Fractional Laser Resurfacing Acne Scars

Fractional Laser Resurfacing Acne Scars At A Glance

  • Best Results2-5 sessions
  • Treatment Recovery1-4 days
  • Procedure Time15-30 minutes
  • Skin SpecialistDavin Lim. Dermatology nurse.
  • Duration of ResultsPermanent
  • AnaestheticNumbing & blocks
  • Back to Work 1-5 days
  • Cost$$- $$$+

Fractional laser resurfacing acne scars

Fractional laser resurfacing can improve most types of acne scars. 2-5 sessions spaced 4-8 weeks apart is a typical program. My team and I employ 10 different types of fractional lasers in order to match the scar type, your skin color & projected recovery. This gives you the best possible results whilst reducing side effects and recovery time. 

FactsFacts on Fractional Laser Resurfacing for Acne Scars

  • Matching the correct fractional laser for your scar & skin type will give the best results
  • We have over 13 types of fractional lasers ranging from CO2 to Fraxel lasers
  • Fractional lasers are useful for shallow scars
  • Fractional lasers are often combined with subcision, TCA CROSS & dermal fillers
  • Recovery ranges from 1 to 7 days, depending on settings
  • CO2 lasers provide the best results
  • Non-ablative hybrid lasers have the least downtime
  • Lasers are safe in all skin types

What is fractional laser resurfacing & how does it treat acne scars?

Fractional laser resurfacing is one of the most technologically advanced methods to remove acne scarring. It works by stimulating collagen production as well as remodeling old scar tissue. This process is called neocollagenesis. Lasers are much more effective than traditional microneedling as they deliver precise & controlled heating of the dermis. Fractional lasers provide accuracy down to 1/100 of a millimeter.  

Fractional lasers come in various wavelengths ranging from erbium, CO2 & other shorter wavelengths. Each wavelength has their pros & cons. My team & I run over 13 different types of fractional lasers. This gives us unparalleled tunability to treat specific scar signatures in patients of all skin colors.

What types of acne scars are amenable to fractional laser resurfacing?

You should approach acne scars with directed treatments, namely to match your scar signature with specific treatments. Everyone has a specific scar signature, hence a tailored program will always give you the best results. Fractional laser can treat the following acne scar types- 

  • Shallow boxcar acne scars: These scars have defined borders & respond well to fractional laser resurfacing. 
  • Shallow rolling acne scars: Rolling scars have gentle undulating borders. 
  • Polymorphic scars: Are super common, they consist of mixed border types & depths.
  • Enlarged pits, picks & pores: Respond well to CO2 lasers. 

Scar types that do not respond to fractional lasers include deep boxcar scars, ice-pick scarring, deep rolling scars, atrophic acne scars, post inflammatory hyperpigmentation (PIH) and red scars (PIE). 


What types of fractional lasers do we employ?

My team & I work with 13 different types of fractional lasers. Why? Because we view lasers as tools of the trade. For the best results, we tailor treatments based on factors such as scar depth, morphology, downtime & skin color. Here is a quick overview on some of our fractional lasers we employ-

  • Ultrapulse CO2 fractional laser: Super powerful, reserved for deep scars. 
  • Hybrid Alma laser: Most advanced laser system currently available.
  • CORE CO2 Candela laser: Super fine laser for darker skin types. 
  • Mixto Laser: Great all rounder.
  • eCO2 fractional laser: The best for darker skin types. 
  • Fraxel Dual 1550 laser: Better than microneedling. 
  • Fraxel CO2 RePair laser: We don’t use it anymore. Far better CO2 lasers. 
  • Erbium ProFractional laser: Great for deep scars in dark skin types. 
  • MCL/Juliet erbium fractional laser: All rounder for scars. 
  • C&B non-ablative laser: Polishing fractional laser for pits & pores.
  • Fractional Picoway laser: great for post acne marks.
  • Fractional Picosure Focus Pro: great for pits & pick scars.
  • Fractional Spectra laser: good overall laser to reduce post acne marks. 

