Acne scarring can be an embarrassing problem that stays on long after the original acne problem itself has cleared up. Some acne scars and discoloration are mild enough to heal and disappear on their own with the passage of time. Other cases may respond to topical treatments like Mederma or exfoliating agents, which lessen their redness and promote scar reduction and healing. For severe cases though, a much stronger treatment will be necessary.
One such method for treating severe acne scars involves the use of lasers. Compared to more traditional methods such as deep chemical peeling or surface abrasion therapies, laser acne scar treatments typically require less treatment time and are relatively bloodless.
Types of Laser Acne Treatment
There are several types of laser treatment for acne scars. Though their methods may slightly differ from one another, they all use high-energy light beams to vaporize damaged skin and promote the formation of new collagen. In addition to acne scars they are also used to treat other skin blemishes like age spots, fine wrinkles, and melasma.
Ablative lasers like CO2 and Erbium:Yag emit short bursts of high-energy laser light to destroy the epidermis (the outer layer of the skin) of the affected areas to get rid of scar tissue and reveal new tissue below. Although they are effective, their main disadvantage is they require a longer recovery time and in fact, the skin may remain reddish for several months after treatment. They also carry higher risks of additional scarring and hypopigmentation due to their more aggressive approach.
Fraxel is a fractional (hence the name) laser method, developed by Reliant Technologies, which works on only a fraction of the skin's surface at a time. It treats the skin "pixel by pixel," like in a digital photograph. The device shoots out tiny beams to create a pattern of small, pinpoint burns, each one surrounded by skin that is left untouched, affecting only about 15 to 20 percent of the skin. The burn is relatively light and heals within a day, versus 7 to 10 days for a traditional ablative laser treatment.
Because it is gentler than other lasers, Fraxel can also be used on the neck, chest, and back -- areas of the body that heal more slowly than the face and are prone to scarring. There are other fractional laser systems similar to Fraxel like eC02 from Lutronic and they work on similar principles of selective, pixel-by-pixel laser treatment.
What to expect with the Fraxel laser treatment
Fraxel treatment is quite simple. First, your skin will be cleansed and a special blue tint will be applied to highlight the contours of your skin. Afterwards, a local anesthetic gel will be applied and will be left on for about an hour to numb the entire face. After that, the laser will be applied for 45 minutes to 1 hour depending on the severity of your scars.
You will feel a prickling sensation as the laser wand is moved over your face. Your skin will start to feel and look different after your first treatment, indicating that the epidermis has started repairing itself. Right after the procedure, you may feel a slight sunburn-like sensation but this usually resolves after 1-2 hours. You can then expect 3-4 days of slight swelling and 1 day of redness followed by minor skin peeling. It is important to moisturize the skin, avoid scratching your face, and avoid sun exposure to facilitate healing.
A single treatment is usually not enough. Depending on your doctor’s diagnosis you will need multiple treatments (e.g., 1 or 2 more), spaced 2-4 weeks apart.
When is Fraxel laser treatment not appropriate?
It is important to note that your acne should no longer be active before undergoing any laser treatments for your acne scars. Otherwise, you risk having more acne breakouts from the treatment and post-treatment care, or you would need more laser treatments in the future with additional costs involved.
People with dermatitis, cystic acne, and psoriasis may not respond well to this type of scar removal. If you have deep ice pick scars, your doctor may opt for other procedures like dermabrasion with or without scar excision.
Acne scarring requires a higher intensity of treatment than other conditions. It is therefore very important to seek out a very competent physician to perform a Fraxel laser treatment for your acne scars.