Why Are the Scars Still There After the Acne Is Gone? From Types of Fraxel to Acne Scar Treatment｜Hongdae Acne Scars

Why Are the Scars Still There After the Acne Is Gone?

If your skin is uneven and depressed after the acne has disappeared, it may not simply be an ‘acne mark’ but an acne scar caused by damage to the dermal structure.

Rather than damaging the entire skin at once, Fraxel creates microscopic treatment zones to induce the skin's healing process and collagen regeneration.

However, because acne and acne scars come in different forms, the same Fraxel treatment is not used for every case.

Depressed acne scars + enlarged pores → Dual Fraxel·Intracell

Deep scars + rough skin texture → Multicell Fraxel

Acne marks + pigmentation + pores·skin texture → PicoSure Fraxel

Recurring inflammatory acne → Treatment that addresses sebum·inflammation and scars together

In particular, red or brown acne marks and acne scars where the skin is actually depressed have different treatment goals.

What Is Fraxel?

Fraxel is a treatment that creates microscopic treatment zones in the skin to induce the natural healing process and collagen regeneration, improving acne scars·pores·rough skin texture.

One of the main reasons acne scars remain for a long time is that acne inflammation affects the deeper layers of the skin and damages the normal collagen structure.

Depressed scars in particular are not simply a problem on the skin surface but also involve damage to the dermal tissue.

Fractional treatments create multiple microscopic areas of stimulation in the skin to initiate the healing process. During this process, the production of new collagen and elastic fibers is stimulated, and the skin tissue is remodeled, gradually improving depressed scars and rough skin texture.

In other words, rather than being a treatment that removes scars by shaving them away, Fraxel is closer to a treatment that induces damaged skin to regenerate.

What Is the Difference Between Acne Marks and Acne Scars?

If the skin surface is flat and only red or brown marks remain, they can be classified as acne marks. If the skin itself is depressed or uneven, they can be classified as acne scars.

It is common to refer to all marks left after acne disappears as ‘scars,’ but they are actually quite different.

Red marks are often caused by vascular changes remaining after inflammation, while brown marks are often caused by post-inflammatory hyperpigmentation.

In contrast, depressed acne scars occur when the collagen tissue in the dermis is damaged during the inflammatory process, causing the skin structure itself to sink downward.

Therefore, the direction of treatment also differs.

Red acne marks → Vascular·redness treatment

Brown acne marks → Pigmentation treatment

Depressed acne scars → Collagen regeneration·scar remodeling

Depressed scars + pigmentation·skin texture → Combination treatment addressing both concerns

This is why repeatedly performing only scar treatments for acne marks, or only toning for deeply depressed scars, may result in limited improvement.

Why Is Fraxel Used for Acne Scars?

Because depressed acne scars require rebuilding the damaged collagen structure of the dermis, fractional treatments that induce skin regeneration and collagen remodeling are used.

When acne causes severe inflammation, the skin tissue becomes damaged.

If sufficient collagen is not produced during the healing process, the skin may not fill back up to its original level and may remain depressed.

Once depressed scars have formed, it is difficult to fill them back in with ordinary cosmetics or moisturization alone.

Fraxel intentionally creates microscopic treatment zones in the skin to induce the wound-healing response again.

During this process, new collagen is produced and the tissue around the scar is remodeled, helping reduce the depth of the scar and make the skin surface smoother.

Can I Receive Fraxel If I Still Have Acne?

If inflammatory acne continues to occur, it is important to consider acne treatment to prevent new scars together with treatment for existing scars.

There is an important point that can easily be overlooked in acne scar treatment.

No matter how much existing scars are treated, if new inflammatory acne continues to recur, new scars may continue to form.

Therefore, during periods when acne is actively occurring, it is important to consider currently active acne separately from scars that have already formed.

In particular, if there is excessive sebum production and recurring inflammatory acne, treatments that also target the sebaceous glands and inflammation may be used.

Methods such as Dual Fraxel, which combine fractional laser with Intracell or Potenza-type needle RF, can be used to treat not only pores·acne scars but also sebaceous glands and recurring inflammatory acne by targeting from the skin surface to the dermal layer.

Acne continues to occur → Acne suppression + scar treatment

Almost no acne remains and only depressed scars are left → Focus on scar remodeling

This is how they can be distinguished.

Which Fraxel Is Suitable for Depressed Acne Scars?

If depressed scars are the main concern, treatments such as Dual Fraxel·Multicell Fraxel·Intracell that can sufficiently stimulate collagen regeneration in the deeper layers of the skin may be considered.

Acne scars do not occur in only one form.

Some scars are broad and gently depressed, while others have clearly defined depressed borders or are narrow and deeply indented.

Therefore, rather than focusing on the number of ‘Fraxel sessions,’ what matters is the depth and method used to regenerate the scar tissue.

Dual Fraxel induces regeneration of the skin surface and dermis through a fractional approach while also using Intracell or needle RF treatments to target collagen regeneration in deeper layers.

Multicell Fraxel uses 10,600nm CO2-based energy to create microscopic treatment zones and induce dermal remodeling, so it can be used to improve depressed scars, enlarged pores, and rough skin texture together.

How Is Dual Fraxel Different from Regular Fraxel?

Dual Fraxel combines fractional laser with Intracell or needle RF treatment to regenerate both the skin surface and the deeper dermal layers simultaneously.

The deeper the acne scars are, the more limited the improvement may be if only the skin surface is smoothed.

Dual Fraxel creates microscopic treatment zones on the skin surface using a fractional laser while inducing an additional regenerative response in the deeper layers of the skin through microneedle treatment.

Through this, it can be used to comprehensively improve

• Depressed acne scars

• Enlarged pores

• Rough skin texture

• Sebum production

• Recurring inflammatory acne

• Reduced elasticity

.

In particular, if acne continues to recur and scars and pores are also concerns, an approach that targets multiple layers simultaneously may be more efficient than treating only one problem.

What Effects Does Intracell Have on Acne Scars?

Intracell inserts microneedles into the dermal layer to deliver radiofrequency energy and stimulate collagen regeneration, improving depressed scars·enlarged pores·skin elasticity.

Intracell differs from methods that apply laser energy only to the skin surface.

After the microneedles enter the skin, energy is delivered at the targeted depth to create microscopic thermal stimulation in the dermis.

As this stimulation heals, collagen production is promoted, gradually improving acne scars, enlarged pores, and skin texture.

Its characteristic feature is that it can directly stimulate the dermal layer while relatively reducing damage to the skin surface.

It is particularly useful when the following concerns occur together.

• Depressed acne scars + enlarged pores

• Sebum production + recurring acne

• Skin texture + reduced elasticity

What Types of Acne Scars Is Multicell Fraxel Suitable For?

Multicell Fraxel is a fractional treatment that can be useful when rough skin texture·pigmentation·fine lines are concerns together with depressed scars and enlarged pores.

Multicell Fraxel uses 10,600nm CO2-based energy to create microscopic treatment zones in the skin and stimulate collagen and elastin regeneration in the dermal layer.

Because damaged tissue is remodeled as the skin heals, it can improve not only acne scars but also multiple concerns on the skin surface at the same time.

In particular, after acne has subsided, if

Depressed scars remain

Pores have become enlarged

Skin texture is uneven

Pigmentation also remains

comprehensive skin remodeling can be targeted.

In other words, rather than treating only one specific scar, it is a useful method when you want to improve scars·pores·skin texture across the entire face together.

Is PicoSure Fraxel Effective for Acne Scars?

PicoSure Fraxel can be useful when pores·skin texture·shallow scars are concerns together with post-acne hyperpigmentation.

PicoSure Fraxel differs from conventional CO2 Fraxel in the way energy is delivered.

It uses short laser energy in the picosecond range to create microscopic stimulation in the skin and induce collagen regeneration.

In particular, if the skin looks uneven in tone after acne and the pores and skin texture have also become rough, one advantage is that pigmentation and skin texture can be treated together.

Therefore, it can be distinguished as follows.

Deep depressed scars → Treatment focused on deep collagen remodeling

Shallow scars + pores + skin texture → PicoSure Fraxel

Brown acne marks + skin texture → PicoSure Fraxel

Both deep scars and pigmentation → Combine scar treatment + pico-based treatments according to the purpose

Rather than understanding PicoSure Fraxel as ‘a Fraxel treatment that can resolve all deep scars while having less downtime,’ it is more accurate to view it as a treatment that improves pigmentation·pores·skin texture and shallow scars together.

Can Fraxel Remove Red Acne Marks?

If red acne marks are the main concern, a laser that targets red blood vessels is a more direct treatment than Fraxel.

Red marks often remain after acne subsides because of changes in the small blood vessels around the areas where inflammation occurred.

If the skin surface is flat and only redness remains, treatment to reduce vascular redness takes priority over scar regeneration.

Conversely, if an area with a red mark actually feels depressed when touched, both problems are present together.

Flat red marks → Vascular laser

Flat brown marks → Pigmentation laser

Depressed scars → Scar regeneration such as Fraxel·needle RF

Red marks + depressed scars → Combine the two treatments according to their respective purposes

Which Is Better for Brown Acne Marks, Fraxel or Pico Toning?