The laser portfolio at Cutis Dermatology is the largest in the Southern Hemisphere. We are the research and development center for several laser companies. Check our social media to see what lasers are acquired as we update our devices on a monthly basis.

How long is the recovery following fractional laser resurfacing?

Recovery is directly related to the depth and density of fractional laser resurfacing. As a guide-

  • Light resurfacing: 2-3 day recovery. Redness for 48-72 hours. 
  • Medium resurfacing: 2-4 day recovery. Redness for around two weeks.
  • Heavy resurfacing: 4 to 7 day recovery. Redness for 4 weeks. For heavy resurfacing I normally use a healing ‘vascular laser’ at weeks 4-8 to markedly reduce redness. 

Is laser resurfacing painful?

My team & I are mindful of discomfort during & after your treatment. We ensure your comfort levels by-

  • Applying a special formulation of super strong numbing gel prior to the procedure.
  • The use of numbing blocks prior to laser.
  • Inhalation of laughing gas.
  • Use of oral or IV conscious sedation for more involved procedures. 

A practice nurse will give you a call a few days before your procedure to discuss the optional pain relief prior to your procedure. We got you covered. 

What does a typical procedure entail?

We perform all our procedures in accredited laser suites at Cutis Dermatology. 

Step 1: Pre anesthetic documentation: includes documentation of scar types with photography. We use standardized photos prior to anesthetic. 

Step 2: Anesthetic. This takes care of any discomfort. We use numbing gel, blocks & in extensive cases sedation. 

Step 3: Mark-up. Scars are marked using angled or tangential lighting. 

Step 4: Treatment time 5-20 minutes, depending on the extent of scarring and the fractional laser employed. 

Step 6: Aftercare. Instructions will be given post laser to ensure your healing is uneventful. 

Step 7: Follow-up.

Davin’s Viewpoint On Fractional Laser Resurfacing

The concept of fractional lasers is to treat portions of skin, known as the density. For example a density of 35% means that 65% of your skin is NOT treated. This allows for much faster healing times. In darker skin types it also means less chances of skin color changes (or more accurately, a quicker resolution of post laser skin darkening). 

My team & I operate with over 10 different types of fractional lasers. This gives us the ability to tailor treatments based upon your history, examination, ethnicity & recovery. We often double up on fractional devices in the one procedure. For example we may use a super powerful CO2 laser, followed by a fine dot CO2 laser. The latter gives us penetration to reach deep scars, whilst a fine CO2 delivered superficially treats shallow scars with less downtime than a big spot fractional laser. It is these small details that provide finesse for every treatment. 

Hybrid lasers are the way of the future. These lasers combine two wavelengths of fractional beams, delivered sequentially, individually or stacked in the one laser entry point. We have extensive experience in the operation of all hybrid devices (as of 2023). Hybrid lasers include the Alma Hybrid CO2/1570, the YouLaser MT & the Sciton HALO. 

HALO is the weakest by far & is the least suited for acne scar treatments primarily due to the lack of penetration (erbium component has 15 times less penetration compared to the big brother ProFractional). Sciton HALO is marketed as a low downtime device ideally suited for skin rejuvenation, however for scar revision, the ProFractional is infinitely better for this job.

YouLaser MT has the most technologically advanced interface, even though it is one of the older generation. The downside is that it is underpowered at 30 watts. Adjusting the pulse duration & stacking sequence, it does have the potential to go deeper, albeit a high rate of PIH. 

Hybrid by Alma is our latest acquisition. It has both ablative & non-ablative components with a super intuitive interface that allows fine adjustments. This laser can treat mild to moderate acne scars in all skin types as we can fine tune the delivery of CO2 & the non-ablative 1570. 

Fraxel has the most market presence as the parent company re-invests the royalties charged for consumables back into advertising. There has not been an update in the Fraxel Dual for close to 13 years, despite the requirement for a more powerful & faster system. It is not that this laser system is a bad one for acne scar treatment, the argument is that there are much better systems that cost less to perform than Fraxel resurfacing.

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