Full layer resurfacing of acne scars still remain as one of the best methods to treat acne scarring. This is a very highly skilled method of scar revision ideally suited for lighter skin types. An Erbium laser or CO2 laser is used to remove the outer layers of skin and the upper dermal layers.
Our Specialists combine full resurfacing with fractional lasers to achieve far superior results than either treatment alone. The recovery time for full laser resurfacing ranges between 7-12 days depending on the depth and your recovery speed.
Full laser resurfacing is ideal for multiple shallow scars, and has several advantages over fractional laser- in most cases one treatment will yield at least 70% improvement in acne scars. This form of laser treatment of acne scars also carries a partial Medicare rebate.
I had lots of shallow acne scars. One treatment with laser resurfacing and they are nearly all gone, recovery was just over one week.
Dr Lim was straight forward with the options available to me. 100% happy with treatments from the consult to after care.
Box Car Scars
Mixed Acne Scars
Rolling & Depressed Acne Scars
Full laser resurfacing treats the entire surface of the skin, whilst fractional lasers only treats ‘Fractions’ of skin. For shallow scars such as box-car scarring or raised ice pick scars, full laser resurfacing offers a much better result than multiple fractional lasers. Dr Davin Lim and other laser specialists combine full resurfacing and fractional lasers together in the one procedure for added benefits.
Because full resurfacing treats the entire area of skin, the heal time from this procedure is longer compared to fractional laser.
Full laser resurfacing requires great skill to perform compared to fractional lasers, however in Specialist hands, this laser can have significant advantages compared to fractional devices. These advantages will need to be weighted against some disadvantages of full ablation.
|Laser Technique||Full Laser Resurfacing||Fraxel and Fractional Laser|
|Heal time||7-12 days||2-6 days|
|Ideal number of treatments||One (two maximum)||3-5 laser treatments|
|Improvement on shallow scars||Marked improvement +++ with one treatment||Moderate improvement with multiple treatments|
|Post laser redness||Several weeks to months (can be reduced with V Beam Laser)||Days to weeks. Uncommon to have lasting redness|
|Skin type treated - skin colour of patient||Skin type 1-3||All skin types suitable, including darker skin|
|Costs of laser procedure||Partially covered by Medicare||Not covered by Medicare, multiple treatment sessions required|
Day one after full laser resurfacing
Day one after Fraxel laser resurfacing
A laser procedure is only as good as the operator and equipment used. Our Specialist will select only suitable scar types and match this with the skin type to achieve results. As a guide, patients will receive between 50-80% improvement of acne scars with one treatment. Note however that full resurfacing is best for lighter skin types, and shallower scars, such as box-car scarring. For scars such as atrophic, ice pick, rolling, and tethered scars, the Synergy Program for acne scar gives the best results. This program combines multiple treatment modalities to treat different scar types.
Laser resurfacing procedures are performed in our Laser Suites at Westside Dermatology. Several step are involved in the laser process and include-
- Planning and assessment prior to laser scar revision. This is done several weeks prior the procedure, scars are photographed and mapped. Planning is essential.
- Day of procedure - patients will arrive 60 minutes before the procedure for local anaesthetic cream. This special mixture numbs the skin.
- In laser theatre you may be given a twilight pain-killer by injection, as well as local anaesthetic injections to the areas. This process ensures that the areas are further anesthetised and that you are relaxed.
- A specialist nurse also helps with the procedure, your treatment area is cleansed with antiseptic wash, scrubbed then dried prior to laser, scar are mapped with a marker, and the process of laser scar revision begins.
- The laser procedure takes between 20- 40 minutes depending on the complexity of scars. Dr Lim usually performs several procedures in the one sitting, including full resurfacing and Fractional laser, and surgery for scars.
- Once laser has been completed a healing balm is placed on the skin, and dressing is left on over night.
- Full resurfacing patients are checked 24-48 hours by both Specialist and nurse, and we will guide you thru the healing process.
Resurfacing is comfortable providing the correct anaesthesia is used. We ensure that comfort levels are maintained throughout the laser resurfacing process by numbing treated area with a specially formulated cream, we also use local anaesthetic to the area, and in some cases provide some mild ‘twilight’ sedation. All laser resurfacing procedures are conducted in our state of the art Queensland Health Accredited Laser Operating Theatre.
Your skin will take over a week to recover following full laser resurfacing. This recovery process is more involved compared to fractional lasers. In general the heal time from full ablation ranges between 7-12 days, and this is dependent on the type of laser used (erbium heals faster than CO2), and the depth of scars.
Conversely, Fraxel and fractional lasers for acne scarring heals within 2-6 days.
Most patients are still red after a few weeks from full resurfacing, however we use the V Beam Vascular laser at week 3 to reduce the redness following full laser ablation. Importantly, patients will need to take extra precaution during periods of sun-exposure for up to 8 weeks after laser, as skin colour changes can occur.
Day one after laser. Skin heals in 7 days
Day 21 after laser. Redness fades.
Only certain skin types can be treated with fully ablative laser- ideal candidates are skin type one and type two: Caucasian patients with blue or green eyes, and white skin. Olive skin patients, including Asian patients can also be treated safely with full ablative laser, however I choose the Erbium laser over the CO2 laser in this setting. For darker skin patients, the Fractional Erbium laser is a safer method of laser scar revision.
