Is the fractional radiofrequency, CO2 laser or erbium laser more effective for deep acne scars?
I am looking at options for acne scars treatment. Personally, I have very deep acne scars, ranging from boxcar, rolling to ice-pick scars.
I would like to know the difference between the ablative fractional radio frequency and co2 or erbium lasers and the effectiveness of the treatments, as I have heard that co2 lasers may not be able to go as deep as fractional radio frequency does.
Please advise. Thank you!
With regards to your question:
- Fractional CO2 lasers generally penetrates deeper than Erbium lasers
- Fractional CO2 lasers also generally penetrates deeper than Fractional RF devices EXCEPT Microneedle RF machines that can reach a depth of 3.5mm (only in some machines) which in this case will have a greater penetration depth as compared to Fractional CO2 machines.
Fractional CO2 lasers also generate more heat than Erbium lasers and as such have better collagen synthesis etc but this also confers a higher risk of heat-related side effects namely Post-Inflammation Hyperpigmentation (PIH) , redness and longer downtime.
As the other doctors have mentioned, this is where Fractional RF machines have a safer side effect profile with a lower risk of PIH.
That being said, one would also have to consider the type of acne scars you...
The current options for ablative treatment of acne scars would be mostly limited to :
- Fractional Co2 laser
- Fractional Erbium laser
- Fractional RF
I would say that for easy understanding, fractional Co2 has the best results because it is able to penetrate deeper into the skin. However, it’s a double edged sword and has much higher chances of side effects like PIH ( Post-Inflammatory Hyperpigmentation) and Hypopigmentation.
Fractional Erbium and Fractional RF were developed precisely because of the higher chances of those side effects, and thus they do not penetrate as deep or ablate as strongly. However, they still give a good result with much lower chances of side effects.
Thus, your idea that fractional RF goes deeper than fractional CO2 is likely not true, based on the above principles.
In a nutshell:
- Fractional CO2 gives the best improvement but is frequently not tolerated in out context because of prolonged downtime and high risk of side effects such as PIH.
- Fractional radio frequency (RF) was invented for this purpose – much safer profile for Asian skin and supposedly less effective.
- However, because it is safer to use Fractional RF at a higher power setting, some doctors actually get better results than the CO2 (which would be undesirable or unsafe to use at higher setting)
- There are two forms of Fractional Erbium – the Erbium Yag and Erbium Glass. The Yag laser is ablative whereas the Glass laser is non ablative.
- The fractional Erbium Glass laser was shown on a clinical study to have better results than the Fractional RF for scarring. Similarly, it is...