If the skin is flat and only brown pigmentation remains, pigmentation treatments such as Pico Toning are more direct. If there are pores·skin texture·shallow scars together with pigmentation, PicoSure Fraxel may be considered.

Brown marks remaining after acne subsides are often post-inflammatory hyperpigmentation.

In this case, the skin structure itself is not depressed, but rather the amount of melanin pigment has increased, so deep scar regeneration treatment is not necessarily required.

Therefore,

• Only brown marks → Pigmentation treatments such as Pico Toning

• Brown marks + rough skin texture → PicoSure Fraxel

• Brown marks + depressed scars → Pigmentation treatment + scar treatment

can be distinguished in this way.

If Acne Scars Are Deep, Is Fraxel Alone Enough?

For deep, clearly defined depressed scars, combining other treatments such as subcision·dot peel·scar injections according to the scar type may be more effective than repeatedly performing Fraxel alone.

Depressed acne scars also vary in shape.

Representative types include broad and gently depressed rolling scars, boxcar scars with relatively well-defined borders, and narrow, deep ice pick scars.

The deeper the scar, the more difficult it may be to achieve sufficient improvement simply by repeatedly delivering energy to the skin surface.

For example, if fibrous tissue beneath the skin is pulling the scar downward, subcision may be used to release the adhesion. For narrow and deeply depressed scars, treatments such as dot peel that directly induce a regenerative response within the scar may also be considered.

In other words, in acne scar treatment, rather than “finding the strongest Fraxel,” it is important to select treatment methods according to the shape of the scar.

Is It Good to Combine Fraxel with Juvelook Scar Injections?

If you want to actively stimulate collagen regeneration in depressed scars, fractional treatment can be combined with Juvelook Scar Injections that help stimulate collagen production.

Fraxel creates microscopic stimulation in the skin to initiate the regeneration process, while Juvelook works by stimulating collagen production.

Therefore, for concerns where rebuilding the collagen structure is important, such as depressed scars or enlarged pores, regeneration can be induced through different mechanisms.

In particular, for older depressed scars or cases where skin elasticity has also decreased, it is important to sufficiently stimulate collagen remodeling in the dermis rather than simply smoothing the skin surface.

Can Fraxel Reduce Pores?

If collagen and elasticity around enlarged pores have decreased, stimulating dermal regeneration with Fraxel can help make the pores appear less noticeable.

Sebum production is not the only reason pores appear enlarged.

If the tissue around the pores becomes damaged due to recurring acne or skin elasticity decreases, the pores may appear wider and longer.

Treatments such as Fraxel and Intracell can help strengthen the tissue around the pores by stimulating collagen production in the dermis.

In particular,

Acne scars + pores → Fraxel·Intracell

Sebum + pores + recurring acne → Needle RF treatments

Pores + pigmentation + skin texture → PicoSure Fraxel

distinguishing concerns in this way can make treatment selection easier.

Is Fraxel Effective After Just One Treatment?

Changes in skin texture may be noticeable even after one treatment, but depressed acne scars often require repeated collagen remodeling, so multiple treatments are commonly performed.

Acne scars are structural changes that develop over a long period of time.

Therefore, rather than expecting all deep scars to be filled after a single treatment, the approach is to repeatedly induce the skin regeneration process and gradually reduce the depth and borders of the scars.

Dual Fraxel is commonly performed 3~5 times at intervals of approximately 1 month, while Multicell Fraxel is commonly performed 3~5 times at intervals of approximately 2~3 weeks.

However, because the energy delivered to the skin and the recovery period differ depending on the treatment method, not all Fraxel treatments are repeated at the same intervals.

Can My Face Become Redder and Acne Break Out After Fraxel?

Temporary redness·heat·dryness may occur after Fraxel, and in acne-prone skin, sebum or breakouts may temporarily increase after the initial treatment.

Fractional treatments intentionally create microscopic stimulation in the skin to induce a regenerative response.

Therefore, immediately after treatment, the skin may feel redder and hotter than usual or become dry.

In particular, acne-prone skin with high sebum production may temporarily experience increased breakouts during the initial treatment process.

If the skin feels rough at this time, immediately using a scrub or peel may cause additional irritation to the skin barrier.

• Redness·heat → Sufficient soothing care

• Dryness → Moisturization

• Flaking → Do not forcibly remove

• Going outdoors → Sun protection

This basic care is important.

When Do Scabs and Flaking Disappear After Fraxel?

Although it varies depending on the type and intensity of Fraxel, redness·heat·fine flaking or scabs may persist for several days after treatment.

CO2-based fractional treatments in particular create microscopic treatment zones on the skin surface, so the skin may become rough or develop tiny scabs after treatment.

Picking off the scabs by hand or using strong exfoliants at this time may increase the risk of post-inflammatory hyperpigmentation.