Remember this form of laser resurfacing is much more complex compared to Fractional lasers. Choosing the correct Specialist, and using the correct equipment is paramount for both safety and results. First of all, selection of correct skin type and acne scar types will be made by the specialist- this markedly reduces the side effects of any procedure.
Overall, side effects are minimal, and predictable and include the following-
- Post laser redness: this occurs in all patients, and may last for weeks to months. As a guide, we usually use a vascular laser 3-4 weeks later to reduce the duration of redness. Some patients tend to flush more after laser, especially if they have a tendency towards rosacea.
- Infection: very rare to have infection, as we place patients on anti-viral tablets and antibiotics after laser resurfacing.
- Darkening or lightening of the skin: can occur in 2-3% of patients, paradoxical colour changes of the lasered skin can occur, and this is usually due to sun exposure. You must stay out of the sun for up to 8 weeks post full resurfacing. The majority of colour changes can be prevented or reversed with creams and time.
- Scarring from Laser hardly ever happens (less than 1%) of cases. The incidence of scarring from Erbium laser is less than with CO2 laser. Most case of scarring following laser is secondary to infection, and hence post laser follow up is essential.
Unlike the majority of clinics who claim to provide treatments for acne scars, we provide effective solutions for your scarring. Our Specialist training coupled with the very latest in technology ensures that you will get the best possible results, provided by a highly skilled team of laser dermatologists and nurses. Our clinic is staffed with doctors who under go an additional specialist degree in Dermatology training, in addition to further training in lasers and scar revision techniques.
Our laser equipment is updated every 3 months to ensure that patients have access to the very latest in technology.
Ideal scars for fully ablative laser are shallow scars, including box-car scars. This allows the laser Dermatologist to remove most scars at the same depth.
Ideal candidates will also have a fair skin type, with little or no tanning.
Note that most patients will have some other form of scarring associated with shallow scars (such as rolling or atrophic scarring) we usually combine full resurfacing with Fractional laser. This Synergy Method of scar revision gives better results than just using one modality.
If you have deeper scars, such as ice pick acne scars, we may employ methods such as TCA Cross 2-4 months before laser resurfacing. The aim is to raise up these scars prior to lasering.
We have 3 types of fully ablative lasers to choose from- Carbon Dioxide or CO2 lasers, Erbium Lasers, and a fusion of both lasers called Erbium Modulation. In addition we can choose from 4 different FRACTIONAL lasers for scar revision.
The choice of Erbium or CO2 will be made depending on -
- Skin type of the patient (skin colour)
- Depth and type of acne scars
- Down time of the patient.
Erbium laser is best suited for acne scars in darker skin types, whilst CO2 laser is ideally sutied for fairer patients. Downtime following erbium laser is longer compared to CO2. Your Specialist will guide you as to our preferred choice considering all the above factors.
Absolutely! In fact most cases of fully ablative laser is combined with Fractional laser in the same procedure- we feel this gives superior results than one type of treatment alone. “The Synergy Method” of scar revision involves using multiple treatment modalities for scarring, as the majority of patients will have different acne scars.
Most patients who undergo full laser resurfacing will also under go a course of vascular laser treatments to help reduce redness after the resurfacing procedure. In some cases we combine full laser resurfacing with a course of fractional RadioFrequency treatments to achieve even better results.
The price of full ablative laser resurfacing cost between $1900- $4400, depending on the areas treated. Some cases are relatively straight forward, and require only one treatment of full resurfacing (often coupled with fractional laser straight after).
In more complex cases of full laser resurfacing, we may combine full laser resurfacing, with fractional laser and then V Beam Vascular laser to reduce the redness. In very complex cases where scarring is extensive we may include RF (Fractional RadioFrequency) treatments 4-6 weeks following full laser resurfacing. This program is called the Synergy Program for acne scars.
Pricing will be reflective upon the number of procedures and complexity of your scars.
Remember, full ablative laser resurfacing for acne scars is claimable on Medicare, and a rebate applies.
Westside Dermatology offers payment plans for acne scar treatments.
Dr Davin S. Lim
Westside Laser Dermatology
Full laser resurfacing for acne scars remains as one of the most effective treatments available. The advantage of this procedure is that one treatment will give maximal results, with out the need for additional treatments associated with downtime. Full laser resurfacing conducted at Acne Specialist Clinic can be done with an Erbium laser, a CO2 laser or a combination of Erbium with CO2 modulation. The selection of what laser I use depends on the skin type of the patient, the scar type and the down time. Fair skin patients are better suited towards the CO2 laser, whilst darker skin individuals are treated with the Erbium laser. Commonly I use full resurfacing, followed by Fractional laser in the one sitting- this can give far superior results than one form of treatment alone.
The downside of full laser resurfacing is the down time- healing takes place over 7-12 days. The greater the depth, the long the down time for the patient. CO2 laser treatment takes a few extra days for healing to occur.
Full laser resurfacing forms part of my Synergy Method of acne scar treatments. This means I use this modality with other treatments to help reduce acne scars. Most often I combine Vascular laser with full laser ablation to help with the recovery process, and reduce redness. Once again, a tailored approach will give the best results.