Why do I get poor results after fractional CO2 lasers for acne scars (photo)?

Doctor's Answers 2

Hi,

There are several effective treatments for acne scars, the choice of which depends of several factors which include: type of scars, effectiveness vs side-effects/downtime, expertise, costs, etc. Current treatments include fractional laser, fractional RF, subcision, scar excision and TCA-cross.

In general, deeper scars tend to improve less compared to more shallow scars, more severe scars will require more effective modalities albeit more potential side-effects and downtime, a combination of acne scars will probably benefit from a combination of treatments.

Even with the best treatments, an average of 30-50% overall improvement is achievable. Claims of improvement greater than 75% and even total scar effacement are almost impossible to achieve in real life.

In my own practice, Fractional CO2 has proven to be very effective in many patients. Factors for poor response may include inadequate laser parameters, deeper scars that may require alternative more effective treatments such as scar excision, too short a duration of observation, will be good if you can be reviewed by your performing doctor, review the pre-post laser photographs, determine the degree of improvement and discuss if alternative treatments may prove more effective.

Dr Chin YC

Hi,

acne scars are difficult problems to solve to start with. Expectations are important to manage. Most will require multiple treatments with the laser. Assessment of the scar to see if it is stretchable or fixed in depth is important in deciding the type of treatment to use.

Most treatments can achieve a 30-50% long-term improvement.

I always advise patients to use the non-ablative lasers first and to control active outbreaks.

regards,

Dr Ben

Similar Questions

Is the fractional radiofrequency, CO2 laser or erbium laser more effective for deep acne scars?

With regards to your question: Fractional CO2 lasers generally penetrates deeper than Erbium lasers Fractional CO2 lasers also generally penetrates deeper than Fractional RF devices EXCEPT Microneedle RF machines that can reach a depth of 3. 5mm (only in some machines) which in this case will have a greater penetration depth as compared to Fractional CO2 machines.

Photo of Dr Rui Ming Ho

Answered By

Dr Rui Ming Ho

Aesthetic

Can aloe vera gel help with acne scars?

Hi, As acne scars are deep and due to disorganized collagen scar tissues formed following active acne inflammation, topicals (creams, gel, lotions) are generally ineffective in treating them. Hence, aloe vera gel will not help with acne scars. Effective treatment of acne scars is mainly based on controlled “wounding” of the affected skin so that the skin may lay down new and more organized collagen during the healing process leading to clinical scar improvement. Such treatments include microneedling, subcision, scar revision, and energy-based resurfacing e. g. fractional lasers.

Photo of Dr Chin Yee Choong

Answered By

Dr Chin Yee Choong

Aesthetic

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox