Fraxel vs CO2 Laser: Which Is Better for Acne Scars?

Both Fraxel (fractional laser) and CO₂ laser resurfacing are widely used in dermatology clinics for acne scar treatment, skin resurfacing, and overall skin rejuvenation. They each approach scar correction differently — making each more suitable for certain scar types and skin conditions. Understanding the difference is key to choosing the right treatment for your scars and skin type.

What They Are & How They Work

Fraxel (Fractional Laser)

• Fraxel delivers microscopic laser “columns” of energy to the skin, leaving surrounding tissue intact.
• This fractional damage triggers controlled skin healing: new collagen, skin regeneration, smoothing of texture and superficial scars.
• Because only a portion of the skin is treated in each session, recovery tends to be faster and less invasive compared to full resurfacing.

CO₂ Laser (Full / Fractional CO₂ Resurfacing)

• CO₂ laser uses a high-energy beam that vaporizes the outer layers of skin — removing damaged tissue across the treated zone.
• It resurfaces skin more aggressively: effective for deep scars, severe texture irregularities, and stubborn scars that affect deeper skin layers.
• Because it removes more tissue, the resurfacing effect is more dramatic but also requires longer recovery and careful aftercare.

What They Do Best: Strengths & Results

Fraxel — Strengths

• Great for mild to moderate acne scars, especially rolling, shallow boxcar, or general uneven texture.
• Improves skin tone, fine scars, pigmented marks, and surface irregularities.
• Shorter downtime: redness & mild peeling for a few days; most people return to routine quickly.
• Lower risk than full resurfacing — safer for sensitive skin or those wary of aggressive lasers.

Best For: Fine-to-medium scars, uneven texture, pigmentation, post-acne marks, early scar correction.

CO₂ Laser — Strengths

• Powerful resurfacing for deep acne scars, deep boxcar or ice-pick scars, or severe texture problems.
• More dramatic smoothing and resurfacing — often results in significant scar depth reduction and overall skin renewal.
• Can improve both scar depth and skin tightness, especially for older scars or heavily textured skin.

Best For: Deep scars, severe texture irregularities, stubborn scars that haven’t responded to milder treatments.

Tradeoffs: Downtime & Risks

Fraxel

• Minimal to moderate downtime (mild redness, some peeling)
• Lower risk of hyperpigmentation or infection
• Multiple sessions often required for optimal results

CO₂ Laser

• Longer downtime (several days to a week — peeling, redness, skin sensitivity)
• Higher risk of irritation, pigment changes, or prolonged healing
• Requires diligent aftercare: moisturization, sun-protection, gentle skincare

When to Choose Fraxel vs CO₂ Laser (or When to Combine)

Choose Fraxel if:

• Scars are mild-to-moderate, shallow, or superficial
• You want minimal downtime and fast recovery
• You’re concerned about skin sensitivity or pigment issues
• You prefer gradual improvement over time

Choose CO₂ Laser if:

• Scars are deep, stubborn, or heavy — not significantly improved by mild treatments
• You want dramatic resurfacing and are okay with downtime and aftercare
• Skin texture and tightness need major renewal
• You want a more “reset” approach rather than subtle improvement

Consider Combining Treatments (Staged Approach):

• Use CO₂ laser for deeper scars and resurfacing
• After healing, use Fraxel or gentle lasers for maintenance and surface tone/texture
• Combine with skin care (moisturizers, sun protection) and possibly skin boosters for best results

Who Benefits Most from Each Approach

• Fraxel: Younger patients, early scarring, mild-to-moderate acne scars, uneven tone — anyone needing improvement without downtime.
• CO₂ Laser: Adults with deep, older scars; people seeking strong resurfacing; those willing to commit to proper aftercare and recovery time.

Final Thoughts: Neither Is Universally “Better” — Choose Based on Scar Type & Goals

There is no one-size-fits-all “best” laser for acne scars. The ideal choice depends on:

• Type and depth of scars (superficial vs deep)
• Skin sensitivity and skin type
• Tolerance for downtime and aftercare
• Desired speed and extent of improvement

For many, a combination or staged treatment plan — resurfacing for deeper scars followed by fractional or maintenance treatments — produces the best balance of smoothness, healing, and long-term skin quality.