Fraxel Acne Scars

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
  • Cost$$-$$$

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.

co2 laser acne scarring
Short PD lasers are preferred over CO2 Fraxel RePair for cases like this.

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.

david lim dermatologist
It is not just the laser, it is about the settings. They MATTER.

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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