I see lot of patients with acne scars in my clinic, which happen due to the skin not healing well after acne breakouts. Most of the time the scars can be depressed (atrophic) and can be disfiguring. That’s why a lot of people wants to do acne scar treatment.
For the past decade, CO2 fractional resurfacing would be considered as the gold standard in treating acne scars. The laser creates tiny dots of injuries into the skin and from there the wound healing take place together with collagen formation, elevating the depressed scar and smoothen then skin texture. But with current technologies and so many new available treatments for acne scarring, would resurfacing laser still be the best choice??
It is actually true, for the past decades many modalities have been developed in order to treat acne scarring. For examples we have energy-based devices like Pico laser, radiofrequency micro needling, CO2 fractional laser (of course), erbium-YAG resurfacing laser and radiofrequency fractional Venus Viva. We also have bio-stimulating injections like Profhilo, Rejuran-S and Radiesse. Then we have the acids like TCA CROSS therapy for ice prick scars. Let’s not forget my all-time favorite scar treatment : subcission! And many more to come (thank you science!). But with all these modalities of treatments introduced, it may be confusing to us to choose which treatment is the best to treat acne scarring problems.
So here come the question. Is the CO2 fractional laser is still the best treatment? Or is the newest technology PICO fractional laser would be the new gold standard? Or should I do something more invasive like subcission? Or maybe the lesser downtime treatment like Venus Viva. Well my answers would be it depends!
Treating acne scar is a complex process. There is no one single treatments which works for everyone. We as doctors must considered a lot of things before we decide to use what kind of treatment suitable for the patient. Different type of scars would react differently to different type of treatments. Skin types also must be taken into consideration. In my practices in clinic I would use combination of therapies for my patient.
In case for resurfacing laser (CO2 fractional, Erbium-YAG), it is actually suitable for box scars and ice pick scars. But the side effects post laser treatments would become the disadvantages here. There will be scabs formation and last for about 5-7 days and the risk for darkening of skin or PIH (post inflammatory hyperpigmentation) especially for Asian/ethnic skin type. Yes, other treatments with the lesser downtime are available but usually the collagen formation is lesser compare to resurfacing laser. So, it is the matter of how much downtime u can take and how much results do you want. That’s why a proper pre and post-treatments care are required here to minimize the side effects, which people sometimes find it troublesome to adhere to.
And also, you have to remember there are a lot of laser machines in the market. Different laser gives different results as the power, the efficacies and safety of different brand varies. Which explains why the cost of acquiring them can be as high as ten-folds. How the laser is applied is also make a difference as well.
So back to the main question again. Is fractional resurfacing laser the best treatment for acne scars treatment. The answer yes, it is certainly but not the only one. Please do see your doctor for more comprehensive consultation in choosing the correct treatment. In Klinik Hana we are always here to help you.
By Dr Muhammad Faiz