Encino Fraxel Laser doctors

Thermage and Fraxel-type lasers can be options for anyone h=who has had a facelift.

Thermage is gentle enough where any concern for skin damage after facial surgery should not be an issue. Thermage can provide a moderate amount of skin tightening, but works best on patients who have maintained good elasticity in their skin. If your skin is thin and loose, then it may not be as effective. Lasers, either nonablative fractionated (Affirm or Fraxel) or ablative fractionated (Lumenis Total FX or Fraxel Repair) can provide some nice skin rejuvenation, wrinkle reduction and improvement in skin tone.

Thank you for your question.

For ice pick and box car scarring, you will need something more aggressive than Fraxel. In your case, I would consider microdermabrasion worthless as it does nothing to remodel the dermal collagen.

I would strongly consider doing fractional CO2 laser as it is the newest technology for resurfacing, with minimal downtime, that would be the best at resurfacing your type of acne scarring. In addition, you can consider the traditional CO2 laser, but there is up to 2 weeks of downtime associated with any treatment. Other options include traditional dermabrasion where the skin is sanded down manually or mechanically, however, there is also significant downtime. The last options include TCA 90% spot treatments, subcision, or excision of acne scars.

Hope this helps!

Thank you for your question.

Let's first talk about the science of the laser, and then talk about what it can do for you. The traditional first and second generation Fraxel lasers are 1550nm infrared lasers that are used to remodel the dermal collagen (second layer of the skin). Simply speaking, this laser targets the collagen in your second layer without causing damage to the surface of the skin.

The traditional Fraxel lasers are "non-ablative fractional" lasers that work by essentially "drilling" areas of heat damage into only the dermal collagen (avoiding crusting, scabbing, and downtime) and allowing the surrounding normal collagen to help speed up healing.

This differs from Erbium and CO2 "ablative fractional" lasers that do the same thing, but also "drill" these heat damage areas through the top layer as well (causing the scabbing, crusting, and increased downtime).

Now that you understand how they work, here's an explanation of what the traditional Fraxel laser can do. By working on remodeling the dermal collagen, you get a tightening in the second layer that will lead to reduction of rough skin texture, fine lines, and wrinkles on the surface. This is seen best when used around the eyes, but can make a great difference around the mouth, on the cheeks, and on most areas of the face.

This can also make some difference on the neck, although not great. The Fraxel is NOT a tightening laser like Thermage or Titan, rather it will improve the skin texture and fine lines/wrinkling instead of the more dramatic pulling of the skin as promised by those devices.

The traditional Fraxel is also used for mild acne scarring. It is best used for the mild rolling type of acne scarring, not for the "ice pick" or deeper rolling acne scars.

To get the best effects from Fraxel, you will need to do anywhere from 3-5 treatments. The effects are gradual and dermal collagen remodeling and tightening will continue even when you are finished with the last treatment, so you may see improvement continuing up to a year after you started. Fine lines will be less visible, skin texture will be improved, some pores may actually appear smaller (not guaranteed), and acne scars (if present) will be flatter. Your face will look younger and fresher.

In regards to downtime and side effects, the Fraxel will give you a "sunburn" appearance for anywhere from 2-7 days. There is no true crusting or oozing as the top layer of the skin is intact. It is safe for all skin types, but can lead to some hyperpigmentation in some patients.

It is best to avoid the sun 2 weeks before and after each treatment. Treatments can be spaced 4-6 weeks apart. Avoid makeup on the treated areas for 1 week after your treatment. You may need to go in once a year for a refresher treatment.

Hope this helps with all your questions!