Dr Davin Lim specializes in the treatment of acne scars and is at the forefront of technology. He performs all forms of fractional resurfacing from energy based mico-needling RF with PRP, through to fractional CO2, Erbium, and Fraxel Re:Pair and Fraxel Restore lasers. Fractional radiofrequency using eMatrix is a non-laser method of scar removal, best suited for early, mild to moderate scarring. Fractional laser resurfacing, as the name suggest, treats ‘fractions’ of skin enabling quicker recovery for patients. Most patients will benefit from a series of fractional laser treatments.

Facts on fractional laser treatment

  • Fractional lasers such as Fraxel, CO2 RE, and Profractional are at the forefront of acne scar treatments
  • Fractional laser treats only a ‘fraction of skin’ which speeds up recovery time and lowers the risks of full laser resurfacing
  • Scar improvements of up to 70% can be seen after 3-4 treatments
  • Side effects are rare and the procedure is very well tolerated
  • Recovery time can be tailored according to each patient, typically 3-5 days
  • Erbium Fractional laser has less downtime compared to CO2 and is best suited for darker skin types
  • CO2 RE Fractional laser has a longer downtime, however it delivers better results compared to Erbium Fractional laser in lighter skin types
  • Fraxel Laser is good all round laser and can be used on all skin types. 3-5 treatments are needed for best results, however I am biased towards other fractional lasers as I can control the parameters
  • Non –laser fractional treatments such as eMatrix RadioFrequency will deliver little or no downtime, however works best for early and very mild acne scars less than 3 months old
  • Picosure Focus fractional laser is best for ethnic skin type with shallow scars and small open pores
  • Each patient will have a unique pattern of acne scarring, and a tailored program will give the best possible results
  • Skin needling is not fractional resurfacing, however this outdated procedure can be considered as the genesis of fractional skin treatments
  • The latest fractional devices incorporates insulated micro needles with controlled radiofrequency heating. Combined with growth factor PRP, this procedure can give excellent results with half the down time of fractional lasers

What types of acne scars respond best to fraxel and fractional lasers?

Rolling and depressed acne scars

Rolling scars acne1.0

Mixed acne scars

mixed acne scars

Box car scars For more on what is the best treatment for YOUR acne scars, I suggest watching the video below. This shows that Fractional Lasers, including Fraxel may not be the best answer for everyone. Finding the correct method for your acne scar type will give you the best results. Most patients will have multiple scar types and hence the best treatment is a multi-method program suited to your scarring. 

How does Fraxel and Fractional laser work?

Fracionated laser treatment (ProFractional, Fraxel, CO2 RE, YouLaser, Picosure Focus  are the latest lasers for acne scarring. The laser produces thousands of tiny ‘ablation’ zones in the treated areas. Each zone is the diameter of a shaft of hair, however these columns extend deep into middle layer of the skin- where scars lie. Laser targets the scarred areas and old collagen, but also leaves areas of healthy tissue to regenerate. This fractional treatment allows your skin to heal much quicker than if the entire surface was treated at once.

Fractional laser treatment allows less patient downtime and side effects but still delivers great results. This form of laser resurfacing is best for atrophic and rolling acne scars. The differences between the types of lasers such as Fraxel 1550, CO2, Protraction Scition Erbium, and the YouLaser all lie in the wavelength as well as power levels.  This YouTube video explains the concepts of fractional laser resurfacing- this pertains to all lasers from CO2 (as seen this video) through to the latest Picosure Focus laser. Each skin type and scar type will have an optimal fractional laser matched, hence I am not a fan of ‘one size fits all fractional laser resurfacing for acne scars’  Fraxel acne scars is a procedure that can work but it is outdated as treatments such as INFINI RF work a lot bette. 

Which fractional laser resurfacing treatment is best for my acne scars?

The best method to revise your scars will give you the best results, and not necessarily the machine. Fractional lasers are only one of the tools I use to revise a particular acne scar type.

The very first step is for me to determine what type of scars you have in context of your skin colour, age of your scars, and take into consideration your downtime. I will then provide a solution that will work for you. Scar revision is a highly complex and variable procedure, and the first step is an accurate assessment and ‘map’ of you.

As a guide-

  • CO2 RE Fractional laser– One of the best fractional lasers for mild to severe scars. Suits fair skin types, but can treat type 3 skin. Downtime can be controlled by me. Your skin will heal up in 2-6 days. 

  • Fraxel Dual Fractional laser– The laser that started it all. An all round laser that can treat most scar types and nearly all skin types. Downtime of 3-8 days. Will need 3-5 treatments. Though I have this laser, I do believe that other methods such as CO2 free hand fractional and INFINI RF are much better than Fraxel. This laser was good- 10 years ago! Technology has moved on, and Fraxel should update their software. 

  • Erbium Profractional laser– Great for mild to severe scarring, best for darker skin types. Downtime of 3-5 days. Can be combined with CO2 Fractional laser. Has less chances of skin darkening after laser than with CO2, but the results for acne scars are not as good compared to INFINI or CO2.

  • RF ematrix Subablative- Non laser, RadioFrequency Fractional treatment- Great for all skin types, good for early scarring. Can be used for mild to moderate scars or as part of our Synergy Method for acne scars. Downtime of 0-2 days depending on energy settings. I never use this of olds scars- other treatments are far more effective. Max RF is a copy of eMatrix, and is even less powerful- I do not endorse these treatments for established acne scars. 

  • RF INFINI- Non laser, RF, 4th generation insulated skin needling with RF. Best for atrophic, rolling and mixed scars. One of my favoured treatments, especially in Ethnic skin types. Combined with PRP this can accelerate healing times and further improve outcomes. I often combine this with CO2 laser. IMO the best device for the most severe acne scars. 

  • Synergy Method of acne scar revision– Combination of fractional lasers, TCA Cross, and RadioFrequency to give the best possible outcome. I may elect to use a combination of fractional devices during different stages of scar revision- this gives the very best results. 

Treatment

Downtime

Skin type-colour

Scar severity

Projected scar improvement

Costs

CO2 Fractional laser

3-6 days

1,2,3

Mild to severe scarring

++++

$750-1200 per treatment

CO2 Fractional +erbium resurface

4-8days

1,2, 2.5

Mild to severe scarring

++++++

$1500-4500

Erbium fractional laser

3-5 days

1-5

Mild to severe scarring

+++

$750-1200 per treatment

RF Fractional Subablative

0-2 days

1-6

all skin colours

Mild to moderate, early scars

++

$1100 for 4 treatments

INFINI RF

0-1 day

1-6

all skin colours

Mild to severe scars

++++

$ 1500+

Fraxel acne scars has largely been replaced by my Youlaser and INFINI RF. The use of fractional fraxel acne scars treatment will be completely obsolete by 2020. 

How does Fraxel laser compare with other fractional lasers for acne scars?

Fraxel 1550 is an all round laser than can treat nearly all forms of acne scars including atrophic, box car, and rolling scars, in all skin types. Fraxel 1550 laser resurfacing also has a lesser downtime compared to CO2 CORE Fractional laser. I also have the Fraxel Re:Pair – a CO2 Fractional laser that is one step above the CO2 CORE. This form of Fraxel is ideal for lighter skin types with mixed, atrophic and rolling scars. Fraxel laser DOES improve acne scars, but it is nearly a decade old, and there are much better devices for targeted acne scarring than Fraxel. The new YouLaser due out in 2017 is twice as powerful as Fraxel, and I do believe this will be a superior fractional laser than Fraxel. 

Dr Davin Lim will always advise you as to what type of laser is best for your acne scars. His collection of fractional lasers and energy based microneedling systems ensures that you will have the absolute best treatment for your acne scars.

The video below will explain why I don’t like the delivery system of Fraxel laser. Sure it works, and for those of you who have had great results, I am disputing the fact that it is effective, what I am trying to convey is that this technology has its flaws, and that newer laser systems are more powerful, safer, and gives me greater control over the 1550 and CO2 wavelengths of  Fraxel. 

More on Fraxel Laser 

How do I perform laser treatments for acne scars?

CO2 acne scars

 

Procedures are performed in one of our three laser suites at Westside Laser Dermatology by myself, assisted by a Laser Nurse. Local anaesthetic cream is applied 45 minutes prior to treatment. Just before the procedure, the cream is wiped off and cleansed with an antibacterial solution. A computer-guided scanner is placed over the treated area and the laser is applied. The procedure takes 15 to 30 minutes to perform. I then use a special formulation of antibiotic and an anti-inflammatory ointment to apply to the treated areas. This helps with the healing process.

Is laser treatment painful?

Laser treatment is well tolerated and discomfort is minimal. I sometimes combine some mild ‘twilight sedation’ as well as numbing cream to ensure that patients are comfortable throughout laser treatments. As a guide, the majority of patients rate the pain as 2 out of 10 on the pain scale. INFINI RF insulated micro needling is more painful than laser, and in some cases I offer sedation for this procedure. 

How long will I take to recover after fractional laser treatment of acne scars?

Immediately after laser the skin is red, swollen and feels like sunburn. Simple panadol can alleviate any pain, and ice packs can cool the treated skin. Downtime or recovery time will depend on several factors including the extent and depth of laser treatment as well as the type of laser we use. As a guide recovery times range from 3 days to 7 days. This will be discussed in detail prior to any laser treatments.

acne scar pre5.6

Significant acne scarring prior to treatment.

acne scar fractional 33

Immediately following one light pass of Fractional Laser. Fractionation, treats a specified percentage of skin. Treatments can be non- aggressive with quick recovery times.

acne scar fraxel 33

3 days after laser. Complete healing is seen at day 6. Swelling has decreased. Best results are seen 2-3 months after treatment- the time it takes for new collagen to reform. 2-4 treatments are recommended. Dr Davin Lim

How many acne fractional laser treatments will I need?

