh how sad😦 I really need you but I have to much money to go Australia 😢😢ok thank you for your message

  5. Chucho Yema says:

    Thank you for the information Dr Davin Lim I started searching i only found the lumenis ultrapulse encore i was just wondering if it the same one as in your video

  6. maushumi deori says:

    Dr. Lim, Thanks for your very informative videos. Could your please tell me what is the difference between Infinity Rf and Scarlet Rf??

  7. Kelvin Truong says:

    Recommendations for Sydney Dermatologists with your passion?

  8. Tricia Nadine Yang says:

    Doc david. Sorry but youre really handsome. Haha. Anyway, i have lots of hyperpigmentation do you think Co2 laser can cure these?

  9. ELFsuju1000 says:

    Can you explain how to determine different types of acne scars and the treatments available?

  10. raidernationcali says:

    Doctor you are our voice and hope, I pray that you get ur message and knowledge to many doctors as possible asap.

  11. Doris Bachorik says:

    many years ago i had a body lift and in between in the crease of my thighs and around my wast and stomach i have a dark scar the doctor used the fraxel laser and it did nothing, can you please recommend what i can do to lighten these dark scars.

  12. Barbie Doll says:

    Hi doctor, I would like to know how much you charge for each session? I am interested to do this treatments.

  13. HantotheNah says:

    I love watching your videos! I'm on a laser journey so it's reassuring to know exactly how the lasers work! Thank you. Keep making videos :)

  14. Bint Faisal says:

    Hi, Dr Lim thank you for the very insightful video. I wanted to ask what are some of the options for people who have acne scars but also have darker skin complications (African decent). What are your favourite methods to treat ice pick scars, boxcar scars for these skin tones? Would it be Different for darker skin or the same but just less evasive? it would be interesting and really helpful to see before and afters of some of your patients with darker skin tones. Best wishes :)

  15. Chucho Yema says:

    I went today with a dermatologist I told him I wanted to get the lumenis ultrapulse he sed that I skin was to dark and he would recommend the fraxal restore laser what do you think Dr Lim

  16. Veta F says:

    Davin, thanks a lot for sharing all this amazing knowledge with us!i started getting permapen treatments after watching your videos and I am extremely happy with the results.too bad we don't have professionals like you in Ukraine 🙁 nor Infini RF yet

  17. Ann Taylor says:

    Hi Dr Lim, wish i'd seen this earlier. I had fraxel 1927 on an area which looked like a bunch of freckles but it was actually a few pimples that scarred many years ago. Unfortunately nearly 2 months later it is still red and darker. I'm thinking of making an appointment with you. Any suggestions what to do? Thank-you

  18. Carlo Villamor says:

    Dr. Davin Lim your very awesome… i love all your videos about scar removal….. i have done many scar removal procedures here in thailand but still the scars are still visible on my both cheecks… the treatment i had underwent are the ff.co2 fractional laser 10x (bison and lutronic)erbium pixel laser 6x (Alma)dermapen 2xderma roller 7xsellas fractional laser 3×Ematrix 2xsubcision 3xtca cross/spot peel 4x

  19. Lisa H says:

    this is a question about techniques in using the skinpen11 for acne scars(I'm a patient)I know it might not always be that great for this problem—But while having this treatment for scars (anyway)would it be protocol for the person giving the treatment to give equal attention to the entire face rather than focus on one large scar more than the other areas of the face? I'm just trying to figure out whether this practitioner knew what she was doing or whether she didn't.thanks,I'm a fan of your work. I think Australia is more evolved in this work….

  20. rahil mohd says:

    doctor. . does infini rf treatment works for all type of scars? I have mixed scars.. not atrophic or tethered.. but shallow icepick and boxcar scars! does this available in all countries? I am from India… thanks for your videos.. really giving hope for people who suffering from these scars