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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.

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