CO2 beforeCo2 after

The number of acne laser scar treatments will vary between patients depending on the depth and types of scars. Two other factors play an important role in the assessment of acne scars- skin type (skin colour) as well as downtime.

As a guide we recommend 3-4 laser treatments for the best results. These treatments are spaced at intervals of 2-3 months apart. Dr Davin Lim will give you an estimate of expected improvement with each treatment.

The choice of which laser I elect to use will depend on your skin type, scar severity and downtime. Dr Lim often combines multiple lasers in the one treatments session- this provides the best outcome for the patient. The use of multiple treatment methods forms the basis of his Synergy Program for acne scar revision.

Who performs fractional laser treatment for scars?

All laser treatments are performed by Dr Davin Lim and his team of laser nurses. Acne scar specialist train as doctors, then undergo additional training as Skin Specialist (Dermatologists), they undertake subspecialist training is scar revision techniques and laser surgery. Expertise, experience and training ensure patients are in the best possible hands. For an unbiased viewpoint on Dr Davin Lim an his unique approach to acne scar revision visit the discussion forums on realself.com or acne.org

His reputation for acne scar work is recognized Internationally. Dr Davin Lim has International and Interstate patients that visit him on daily basis for scar revision.

What is radiofrequency fractional treatment for acne scars?

RadioFrequency or RF treatment for acne scars is the newest method of acne scar removal. This treatment is not a laser-based method of fractional skin resurfacing, but it involves the use of radio waves to target scarred collagen beneath the skin’s surface. RF is a form of FRACTIONAL SKIN treatment, with out the downtime of lasers. RF is best suited for early onset mild to moderate acne scar. Early scarring can be defined as acne scars less than 3 months old. RF can be combined with anti-acne treatments. 3-5 treatments are ideally needed for optimal results. Fractional RF is the safest method of acne scar removal in darker skin types.

The recovery from RF is very quick, and will depend on the power setting we use. As a guide low setting RF subablative- downtime of up to 12-16 hours. High energy RF for acne scars will have a 48 hours recovery. eMatrix RF clocked to 100 mJ per pin is the industry leader for non- needling RF- it offers the most powerful and consistent results. Always select a device whereby an accurate energy level can be measure. Remember, acne scar revision is a medical procedure and not a cosmetic one!

Note that RF treatments are best for early mild acne scars, in patients who have little downtime to spare. Fractional Laser treatments such as Fraxel, Erbium or CO2- Fraxel is a better treatment for more severe scarring. Once again a tailored program, depending on scar type, skin type and down time will give the best results.

More on eMatrix RadioFrequency treatment for acne scars

What is fractional skin needling RF INFINI?

This is the very latest in acne scar remodeling and has revolutionized acne scar treatments. Unlike laser, RF needling targets scars that lie beneath the skin, and spares the skin’s surface. This treatment is not skin needling, but controlled RF insulated micro-needling. The biggest difference is that it uses 49 needles per area, delivered in different depths (0.5 mm to 3.5 mm), and delivers controlled heating over a set time. This is the best device for severe acne scarring, and is far superior to even the most powerful fractional lasers. The key to why INFINI excels over lasers is the design of the insulated needles. 

In summary INFINI RF is-

  • Ideal for atrophic, rolling, mixed and tethered scars

  • Associated with a downtime of only 1-2 days

  • Can be safely used on all skin types

  • Is extremely effective

  • Is infinitely adjustable for every patient and scar depth

  • Can be combined with PRP for even better results and faster healing times

More on INFINI RF

What is the first step towards fixing acne scars?

Fraxel acne scars

The first step can be a daunting process for many patients. Dr Davin Lim will assess your acne scars and provide solutions based upon individual assessment.

Acne scar treatment is a highly individualized treatment, and at Laser and Lifts, Dr Davin Lim will tailor a bespoke program based upon your skin type, scar type and downtime. This will ensure the best possible outcomes for all patients. Fraxel acne scars can be good, but newer lasers are better. 

Call us directly on 07 3871 3437 to make an appointment, or to discuss issues regarding the referral process.

fraxel acne scars

How do I differ from other places that provide acne scar treatments?

Dr Davin Lim’s main focus is on acne scar revision, half his daily work is spent revising acne scars. He is considered a World authority on acne scar revision and lectures Internationally on his procedures. Scar revision is complex, and having a specialist trained in all aspects of scar removal ranging from peels, lasers, RF, surgery and fillers are essential for the best outcomes. Having access to over 20 lasers and energy based devices assists him in matching the correct device for your scar type.

