Fraxel Laser For Acne Scars At A Glance
- Best Results4-8 sessions
- Treatment Recovery3-7 days
- Procedure Time30 min
- Skin SpecialistNurse
- Duration of ResultsLong Term
- AnaestheticNumbing, Blocks
- Back to Work2-7 days
Fraxel Laser For Acne Scars
Fraxel laser resurfacing is synonymous with ‘fractional laser treatment for acne scars.’ I do think that Fraxel is an excellent device for skin rejuvenation, however it falls short when it comes to acne scars treatments. There are far better & more cost effective treatments compared to Fraxel.
FactsFacts on Fraxel Acne Scars
- Fraxel comes in three wavelengths, each with a different role
- The 1550 & CO2 10,600 wavelengths are widely used to treat acne scars
- Fraxel can improve superficial scarring
- Newer lasers do a better job at scar treatments compared to Fraxel
- I still employ Fraxel as a skin rejuvenation laser
Can Fraxel treat acne scars?
Fraxel Acne Scars
Yes, however the question should be phrased as ‘ are there many better treatments for acne scars? !” Fraxel can improve superficial scars, however there are far better devices & methods to treat acne scars. The problem with Fraxel is the lack of adjustability as well as power in the context of acne scarring.
As disclosure I do have 4 Fraxel devices at the time of writing, however I do not use this laser to treat true atrophic & established acne scars. I do believe that using other devices such as fractional CO2 lasers I am able to treat scars more effectively, with less treatments & at less costs to the patient.
Unfortunately, Fraxel builds in consumable tips into their pricing. This generates revenue for the company, however, this cost gets passed on to the patient.
How does Fraxel work?
Fractional lasers, as the name suggests, treat a portion of the skin’s surface. This is measured as a percentage of surface area or laser density. Typically density ranges between 5 to 70%. Each beam produces what is known as a microscopic treatment zone, or MTZ which is essentially an area of thermal damage (controlled burn).
The untreated areas of skin accelerate skin recovery following MTZ injury of the treated skin. For example if 30% of skin is treated, in theory the 70% of untreated surface area functions to accelerate skin recovery on the treated percentage of the skin. The higher the MTZ percentage, the longer the recovery time.
The advantage of fractional resurfacing includes faster recovery & healing times, with less side effects. The disadvantage of fractional resurfacing is that it frequently requires more sessions to get the job done.
What is the difference between Fraxel Dual & RePair?
Fraxel has 3 wavelengths. Each wavelength has a specific job that it is best at. As a guide, Fraxel Dual has 2 wavelengths- the 1927 & the 1550, whilst the Fraxel RePair is a CO2 fractional laser.
Fraxel RePair: suitable for wrinkles, bad sun damage, acne scars in skin type 1-3.
Fraxel Dual : suitable for mild to moderate sun damage, mild to moderate acne scars in skin types 1-5.
The primary difference between these two lasers is the fact that Fraxel Dual is a non-ablative laser, meaning that the upper layer of skin is intact after treatment.
Fraxel RePair is an ablative laser. This means the upper layer of skin is vaporized during treatment, hence the longer recovery.
How many sessions will I require?
Typically 4 to 8 sessions, depending on your skin type, scar type, as well as your expectations. Scar directed treatments with execution of aligned methods would give better results than protocol driven Fraxel treatments.
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What are the potential side effects of Fraxel?
Fraxel, especially the 1927 & 1550 wavelengths of Dual are super safe. This laser is designed as a protocol driven device with in-built safety margins. The Fraxel Re:Pair however has more complications than the non-ablative Dual.
Side effects include-
Is the treatment painful?
Laser treatments at Clinic Dermatology are well tolerated as we are mindful of patient comfort. Numbing creams can be augmented with blocks, gas, or in some cases mild sedation.
What is the recovery time following Fraxel resurfacing?
2 to 7 days, depending on the settings & the wavelengths. Typically Fraxel Dual 1550 has a healing up time of 2-4 days, whilst the stronger CO2 RePair may take over a week to heal.
Heal time is also dependent on the settings, namely the power, measure in millijoules & the passes or density. The higher the setting, the longer the recovery time.
What other lasers can be used to treat acne scars?
I do believe that there are many better lasers for acne scarring. These include the Ultrapulse, eCO2, Mixto, CORE, as well as Deka CO2 lasers. As mentioned, I do not like the non-ablative wavelengths to treat acne scars. I find CO2 & or erbium lasers work alot better.
Why is method more important than laser for acne scar treatments?
Ideally acne scars should be treated according to the clinical findings. Not all scars require fractional lasers. In some cases, simple peels can outperform even the most technologically advanced laser systems.
This is probably the most important aspect of scar revision to understand. Some scar types are best treated with other lasers. This includes vascular lasers for red scars, pico lasers for brown scars, & ablative lasers for deeper scarring. In other cases, surgical techniques are indicated. It is about the method, & not the device itself.
How much does Fraxel treatment cost?
Fraxel starts at $790 for small areas of acne scarring.
Full face Fraxel from $990-$1390
*For reference fractional erbium or CO2 resurfacing cost $690 for small areas (eg. cheeks). The primary reason why erbium or CO2 resurfacing is cheaper is that there are no consumables associated with these lasers.
** Price quoted when performed by laser trained nurses.
Is acne scar treatment covered under Medicare?
In September 2022, the new rules apply. Subcision can be performed on acne scars, however it is not covered under Medicare.
Davin’s Viewpoint: Fraxel & Acne Scars
It is not that I am against Fraxel, at the time of writing I have 4 Fraxel devices. I do think that the 1927 Dual is a brilliant wavelength. This is my go to when it comes to treating skin type 1 & 2 for sun damage & general skin rejuvenation. My clinical team performs up to 8 treatments per day using the Fraxel Dual.
When it comes to acne scars, this is when I think that there are far far superior treatments than the Fraxel Dual 1550 & there are many better CO2 lasers compared to the Fraxel RePair. Firstly, the non-ablative wavelengths are a real disappointment, once again in the context of acne scarring. This includes everything from the 1420 to 1550+ wavelengths, irrespective of devices. A low density CO2 that is strong with a short PD (pulse duration) can give infinitely better results than, say, multiple sessions of non-ablative lasers. Other devices including RFM also known as RF Microneedling with devices such as Genius RF, Infini RF or even competitors such as Morpheus 8, Secret RF, Intracel etc… can give better results than non-ablative lasers.
The Fraxel RePair is good for general skin rejuvenation, however it has not got the depth (or adjustability) to treat significant deep acne scars. Lasers such as the eCO2, Ultrapulse, DEKA etc.. do a much better job. Once again it is in the context of treating acne scars.
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