Why a One-Shot Laser Treatment Won't Fix Your Acne Scars

Scars represent tissue loss. This means you need to somehow replace the lost tissue with new collagen. A single treatment of fractional laser (for example MiXto or DeepFX CO2 or Fraxel Erbium) won't be sufficient to get the job done. Nor will a single session of any other fractional procedure be a cure-all.

Here's why: Collagen response to laser is based on a controlled purposeful injury. Fractional laser gives you a certain level of that injury which is sufficient to turn on collagen building, but also not so severe that you have to endure painful or disruptive downtime. But it is only through repeated treatments that you get the accumulated collagen build that you need to effectively smooth acne scars.

Depth is not the issue as much as frequency. Each treatment builds on the one before to eventually provide a smoothing effect from the repeated collagen production.

Avoiding the trap of Post Inflammatory Hyperpigmentation

Depending on the pigmentation levels of your skin, certain lasers will promote post-treatment Hyper pigmentation, referred to medically as PIH or post inflammatory hyper pigmentation. Laser heat can quickly turn on the melanin production and push it into overdrive. The end result is improved appearance of acne scars but new - an unwanted - discoloration. This is often seen in skins with Middle Eastern, Asian and South American gene pools. If you tan easily, chances are you will also hyper pigment easily.

Of recent note is eMatrix Sublative resurfacing which is not laser, but radio frequency and thus bypasses much of the post treatment pigmentation risk. It's problematic to trade one problem for another, so those with highly reactive skin (in terms of pigment production) need to take special care in choosing the type of treatment so they get the skin smoothing benefits without the discoloration that is associated with the high epidermal heating of lasers.

Highly pigmentable skin can sometimes successfully sidestep PIH when the process includes pretreatment before laser or energy treatments with melanin suppressors such as hydroquinone or some of the new peptides which interrupt the pigmentation development.

Keeping your skin hydrated, protected from the sun and clear with a good acne control regimen will be of positive benefit during your treatment program and should be part of the plan.

Patience is key - as is a careful technician. Never be afraid to ask questions of your treating doctor or nurse. having someone with lots of experience means you won't be part of their learning curve.

Acne Scarring treatments are offered in Los Angeles, California at the Dermatology practice of Rebecca Fitzgerald, MD.