A fractional ablative CO2 laser, the gold standard for remodeling collagen in shallow box car and rolling scars.
Acne scars have abnormal, haphazard, or decreased collagen. Resurfacing lasers utilizing either Erbium or CO2 are a vital part of a multi modal approach to remodel collagen in acne scars. Fractional ablative CO2 laser resurfacing is the gold standard approach to treating shallow box car scars and rolling scars in patients with lighter skin tones. In darker skin tones, there is a higher risk of post inflammatory hyperpigmentation (PIH) that can last months. Therefore, in this population, Fractional Erbium laser is preferred as there is less risk of PIH.
CO2 lasers target the water in the skin causing ablation (vaporization of tissue) and coagulation (heating of tissue with skin tightening). Fully ablative lasers destroy 100% of the skin surface leading to dramatic improvement but with prolonged downtime (up to a month) and significant risk of complications such as permanent loss of pigmentation and scarring. Fractional ablative lasers destroy only a fraction of the skin (5% to 25%) leading to a safer and less painful procedure, with much faster healing time and far less risk of complications.
Whereas fully ablative lasers need just one or two treatments, fractional lasers require multiple treatments for optimal results.
Your journey begins with a comprehensive consultation. Dr. Singer will examine your skin under direct and tangential lighting, conducting a detailed skin analysis, and discussing your aesthetic goals. High resolution photos are taken.
On the day of the procedure, you will need to arrive a minimum of 60 minutes prior to the laser treatment for application of topical numbing. If you choose, Dr. Singer can prescribe Xanax in advance to reduce anxiety. If subcision is performed the same day, oral sedation is required. The skin is thoroughly cleansed, and the patient is positioned comfortably. Laser eye goggles are placed to protect the eyes from the laser beam. The procedure is conducted exclusively by Dr. Singer over the next 30 minutes. Cooling fans and ice are used for patient comfort during the procedure. Occasionally nerve blocks with injectable lidocaine are needed if the patient finds the procedure too uncomfortable. If tumescent anesthesia is used for subcision, then the area treated by laser will already be anesthetized.
Written postoperative instructions are provided with close follow-up over the next week.
Watch
Real case at the Acne Center of Michigan.
Pre treatment photo of ice pick, box car, and rolling scars using a single comprehensive acne scar treatment including CO2 laser. The healing progression:
This 2 week result followed a single comprehensive session combining:
Significant healing and mild redness which may persist for more than a month.
It can be painful depending upon the settings, but most people tolerate CO2 laser with topical numbing, ice, and fan cooling. If more aggressive settings are used, then we may want to give you Xanax prior and/or we may need to perform a local nerve block or tumescent anesthesia.
Most people need 3 sessions spaced apart a minimum of 2 months to see optimal results. Every few years, we may want to refresh with a single session.
It is hard to say for sure, and no guarantees can be made. The younger you are, the more collagen you will make from the resurfacing treatment. You will continue to age after your procedure. But if you practice good sun protection and use tretinoin and vitamin C, results should be visible for many years.
Days 1 to 3: Initial recovery involves redness, swelling, and mild discomfort, like a sunburn sensation. Patients should expect to stay indoors and follow strict sun protection protocols during this period. Cool compresses and prescribed skincare products will help manage any discomfort.
Days 4 to 7: Skin begins to peel and flake as new skin cells emerge. Redness starts to subside, though you will remain pink for a while. Patients can usually return to light daily activities on day 7 while wearing proper sun protection.
Days 8 to 14: Most surface healing is complete, though pinkness will likely persist. Makeup can typically be applied after day 7 to 10, depending on your specific treatment. Patients can resume most normal activities.
Weeks 3 to 4: Skin color begins to normalize, and the initial results of the treatment become more visible. Some patients may still experience mild sensitivity or redness in certain areas, and flushing with exercise is common.
Months 1 to 3: Continued improvement in skin texture and tone as collagen production increases. Results typically become fully visible during this period as the skin completes its remodeling process.
Long-term care: To maintain results, patients should follow a prescribed skincare regimen and protect their skin from sun exposure. Some patients may benefit from maintenance treatments every couple of years.
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Recognized dermatologist
Located in Bingham Farms, Acne Center Of Michigan was founded by Dr. Craig Singer, a board-certified dermatologist.
We specialize in the treatment of acne and acne scarring, offering numerous therapeutic options tailored to each patient’s needs.
Dr. Singer experienced significant acne when he was in college and has personal experience with his teenage children’s acne as well. He has helped thousands of patients look their best.
Acne Center of Michigan offers the most advanced acne treatments, drawing from both traditional and alternative approaches. Dermatologists across the region refer their most complex acne-scar cases to Dr. Singer, and patients travel from across Michigan, neighboring states, and Canada for his care.
Dermatologist
Helped look their best
