Laser Dermatologists specialise in the treatment of acne scars and we are at the forefront of technology. The clinic has 5 types of Fractional skin resurfacing procedures. The method of fractional treatment will depend on your skin type, scar type and downtime. Fractional radiofrequency is a non-laser method of scar removal, best suited for early, mild to moderate scarring, whilst fractional C02 lasers are best for moderate to severe scarring. Erbium fractional laser is an intermediate fractional laser used in darker skin types.

Fractional laser resurfacing, as the name suggest, treats ‘fractions’ of skin enabling quicker recovery for patients. Most patients will benefit from a series of fractional laser treatments.

Facts on fractional laser treatment

  • Fractional lasers such as Fraxel, CO2 RE, and Profractional are at the forefront of acne scar treatments
  • Fractional laser treats only a ‘fraction of skin’ which speeds up recovery time and lowers the risks of full laser resurfacing
  • Scar improvements of up to 70% can be seen after 3-4 treatments
  • Side effects are rare and the procedure is very well tolerated
  • Recovery time can be tailored according to each patient, typically 3-5 days
  • Erbium Fractional laser has less downtime compared to CO2 and is best suited for darker skin types
  • CO2 RE Fractional laser has a longer downtime, however it delivers better results compared to Erbium Fractional laser in lighter skin types
  • Fraxel Laser is excellent all round laser and can be used on all skin types. 3-5 treatments are needed for best results
  • Non –laser fractional treatments such as RadioFrequency will deliver little or no downtime, however works best for early and very mild scars
  • Each patient will have a unique pattern of acne scarring, and a tailored program will give the best possible results
  • Skin needling is not fractional resurfacing, however this outdated procedure can be considered as the genesis of fractional skin treatments

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Related before & afters

Case 1 - Moderate to severe acne scars

Diagnosis: Moderate to severe acne scars. Rolling, atrophic, mixed scars, uneven skin texture in 35 year old female. Acne scars on cheeks, but also neck area. Enlarged pores.
Treatment: Full laser resurfacing coupled with Fractional Laser. Followed by V Beam laser to reduce recovery time. 3 treatments of RadioFrequency. Program period 4.5 months. Downtime of 7 days following first procedure.

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Case 1 - Moderate to severe box-car scars

Diagnosis: Moderate to severe box-car scars, present for 20 years
Treatment: Laser resurfacing Erbium Micorpeel (Full resurfacing) combined with Fractional Laser resurfacing. One treatment. 8 days to recover. Excellent improvement with only one treatment

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Case 11 - Rolling and atrophic scars on the temples

Diagnosis: Rolling and atrophic scars on the temples, dark skin acne scars
Treatment: Skin Needling. This procedure is outdated, fractional erbium and CO2 lasers provide much better results than skin needling. Laser treatments are safer, with fewer treatments needed. Skin needling is NOT FRACTIONAL RESURFACING.

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Case 2 - Moderate severity box-car scars on type 2 skin

Diagnosis: Moderate severity box-car scars on type 2 skin
Treatment: Laser resurfacing Erbium Laser combined with Fractional erbium at the same time. One treatment. Subscision used on anchored scars on right cheek, all in the same procedure. Only one scar revision procedure performed.

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Case 3 - Moderate to severe mixed acne scars

Diagnosis: Moderate to severe mixed acne scars cheeks of 24 year-old female.
Treatment: Full laser resurfacing coupled with Fractional Laser + Subscision, all in one treatment. 4 treatments of V Beam vascular laser were conducted to reduce redness following full laser resurfacing. Excellent improvement in acne scars. Picture 2 shows recovery 24 hours follow laser resurfacing. Downtime of 8 days.

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Case 3 - Moderate to severe mixed scars

Diagnosis: Moderate to severe mixed scars, including hypertrophic scars, box and rolling scars. Extensive acne scarring on cheeks, temples and chin area of female patient.
Treatment: Laser resurfacing Erbium Micorpeel (Full resurfacing) combined with Fractional Laser resurfacing. Patient took 8 days off work to recover, however only one Full Resurfacing procedure was conducted, followed by 2 vascular laser treatments to reduce redness.