It is important to wait until they fall off naturally and maintain sufficient moisturization and sun protection.

If you have an important event, it is better to plan with enough time for the redness and flaking to subside rather than scheduling the treatment on the day of the event.

How Should I Care for My Skin After Fraxel?

After Fraxel, focus on moisturization and sun protection so as not to interfere with skin regeneration, and avoid heat·friction·strong exfoliation.

After treatment, the skin may temporarily become sensitive to external irritation.

CHECK POINT

✔Use sufficient moisturizer

✔Use sunscreen when going outdoors

✔Do not forcibly remove flaking or scabs

✔Temporarily avoid irritating products such as scrubs·peels·retinol

✔Avoid strong heat exposure such as saunas·hot rooms·strenuous exercise

✔Do not rub the face vigorously

In acne scar treatment, the process of allowing the skin to regenerate stably after treatment is just as important as the moment the laser treatment is performed.

Which Fraxel Is Suitable for My Acne Scars?

For acne scar treatment, rather than asking ‘which Fraxel is the best,’ it is important to first distinguish whether the remaining concern is active acne, pigmentation, pores, or actual depressed scars.

Simply put, they can be divided as follows.

• Recurring acne + sebum + scars → Dual Fraxel·Intracell treatments

• Depressed acne scars + enlarged pores → Dual Fraxel·Intracell

• Depressed scars + rough skin texture + overall skin remodeling → Multicell Fraxel

• Brown acne marks + pores + skin texture + shallow scars → PicoSure Fraxel

• Only red acne marks remain → Vascular laser

• Only brown acne marks remain → Pigmentation laser·Pico Toning

• Deep, tethered scars → Fraxel + combination scar treatment such as subcision

Ultimately, acne marks and acne scars are not treated in the same way.

If only discoloration remains, vascular or pigmentation treatment is used depending on whether the marks are red or brown. If the skin is actually depressed, treatment that rebuilds the collagen structure of the dermis is needed.

If acne is still occurring, the key to acne scar treatment is to improve existing scars while also reducing the process that leads to new scar formation.

Acne Scar Fraxel FAQ

Can I Receive Fraxel While I Still Have Acne?

Yes, but if acne continues to occur severely, treatment to reduce current acne should be considered together with scar treatment. This is because recurring new inflammation can continue to cause new scars.

Is Fraxel the Best Treatment for Acne Scars?

Fractional treatments are commonly used for broad depressed scars and improving pores·skin texture, but not all scars are treated with Fraxel alone. Other methods such as dot peel·subcision may be more direct for deep, narrow scars or tethered scars.

Can Fraxel Also Reduce Acne?

When Intracell·needle RF treatments that deliver energy to the sebaceous glands are used together, the treatment can also target sebum production and recurring inflammatory acne. However, the purposes of scar treatment and treatment for currently active acne should be distinguished.

Can Depressed Acne Scars Completely Disappear?

A realistic treatment goal for depressed scars is to reduce their depth and borders and make the skin surface smoother. Older and deeper scars may require combination treatments using multiple methods.

How Many Fraxel Treatments Are Needed?

Acne scars are commonly treated with approximately 3~5 repeated sessions. However, the interval may vary depending on the type of Fraxel and treatment intensity.

What Is the Difference Between Pico Fraxel and Regular Fraxel?

Pico Fraxel has strengths in improving pigmentation·pores·skin texture and shallow scars together, while CO2-based Fraxel is used for more active skin remodeling and improvement of depressed scars.

Is Pico Fraxel Good for Red Acne Marks?

If only red marks remain, a vascular laser is more direct. Pico-based treatments are more useful when brown hyperpigmentation and skin texture concerns are present together.

What Treatment Is Good for Brown Acne Marks?

If the skin is not depressed and only brown marks remain, a pigmentation laser or Pico Toning is a more direct option. If you also want to improve pores·skin texture, PicoSure Fraxel may be considered.

Can Acne Scars and Pores Be Treated Together?

Yes. Treatments that stimulate collagen regeneration, such as Fraxel·Intracell, are used to remodel both depressed scars and the tissue around pores.

When Can I Wear Makeup After Fraxel?

Lower-intensity fractional treatments allow a relatively quick return to daily activities, but treatments such as CO2-based Fraxel that create microscopic scabs on the skin surface require consideration of the recovery period. While the skin is red and stinging, it is recommended to minimize irritating makeup.

Is Fraxel Effective for Old Acne Scars?

Older scars can also be improved in depth and skin texture through collagen remodeling treatments. However, for old and deeply tethered scars, combining Fraxel with subcision·dot peel·collagen regeneration treatments may be more suitable.