Does Fraxel Laser Treat Deep Rolling Acne Scars?

Puberty was definitely not my friend. It left me with these deep red marks and my face looks like it has a permanent sun burn. How can I get rid of this? Is Fraxel Laser a strong enough treatment to treat my complexion?

jodylove

F, 33, Massachusetts

Rolling acne scars are atrophic scars caused by bands of fibrous scar tissue that develop under the skin. As scar tissue develops in response to pimples and acne, the growing fibrous tissue pulls back on the epidermis and binds it to the subcutaneous tissue. This pulling action results in the wave-like scars and skin depressions we see in rolling acne scars.

Both Fraxel Re:pair and Re:store laser treatments are good options for treating this type of scarring, but of the two I generally prefer Re:pair.

Fraxel's Re:pair lasers are able to penetrate to deeper layers of the dermis than most other CO2 lasers, which makes them well suited to acne scarring.

Fraxel's Re:store lasers are non-ablative erbium lasers and have less peripheral heating outside of the treatment area.

Because Re:pair is an ablative laser, it requires a longer recovery time between sessions than the milder, non-ablative Re:store. Acne scar treatment with Re:pair typically requires just one to three treatment sessions while Re:store usually requires four to seven sessions or more.

Based on your description of your scarring looking like a "sunburn", it doesn’t sound like you had particularly severe acne. In cases of deep pitted scars, boxcar scars, ice pick scars, or other very deep scars, I usually recommend Re:pair because the depth is greater and the results more noticeable. For milder cases of light scarring, Re:store may be more appropriate.

While both options may be suitable for your specific needs, you should be aware that Re:pair requires significantly more post-procedure downtime than the milder Re:store.

After laser resurfacing with Re:pair most patients are required to spend the next week to 10 days indoors. You should expect redness, inflammation and crusting for the first three days following treatment.  

Not all patients can afford a 10 day recovery time -- especially when they may need more than one treatment. For patients who have demanding schedules and can’t afford a week or more of downtime after their treatment session, we can achieve similar effects with the Re:store erbium laser set to a high setting.

Remember to consult only with board-certified plastic surgeons or dermatologists to ensure safety and best results.

Dr. Lawrence Broder has 1 Acne treatment before & after:

Acne treatment before image performed by Dr. Lawrence BroderAcne treatment after image performed by Dr. Lawrence Broder

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Yes. fractional laser treatment is a good choice for resurfacing indented scars and areas where acne scars have created a rough skin texture.

Keep in mind that Fraxel is only a brand name and not an actual type of laser. In the Fraxel family there are different types and strengths of lasers. For treating deep acne scars I usually choose Fraxel's "Repair" laser. The Repair laser is an ablative laser, which means that it removes the top layer of skin. Because of this Fraxel Repair is able treat a wide variety of scars, among them boxcar, keloid, and rolling acne scars, in addition to deep scars caused by cystic acne.

Laser treatment can also help to remove dark marks and hyperpigmentation. The controlled damage of the ablative laser should also encourage new collagen production and skin growth.

Fractional laser treatments have associated downsides though. For example, the recovery time after a Fraxel Repair laser treatment is typically one week, and sometime longer.

For patients who are looking for a treatment with less downtime (or whose skin type doesn't work well with fractional lasers), I recommend a series of chemical peels, like a TCA peel or glycolic acid. These treatments help to smooth the skin, treat dark spots, and over time smooth areas of rolling acne scars. For deep-pitted scars we can use a TCA Cross within each scar to close it.

In many cases, subcision is another excellent treatment for rolling acne scars.

Without a direct examination I can't offer you any specific recommendations, but I do encourage you to consult with a nearby board-certified plastic surgeon or dermatologist to discuss which skin care options will make the most sense for you.

Absolutely - either the fractional CO2 or fractional Erbium ablative lasers are excellent treatment options for acne scarring. Good Luck!