New skin resurfacing technology: ActiveFX laser

Wow, when I say the company gave me feedback, did they ever! :-0

I haven't had the time to digest it all, but if you have comments or additional questions, I can pass them over to the ActiveFX folks ~Lisa

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From Lumenis:

First, let me give you a little background on ActiveFX.
1. The procedure uses the 10,600nm wavelength which is considered by dermatologists and plastic surgeons to be the "gold standard" for removing wrinkles, dyschromia, etc

2. In the past, systems using this wavelength provided excellent results -- but the down-time was prolonged (as much as 6-8 weeks before make-up can be applied!)

3. Consumers wanted noticeable effects with minimal downtime.

• We did months of work to identify the correct wavelength, settings, etc.
• We found that the ideal laser would need to ablate the top layers of the skin and also simultaneously provide heat to the lower layers.
• The ablation causes immediate contraction of wrinkles and loose skin (up to 30%) and also removes any pigmentation problems.
• The heat causes new collagen promotion -- which serves to plump up from below AND to re-build the skin's scaffolding to prevent future wrinkles.
• However, if you go TOO deep, you can get dermal scarring or dimples from fat atrophy -- both of which are long-lasting (if not permanent) side effects.
  

4. Guess what... we already had something close! But, we needed to completely change the settings, the spot size, and other things.

• We reduced the spot size so that we don't have as much collateral heat. This is important to reduce the redness and swelling so that we have a fast recovery
• The system uses a Computerized Pattern Generator (CPG) to place up to 600 of these tiny dots in a second! However, we wanted to make sure that none of these dots were placed side-by-side in a sequential manner. If we do, having several small dots placed nearly-simultaneously is almost as bad as one big dot. So, we made the computer program to put the dots in a non-sequential manner (called CoolScan) so that each individual tiny dot cools off before the one next to it is placed. Again, this is to reduce erythema, edema, etc
• We found that the dots should be spread out so that they never touch each other. This means that we leave little "bridges" of healthy, untouched skin between the tiny dots. This "fractional" technique (a fraction of the surface is treated instead of 100%) also really speeds up the re-epithelialization and healing process.
• We took several more months to study the energy settings. In the end, we came up with settings that are JUST enough to vaporize/ablate (shrinkage and remove damaged skin) AND enough to provide some heat in the dermis (new collagen) without giving us a long downtime or dermal side effects.
  

5. All of these things added together give us consistent, reproducible results! We say "ActiveFX is for people with ACTIVE lifestyle who want noticeable EFFECTS -- dramatic improvement in Tone, Texture and Tightening -- all in a single treatment!" It is really incredible to watch a procedure -- you can see the skin "shrink-wrap" before your eyes!

OK, so now (finally) to your question about Fraxel.

1. Both ActiveFX and Fraxel use "fractional" coverage. Fraxel covers about 20% and ActiveFX covers about 80%. The studies we did showed that we got VERY consistent results with 80% (less coverage had too little results on some patients and more caused too much down-time). While 20% will reduce down-time, it also required multiple procedures or you have diminished results.

2. If one has an "aggressive" treatment with Fraxel (to try to eliminate the need to go back and forth to the doctor for multiple procedures), the Fraxel brochures indicate that down-time is 14-20 days! Let's ignore the "subtle" results that you would get and focus on down-time. With ActiveFX, you get VERY noticeable results with downtime much less than a week. In fact, most people can put make-up on in 3-4 days and ALL pinkness is gone in less than a week. Now let's consider the PAIN associated with an aggressive Fraxel treatment: with ActiveFX, most people have little/no pain and can drive themselves home!

3. Fraxel uses NON-ablative technology. Without ablation, there is no immediate contracture. And, it takes a long time for dyschromia to diminish -- immediate with ActiveFX. (Do you remember the old CoolTouch system? It used a 1320nm wavelength to try to reduce wrinkles -- this is a very similar wavelength to Fraxel. That system has basically died now -- no noticeable results despite multiple treatments!)

4. According to their Physician Guide, Fraxel's heat penetrates to 900microns. The eyelid's epidermis + dermis is only about 300microns thick. Therefore, can you safely use that system there? That is why their documentation and photos never show treatment within the orbital rim. However, the ActiveFX procedure is impressive on the eyelids, especially when you consider that this is a single treatment with minimal downtime

5. One final point is the consumable cost of Fraxel. They have to apply and remove the OptiGuide Blue gel -- which is really a minor cost. The big expense is the $400 tip. If the cost to the doctor is $400, then what must be the cost to the patient?!? The ActiveFX has no consumable costs!