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Fraxel vs Microneedling

Fraxel: A laser that heats thousands of microscopic columns in the skin and leaves the skin between them untouched. Used for sun damage, acne scars, and rough texture. It takes a course of treatments and a few days of looking sunburned each time.

Microneedling: A pen or roller of fine needles makes thousands of tiny controlled punctures in the skin, which sets off healing and new collagen. It is used mainly for indented acne scars and rough texture. It makes them shallower over a course of sessions, not gone.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026
Editorial illustration for Fraxel, based on the entry’s treatment or equipment reference.Editorial illustration for Microneedling, based on the entry’s treatment or equipment reference.
Choose ifKey differencesWhat is it?What it treatsTreatment areasSkin tonesHow it worksBefore your treatmentDay of treatmentAfter your treatmentRisksCostQuestionsRelated

Choose Fraxel if…

Choose for acne scars or sun damage with a few days of downtime per session instead of the week-plus of ablative lasers.

  • Rolling or boxcar scars
  • Sun spots and rough texture
  • You can plan 3–5 sessions

Choose Microneedling if…

Choose for indented acne scars and rough texture with little downtime and low pigment risk — shallower, not gone.

  • Rolling or boxcar acne scars
  • Deeper skin tone, where lasers are riskier
  • You can plan 3–6 sessions
Alternatives, not combined

Can you have both?

Both build collagen for scars and texture. Fraxel is stronger; microneedling is milder and lower cost. One is usually chosen per plan.

Key differences

● Fraxel
● Microneedling
DowntimeNone → 2+ weeks
3–7 days
1–2 days
PainMinimal → Needs anesthesia or sedation
Moderate
Mild
Results showImmediately → 3+ months
1–3 months
1–3 months
How long it lastsWeeks → Years or permanent
Years or permanent
Years or permanent
Visits neededOne → Every few months
A longer series (4–6+)
A longer series (4–6+)
Cost per visit$ → $$$$$
$$$
$$
ReversibleYes, can be undone → No, permanent
No, permanent
No, permanent

What is it?

Fraxel

Microneedling

What is it?

It is a nonablative fractional laser.

Fraxel heats microscopic zones while sparing skin in between.

Platforms differ.

Wavelength and device determine the treatment.

It is not CO2 resurfacing.

It is less intensive than ablative lasers.

It is not risk-free.

Burns, redness and pigment changes can occur.

It creates controlled punctures.

Fine needles puncture the skin in a controlled way.

It treats scars and texture.

Results depend on device, depth and technique.

It differs from RF microneedling.

No radiofrequency energy is involved.

Added substances change the risk.

Devices are not cleared for use with every serum or blood product.

What it treats

Evidence level
Fraxel
Microneedling
Strong evidenceMost established uses
Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Improves rolling and boxcar scars.

AI-generated educational illustration of Sun Spots: 1. Sun Spots Header — Light Skin; Lighter skin. Not a clinical photograph.

Sun Spots

Clears sun damage.

Acne scarring on light skin. Small sharply cut pits and broad shallow dips across a cheek, several sitting inside faint flat pink marks, with no active spots.

Acne Scarring

Improves rolling and boxcar scars.

Rolling Scars.

Rolling Scars

Good results with a series.

Moderate evidenceSome supportive research
A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Smooths texture.

Two areas of fair skin side by side on a hip. New pink-red bands sit above, and older flat silvery-white bands below, with only a small difference in color between the pale marks and the skin around them.

Stretch Marks

Softens older marks.

A relaxed forehead with faint shallow horizontal fine lines.

Wrinkles and Fine Lines

Improves texture.

Limited evidenceEarly or small studies
Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Low settings may help some.

—
Little evidence
Ice Pick Scars on light skin.

Ice Pick Scars

Too deep for most sessions.

Ice Pick Scars on light skin.

Ice Pick Scars

Too deep for needling alone.

Can make it worse
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Can worsen redness.