For an unbiased opinion on who provides the best service for acne and acne scar treatments, ask your General Practitioner or go to www.realself.com Be guided by reviews and not just adverting. You can do some research on Dr Davin Lim on websites like acne.org or real self.com  Real people, real experiences, real results and real reviews. The YouTube video shows how I practice acne scar revision (update due in early 2017). This field is constantly evolving, and I am at the forefront of its evolution. 

What are the costs for fractional laser scar treatments?

This is just a guide as to the cost of laser treatments. In some cases acne scar revision performed by a Specialist Dermatologist or Plastic Surgeon is claimable on Medicare.This is based on a case to case basis, depending on the scar type and procedure we perform. Fractional laser treatments are NOT claimable through Medicare- Private Health insurance. 

  • Fractional laser (CO2, Fraxel 1550, Erbium, Picosure Focus) $800-$1200 per treatment
  • Fraxel CO2 laser resurfacing $1900-$3500 per treatment
  • Total laser resurfacing + Fractional laser $490- $4900 per treatment* Out of pocket- rebate applies. 

(For fractional laser 2-4 treatments advised. Treatments spaced 8-12 weeks apart. Costs dependent on the extent of scarring- depth and area. Full laser resurfacing – one, possibly two treatments recommended, Medicare rebate applies for fully ablative lasers, but not for fractional laser resurfacing.)

Treatment

Treatment time

Number of treatments needed

Downtime

Ideal scar severity

Projected scar improvement

Costs

Clear Skin Program

60min

4

Hours

Mild scarring

+

$590

Chemical peels

15 min

4-6

Hours

Mild

+

$98

RF RadioFrequency eMatrix

15 min

4

0-2 days

Mild early scars

+++

$1500 for 4

Fraxel and Fractional laser 1550

30 min

3-5

3-6 days

Mild to severe

++

800-1200 each

INFINI RF

30 min

2-3

1-2 days

Mod to severe

+++++

1700+

Synergy laser –Full laser resufacing

15 min to 60 min

3-7

1-12 days

Mod to severe

++++++

3500-7800

Does Medicare provide any assistance for acne laser scar treatments?

Medicare does NOT provide any rebate for fractional laser treatments, however for Full Laser Resurfacing, a rebate does apply. Some acne scar revision procedures performed by Specialist will carry a rebate.

Dr Lim will give you an idea as to what can be claimed on Medicare and your out of pocket costs for all procedures. Fully ablative lasers such as CO2 and Erbium are useful for the finishing touches of scar revision, or if you have shallow scars that lie in the same plane, in lighter skin types. This video shows how I perform fully ablative laser resurfacing for acne scars under sedation. 

Dr Davin Lim on fractional laser treatments for acne scars

Dr Davin Lim

Consultant Laser Specialist

Lasers and Lifts
Dr Davin S. Lim copy

Traditionally, fractional lasers have provided a safe and effective means of treating acne scarring in all skin types. We now have a variety of fractional devices to resurface acne scars. Skin needling was one of the first methods to provide fractional resurfacing, however this method is historical. Fraxel laser paved the way in 2005, followed by a variety of fractional methods. As the name suggest, treating skin area in fractions enables quicker healing times, and in darker skin patients it poses less risks.

With an array of fractional devices at Laser and Lifts I can tailor downtime for each client and weight the risks and benefits for each form of fractional treatment.

For results the CO2RE fractional laser is the ‘big gun’ in acne scar revision, however it has a longer downtime compared to erbium Scition Profractional laser. Erbium is an excellent method of fractional resurfacing in darker skin types, or when down time is an issue. Newer non-laser based subablative RadioFrequency fractional devices are useful for mild to moderate, early scarring. The real game changer is INFINI RF- this has really revolutionized rather than evolutionized acne scar treatment. This treatment enables me to treat all skin types and target energy at a specific depth- this treatment is best for rolling, atrophic, tethered and mixed scars in all skin types. In 2017, I will take delivery of a new laser system called the YouLaser. This laser is a combination of CO2 and non-ablative fractional laser- a so called hybrid system. This in theory provides shorter downtimes with better results. I have yet to see MY results, so stay tuned, I am super excited to see what this laser can deliver. 

What device I choose is based upon scar type, skin type and downtime. Careful examination with angled lighting and animation together with scar mapping is the very first step. I then consolidate this information and plan for and an individual acne scar revision program. This gives the very best results. 

Fractional lasers are not the be all to end all for acne scar revision – I often combine techniques such as subscision, TCA chemical peels and full resurfacing for best patient outcomes. Fractional lasers form part of my Synergy Program for acne scars. Acne scar treatments have evolved a long way from fraxel acne scars treatments, newer lasers are far more effective Fraxel acne scars provide patients with unnecessary consumables, increasing the cost of acne scar treatments.