Which laser would be best for acne scars if I’m Asian and had cystic acne?

Dear Dr. Irwin, Being a fair Asian lady who had suffered from high grade cystic acne and completed a course of accutance, all I'm left with now is a face that is still somewhat pink and highly uneven. Certain parts of my face have sunk after accutane as previously, the lesions were protruding so much. I'd like to know if fraxel or mosaic would serve me better in leveling my skin and what I can do to lighten the pink patches left by the acne. Thank you.

Between these two, I would vote for the Fraxel (not the Fraxel Dual).  It has much more data and experience behind it including several studies in Asian patients.   The depth of penetration of the Fraxel laser is well known and it’s deep enough to treat mild to moderate acne scarring.  The Fraxel Dual is the original Fraxel plus a second laser if needed.   For acne scarring, just using the original wavelength (1550nm) is best.   

However, you sound like you might have deeper scars???  If you do, you might want to consider a fractionated CO2 laser like the DEKA DOT or Active FX (Lumenis).  These fractionated CO2 lasers are more effective for acne scars that are deeper.  You might want to get opinions from several different doctors who are experienced with lasers before deciding.  

These lasers can be done safely (without causing pigment problems) if the doctor is an expert with lasers  and you are extremely careful about avoiding time outdoors for a month or two afterwards and are double sunscreened whenever leaving the house!    Dr. I

Dr. Brandith Irwin, MD

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