Fractional Laser Resurfacing – Savior of Acne Scars

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The most feared and worst complication of acne is the permanent scarring which can be disfiguring and can even affect one’s self esteem. Acne scarring is notoriously difficult to treat. Fortunately, advances in technology in the past few years have allowed the aesthetic physician tackle this problem much more effectively.

Ablative Laser Resurfacing: Effective but horrifying

In the not too distant past, the only way to improve the scars was to undergo an ablative laser resurfacing. (e.g. Erbium laser). In simple terms, the procedure involved using a laser to vaporize the entire top layers of the skin. The procedure was extremely painful – even needing general anesthesia, had a high rate of complications especially in Asians, and had a downtime of about a month!

Non-Ablative Lasers: No down time but little results

Needless to say, ablative laser resurfacing was not the most popular procedure. Then came the non-ablative lasers. This involved using lasers to heat up the dermis and stimulate collagen in hope of improving the scars.

There was no down time, but unfortunately, many sessions were needed, results were modest at best, and also very variable.

Fractional Lasers: A good balance

In 2001, scientists at Fraxel® pioneered the science of fractional photothermolysis, which revolutionalized acne scar treatment.

This approach to acne scarring strikes a balance between the former 2 predecessors: the laser creates microscopic columns of thermal damage in the skin, very much like punching little holes in the skin. This allows new collagen to form, and also minimize downtime (expect redness for a few days, but no clinical downtime) and complications.

Results are excellent, and the treatment proved to be safe even for dark Asian skin!
Just 8 years after introduction, fractional laser treatment is now the gold standard for treating acne scars. Significant improvements in acne scars are seen usually with 3 to 5 treatments.

Choose the Right Laser


After the original Fraxel® laser, many other laser companies have come up with their own fractional lasers, flooding the market and again making it very confusing for the patient (and doctor!)

Fractional lasers using CO2 (e.g. eCo laser) have also proved to be very efficacious for treating acne scars, although the downtime may be slightly more prolonged compared to the Fraxel® laser.

Not all fractional lasers are created equal, so it is important to find a doctor you trust when getting your acne scars treated, and to find out more from him/ her before getting the procedure done!

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