CO2 Laser Resurfacing
Acne Scars
Laser resurfacing is best for superficial to medium depth scars. These include boxcar scars, shallow pick and ice pick scars, superficial rolling scars as well as hypertrophic scars.
CO2 laser resurfacing acne scars at a glance
Some key information surounding the treatments include:
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For: Boxcar scars, pits, shallow rolling scars
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Procedure time: 60 minutes
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Duration of results: Permanent
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Recovery: 2-9 days
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Anesthetic: numbing gel, Nerve blocks
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Back to work: 1-3+ sessions
Key Points
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CO2 laser are the gold standard in scar revision
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Lasers are useful in treating superficial to medium depth scars
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Fractional CO2 is the most prescribed procedure for scars
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Fully ablative CO2 is useful for scars that lie in the same depth
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Recovery can be tailored according to your downtime
Frequently Asked Questions
What scars do best with CO2 lasers? Laser resurfacing is best for superficial to medium depth scars. These include boxcar scars, shallow pick and ice pick scars, superficial rolling scars as well as hypertrophic scars. Lasers will also improve skin quality, shrink pores & reduce pigmentation. They can improve the light reflex & radiance of your skin.
What is a CO2 laser and how does it work? CO2 lasers are the gold standard in scar revision. They have more evidence behind them in comparison to non-ablative lasers, microneedling & radiofrequency treatments. CO2 can be delivered with a full beam, covering all the skin’s surface, or fractional laser resurfacing, covering between 5 to 60% of the surface area. Fractional resurfacing provides great outcomes with minimal downtime, risks & costs. Laser work by stimulation of collagen as well as breakdown of scar tissue. Controlled heating of lasers stimulates a cascade of pro-inflammatory mediators through HSP or heat shock protein. This results in generation of new collagen production in the deeper layers of skin. “Cold” devices like microneedling are useful for delivering agents into the skin, but do not generate HSP, hence are not as effective for scar revision.
How many treatments will I need? One to four sessions. It depends on factors such as- Skin type. Darker skin will require more sessions. Scar type. Deeper scars require more treatments. Downtime. Shorter recovery means more sessions. Expectations. Self-explanatory. Our aim is to improve your scarring in the minimum number of sessions, respecting your skin colour & downtime. Your practitioner will give you an accurate estimation prior to treatments.
Are treatments painful? Pain relief is tiered according to the depth & coverage of the laser. Superficial laser resurfacing: numbing only Medium laser resurfacing: numbing, and nerve blocks. Post procedure and throughout the recovery process, there is no pain.
Can all skin types be treated with CO2 lasers? Yes, but settings matter. CO2 lasers are best for fair to medium skin tones. If you have darker skin colour, we use other lasers are required to reduce the chances of post treatment darkness. Our clinicians will match your skin tone to specific lasers, ensuring that outcomes are optimal, whilst minimising side effects.
When will I see results? Results are seen as early as one week after resurfacing, with maximal gains at 4-6 months. It takes this long for collagen remodelling. With a series of treatments, results will compound over a period of 6-12 months. Outcomes are predictable providing you have your acne under control. Active acne leads to inflammation. Inflammation slows down collagen production.
How much do treatments cost? Cost depends on the complexity of laser resurfacing. As a guide- Light resurfacing $590-$890 per session. Medium resurfacing: $650-$990
What should you consider before undertaking laser treatments? Undergoing pigment treatment is an investment for patients. Here are some helpful points that may help you along your journey. Always control your acne. You will go infinitely faster & better with any scar revision treatment. This means absolute (or almost absolute control), it does not mean ‘much better than before.’ If in doubt, see a dermatologist. Sun protection is paramount. It does not mean you can’t go out in the sun, it means sun protection is important. SPF 50+ twice a day regardless of exposure. If a 50 ml bottle lasts longer than 3 weeks, you are not using enough sunscreen. Darker skin types: you may require more sessions compared to lighter skin. In some cases, we will expectedly darken your skin, but will come up with solutions to lighten it back to normal. Settings of laser matter. Lasers are just tools to get the job done. Laser parameters are crucial for best outcomes. Additionally, using the correct CO2 laser is vital for good outcomes.
What is recovery like? You look worse than you feel. CO2 lasers give epic results, but also longer recovery times. As a guide; Superficial or level 1-2 resurfacing: 2-4 day recovery. Red for 4-6 days. Medium or level 2-4 resurfacing: 3-5 day recovery. Red for one to two weeks. We will give you an accurate time frame of the recovery process. For deeper resurfacing, recovery can be sped up with LED, vascular lasers & pico lasers.
How does CO2 compare to microneedling? No comparison. CO2 provides much better results compared to microneedling in the context of atrophic scars. It is primarily due to the heating achieved with lasers over microneedling. We apply lasers in a special way to reduce side effects & downtime. We do however use microneedling to treat some forms of scarring, including tethered scars & hypertrophic scars. Microneedling is useful to deliver topicals into the deeper layers of skin.
Why is sunscreen so important after CO2 laser resurfacing? UV prolongs the recovery from lasers. Sun exposure can make redness worse as well as pigmentation. It is important to choose a cosmetically elegant stand-alone sunscreen. Use as follows; AM: 2-3 ml application face, neck Noon: 2-3 mls Re-application
Pre & Post Treatment Care
Pre Treatment
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Discontinue skin irritants 1 week prior (retinoids, salicylic acid, hydroquinone, glycolics) and avoid sun exposure/tanning. No accutane within 1 year.
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Arrive with clean skin void of lotion, oil, makeup or self tanning agents.
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Please let us know if you are prone to cold sores so that prophylactic medications can be given.
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Fill all medications at the pharmacy, prepare cool compresses (frozen peas in small Ziploc bags), and vinegar soak solution
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Arrive without contact lenses and bring glasses in the event that we place ocular shields for treatment close to the eye.
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Bring a large hat to protect from the sun.
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Coordinate a driver if you plan to take medication for pain/anxiety
Post Treatment
We will apply a barrier cream post treatment, which you are to continue applying for a few days after treatment.
We ask you not to apply active ingredients such as AHAs, BHAs or Retinols for 7 – 10 days post treatment. Make-up can usually be resumed 2 – 4 days after treatment.
As Alma Hybrid downtime is highly customisable, ensure you follow the after care instructions discussed at the time of your appointment.
