Ask Dr. Pane! Will Co2 laser get rid of my acne scars? 

The Question

Cosmetic surgery encompasses a lot more than just sculpting someone’s body to a desired form. Often, cosmetic surgery can help improve a patient’s appearance and comfort in their own skin after illness, injury or the ravages of time and hormones. This is the case with the subject of this week’s Ask Dr. Pane segment, presented by Atlantic Coast Aesthetics. The patient asks, “Will CO2 laser get rid of my acne scars?”

The Case

Dr. Pane evaluated the patient’s photographs to establish a baseline for initial prognosis. While this is not a substitute for in-person clinical evaluation, Dr. Pane feels confident in his evaluation of this patient’s condition given the points under consideration.

The Answer

In this patient’s case, CO2 laser treatment can be expected to give excellent results relative to his current condition. The patient does have a couple of options, including both a full course of CO2 laser treatment and fractional laser treatments. As part of his answer, Dr. Pane weighed the pros and cons of both treatment options.

The advantage of a full course of treatment is that it gets the full treatment resolved in one session, encompassing the entire area and giving the patient one block of recovery time to deal with. The drawback is that with a full course of treatment, the healing time will be longer, usually up to about a week. However, once the treatment is complete and the patient has healed from the removal of the top layers of the epidermis, the patient can expect about 50% improvement of the acne scarring.

Conversely, the fractional laser therapy breaks the procedure up into monthly treatments, usually up to about six. This minimizes healing time per procedure, but does extend it more over time. Overall, the patient can expect about the same results over time once the full course is completed.

The primary thing to remember about scar remediation and revision is that while it is possible to minimize their appearance, it is not possible to remove them completely, regardless of the source or cause of the scarring. In the case of acne scars, it is usually possible to achieve an acceptable level of minimization, but they cannot be wholly removed. If, for example, the patient were to undergo two full courses of CO2 laser treatment about 18 months apart, which is the normal protocol, the patient could expect roughly a 50% reduction in scarring appearance from the first procedure and an additional 25% reduction after the second. Thus, at a certain point the patient will experience a point of diminishing returns, where the effects of the treatment will no longer justify the results.

In addition to CO2 laser or fractional laser treatment, there are some treatments which are less or noninvasive which may help. These treatments may be used in conjunction with or instead of the laser treatments. However, their utility will be predicated on the patient’s overall skin quality, desired and expected results, the depth and extent of the scarring and other factors. Based on the photographs the patient provided, CO2 laser treatment, either full or fractional, is the patient’s best chance for an optimal outcome, especially when paired with a less-invasive treatment protocol tailored to this patient’s unique needs, physiology and medical history.

As always, it is important to remember photographs do not always accurately reflect the totality of a patient’s situation. Photographs are useful only to a point, but a clinical evaluation is the best possible way to design a treatment plan which offers the best chance of a positive outcome to the patient. In addition, especially after treatments which affect the epidermis directly, the patient will need to be extremely diligent about following aftercare directions and avoiding environmental, habitual and other hazards which may compromise the outcome or lead to post-operative complications.

If you have a concern, interest or question regarding cosmetic surgery, the staff and clinicians of Atlantic Coast Aesthetics are always happy to discuss the things you want and need to know. Simply email us at https://acplasticsurg.com/contact; call us at (561) 422-4116; or follow us on Twitter, Facebook and/or Instagram to ask your question. It’s possible you might even help us educate and inform others who share your interests if your question is selected as the focus of an upcoming Ask Dr. Pane segment, where our Chief Medical Officer and founder, Dr. Thomas A. Pane, will address your question personally in a Google Hangout. Remember, at ACA we believe the only bad question is the one you don’t ask!