Inflamed acne on light skin. The spots sit in a patch of pink, and the ring of redness around each one is easy to see. A few have a yellow-white head, and the skin between them is dry and flaking.

Acne

Can spread active breakouts.

Treatment areas

Treatment areas

Face and hands.

Face; the selected area depends on the concern and treatment plan.

Skin tones

Skin tone
● Fraxel
● Microneedling
Lighter skin
Low risk
Redness and swelling for days.
Low risk
Redness like a mild sunburn.
Medium skin
Some risk
Dark marks possible; lower settings help.
Low risk
One of the safer scar treatments.
Deeper skin
Some risk
Safer than ablative lasers at lower density with an experienced provider.
Low risk
Lower pigment risk than lasers; dark marks are still possible.

How it works

Fraxel

Microneedling

How it works
Fraxel DUAL diagram: 1927 nm reaches up to 0.3 mm and 1550 nm up to 1.6 mm, depending on settings.
Microneedling mechanism diagram. Fine needles create tiny punctures: A device makes controlled channels in selected skin. Healing signals are released: The tissue response activates repair processes. Collagen remodels gradually: Healing may improve selected scars and skin texture.
Diagram explanation

Fractional heat zones leave surrounding tissue untreated. Superficial 1927 nm treatment helps fade uneven pigmentation; deeper 1550 nm treatment triggers repair and collagen remodeling.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Fine needles create tiny punctures: A device makes controlled channels in selected skin. Healing signals are released: The tissue response activates repair processes. Collagen remodels gradually: Healing may improve selected scars and skin texture.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Fraxel
Microneedling
2–4 weeks before

4 weeks before: Sun: Avoid tanning, self-tanner and sunburn.

Pigment preparation: For deeper skin tones, providers may prescribe a pigment-lowering cream for 2–4 weeks and test near the ear.

Pigment cream: On deeper skin tones, some providers start a pigment-blocking cream a few weeks ahead.

The week before

Cold sores: Tell your provider; preventive antiviral medicine often starts the day before.

Hair removal: Stop waxing, threading and hair-removal creams.

Actives: Stop retinoids, retinol and acids 3–7 days before.

Actives and hair removal: Do not arrive tanned or sunburned.

Actives and hair removal: Stop retinoids (tretinoin, adapalene, retinol), benzoyl peroxide and acids 3 to 5 days before.

Actives and hair removal: No waxing, threading or hair removal creams.

Day of treatment

Fraxel
Microneedling
Before you arrive

Arrive with clean skin and no makeup.

Arrange a ride if you will have strong settings or oral pain medicine.

Clean skin: Come with a clean face and no makeup, and plan not to wear any that day.

Clean skin: If you have active pustules or an infection in the area, move the session.

Arrival & prep

Skin is cleaned and photographed. Numbing cream stays on for 45–60 minutes.

Skin is checked and photographed, and you confirm what you have stopped using.

Treatment

The laser passes over the skin while cold air cools it.

Expect prickly heat that builds with each pass, often strongly uncomfortable—especially on the forehead and around the mouth.

The pen is passed over the skin in overlapping passes, one area at a time, with sterile gel or saline as a glide.

It sounds like a small vibrating motor and takes 20 to 30 minutes for a full face. Pinpoint bleeding is normal at deeper settings over scars. With good numbing it is uncomfortable rather than painful, a scratchy dragging with pressure.

Before you leave

Skin feels hot, red and swollen. Ice packs and a bland ointment are usually applied.

Skin is bright red, warm and tight, like a strong sunburn, sometimes with faint tracking lines and dots of dried blood.

After your treatment

Fraxel
Microneedling
First 24 hours

Days 1–2: Redness and swelling, especially around the eyes.

Days 1 to 5: Redness turns pink and swelling settles, most noticeably around the eyes the first morning.

Days 2–7

Days 3–7: Rough, bronzed skin flakes away. Do not scrub or pick.

