Are Ablative or Fractional lasers better for deep acne scars? (photo)
For atrophic and box car scars, if downtime is not of a concern, is it better to have FULLY ABLATIVE lasers treatment rather than FRACTIONAL lasers treatment (either by Erbium/CO2 lasers) since ablative usually has better results in 1 treatment as compared to 3 sessions of Fractional laser treatments? What is the difference between Erbium Vs Fractional CO2 Lasers? Please advise with thanks!
You are right in that ablative lasers usually have better results per treatment session. An Asian study by South Korean doctors did a comparison of lasers for acne scar treatments and found that the non-ablative (i.e fractional laser) treatment groups had a slightly lower improvement score and required a greater number of treatments compared to the ablative laser treatment groups.
However, patients who had the ablative laser had a prolonged recovery period and higher risk of complications. Complications of ablative laser include hyperpigmentation, hypopigmentation, skin infections, prolonged redness and laser burns. It is for this reason that many doctors may advise you to start off with a fractional laser instead. The study also concluded that 3 consecutive fractional lasers are as effective as a single treatment of ablative laser. This may be a good trade off, for a much lower risk of complications, especially in Asian skin, which is prone to developing hyperpigmentation.
Hope this helps in your decision!
Dr. Joanna Chan
Source: Comparison of four different lasers for acne scars: Resurfacing and fractional lasers. JPRAS Jan 2016.