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Case 4 - Long standing acne scars in Asian skin patient

Diagnosis: Long standing acne scars in Asian skin patient. Primarily rolling and atrophic acne scars on the back ground of sundamage skin.
Treatment: Fractional laser resurfacing using Scition Erbium Fractional laser. Downtime of 4 days. Last picture shows what the skin looks like at day 5 after laser.

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Case 4 - Severe mixed acne scars

Diagnosis: Mixed acne scars - severe. Atrophic, rolling, tethered and anchored acne scars in male.
Treatment: Low dose isotretinoin coupled with 5 fractional RadioFrequency and fractional laser treatments . Downtime of 2- 3 days following fractional treatments. Marked improvement in acne scarring.

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Case 4 - Severe scars, Asian male

Diagnosis: Severe scars, Asian male. Acne scars mixed with skin pigmentation
Treatment: Laser resurfacing Erbium Micorpeel combined with Fractional Laser resurfacing. One treatment. 4 days to recover. The pictures depicts before, immediately after laser, and day 4 after Erbium laser. Ideally this patient will benefit from another laser treatment.

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Case 5 - Long standing acne scars in Caucasian Skin type

Diagnosis: Long standing acne scars in Caucasian Skin type. Rolling scars, atrophic scarring on the background of mild sundamage.
Treatment: Erbium micropeel, followed by Fractional Erbium Laser. 2 treatments, 8 weeks apart. This was done in 2008. Now I would use newer generation CO2 CORE laser + Erbium followed by Fraxel 1550. This combination will result in more superior scar reduction. Ideally followed by focal fillers.

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Case 5 - Scarring in Asian skin type

Diagnosis: Scarring in Asian skin type. Note - mixed scars, ice pick and box car scars.
Treatment: TCA Cross to Ice Pick scars and pores, followed by full erbium laser resurfacing + Fractional laser during the same procedure. Downtime of 5 days following TCA Cross, and 8 days following laser.

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Case 6 - Atrophic, box-car, mixed acne scars in Asian skin type

Diagnosis: Atrophic, box-car, mixed acne scars in Asian skin type
Treatment: Fraxel 1550, 5 treatments. In darker skin types, more laser treatments are needed on the side of safety. Darker skin patients have higher chances of post laser skin colour changes, and hence lower settings are needed. The flip side is that an extra one or two Fraxel treatments are needed- all on the side of safety.

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Case 6 - Moderate to severe mixed acne scars

Diagnosis: Moderate to severe mixed acne scars-element of hypertrophic and rolling scars.
Treatment: Full laser resurfacing (ERBIUM) coupled with Fractional Laser all in one treatment. V-Beam vascular laser and one RF treatment were conducted following full laser resurfacing. Great improvement in acne scarring. Picture 2 shows recovery 6 days follow laser resurfacing. Downtime of 8 days.

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Case 7 - Mixed acne scars

Diagnosis: Mixed acne scars. This patient had FRACTIONAL RESURFACING before seeing me- hence the grid like patterns on top on acne scarring. I had to remove the grids and the acne scars.
Treatment: Full laser resurfacing (ERBIUM), no Fractional component was used due to pre-existing grids. Downtime of 9 days. Followed up with 3 VBeam vasulcar laser treatments to aid recovery and decrease redness. Marked improvement in pore size, grids, texture and scars.

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Case 7 - Rolling and atrophic acne scars on background skin type 4

Diagnosis: Rolling and atrophic acne scars on background skin type 4
Treatment: Fraxel laser, 5 treatments. Last photo shows results 1 month post laser. Once again in darker skin patients with acne scarring the treatment parameters MUST be conservative or post laser skin changes can occur. Acne scar revision in darker skin patients is best carried out with FRACTIONAL laser resurfacing - Fraxel or Erbium. In some cases I do use CO2 laser, but do not overlap. Dark skin patients can be treated with laser, but treatment is always conservative.

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