Acne Scarring: CO2 vs Fraxel Restore

Having performed traditional CO2 treatments and both fractional CO2 (Lumenis, Total FX) and Fraxel Restore for over 10 years, I have noticed positives and negatives about Fraxel vs the CO2 laser. I have asked colleagues around the country what their impressions are, and, for the most part, we agree. Doing one fractional CO2 laser treatment for acne scarring is often times NOT ENOUGH to achive really good results. Most patients need at least 2 treatments with the CO2 laser for acne scarring, and sometimes more than that. The bummer about that is the long down-time and intensity of the treatment.
I have performed hundreds of Fraxel laser treatments for acne scarring, and really feel like we get very good results. It does take a series of treatments (at least 4). They need to be spaced about 4-6 weeks apart for optimal results. This is almost always what I recommend for patients. The down-time is only a few days, you can drive yourself home from the appointment, and you don't have raw skin. What I usually tell patients, is that we should start with a series of Fraxel Restore treatments and then we will evaluate their skin and might decide to follow the Fraxel series with one CO2 treatment. This has given really good results. Now, I realize that it is a major project to undergo so many treatments, but it seems, in my hands, to be the best.
Dr. Jennifer Reichel
Seattle and Renton Dermatologic Surgeon
Director, Pacific Dermatology & Cosmetic Center

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