Not specified
Weeks 2–4
Not specified

Weeks 1 to 4: Skin looks normal and nothing appears to be happening.

Beyond 1 month

1–3 months: Time to results.

Scar improvement can last years; sun damage can return with sun exposure.

Months 2 to 6: Texture keeps improving after the visible healing finishes, which is why the photograph that matters is taken months later, not the week after.

Time to results
Not specified

1–3 months after each session

How long results last
Not specified

Years for scars

Risks

Risks
  • Dark patches
  • Worsening redness
  • Cold sores
  • Acne or white bumps
  • Lighter patches
  • Dark patches
  • Tracking lines
  • Prolonged redness
  • Bumps that will not go
  • A cold sore outbreak

Cost

Per session

About $900–1,500 for a full face in the US. Smaller areas cost less.

In the US a full-face session usually runs about $200 to $700, with medical offices at the higher end and packages of three to six cheaper per session.

Full course

Several thousand dollars. Packages may reduce the per-session price.

Not specified
Insurance

Cosmetic treatment is not covered. Coverage for surgical or injury scars is uncommon.

Insurance does not cover microneedling for acne scars, since it is classed as cosmetic.

Questions

Fraxel

Microneedling

Individual Questions
How many Fraxel sessions will I need?

Three to five, two to four weeks apart. Sun damage sometimes needs fewer, acne scars usually need the full course, and deeper skin tones are treated at lower settings, which means more sessions.

Does Fraxel get rid of acne scars?

It improves them rather than removing them. Studies of nonablative fractional lasers show partial improvement in scar depth and appearance over a course. Deep icepick scars respond least and are often better treated by combining the laser with subcision or filler.

How much downtime is there really?

Plan for a week. Two days of redness and swelling, then a few days of rough, bronzed skin that flakes off. Most people cover it with makeup from day three and look normal by day seven.

Does it hurt?

With an hour of numbing cream and cold air, most people call it hot and strongly uncomfortable rather than unbearable, and it stops as soon as the laser does. The forehead and around the mouth are the worst.

Is it safe for deeper skin tones?

It can be done, but differently. The main risk is temporary dark patches. Lower settings, more sessions, pre-treatment creams and strict sun protection all lower that risk, and the provider experience with your skin tone matters more than the device.

Is Fraxel the same as CO2 laser?

No, though one device sold under the Fraxel brand is a carbon dioxide laser. The Fraxel most people mean is nonablative, heating the skin without removing the surface. A carbon dioxide laser removes tissue, does more per session, and brings one to two weeks of downtime and more pigment risk.

Does microneedling get rid of acne scars?

No. It makes indented scars shallower and less noticeable over three to six sessions. Rolling and shallow boxcar scars respond best, icepick scars respond poorly, and improvement is partial in every study. That is worth having; complete clearance is not what this treatment does.

How many sessions will I need?

Three to six for scarring, four to six weeks apart, then a wait. Texture keeps improving for three to six months after the last session, so do not judge the outcome before then.

Does it hurt?

With numbing cream on for 30 to 45 minutes it is uncomfortable rather than painful, a scratchy pressure rather than a sharp pain. The forehead, nose and jawline are the worst part, and deeper settings over scars are sharper.

Is microneedling safe on deeper skin tones?

One of the better options, because there is no heat or light for melanin to absorb. Dark marks are still possible if the settings are aggressive or the skin sees sun afterward, and they fade over months. Choose someone who treats deeper skin tones routinely.

Can I do this at home with a dermaroller?

Anything at 0.5 mm or deeper is a medical depth and should not be used at home. Needles blunt, home rollers cannot be properly sterilized, and serums through fresh channels have caused lasting lumps of inflammation. Rollers at 0.2 to 0.3 mm are mostly harmless and mostly useless.

Is PRP worth adding?

Platelet-rich plasma is your own blood, spun down and applied or injected during the session. The evidence that it improves scar results is mixed, and it often doubles the price. A course without it is a reasonable course.

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