Milwaukee Fraxel Laser doctors

The Fraxel laser employs the concept of “fractional” resurfacing. This means a portion of the skin is treated, and a portion of the skin remains untreated; zones of treated skin are surrounded by intact, unaffected skin, so only a “fraction” of the skin is treated in any given session.

The Fraxel laser creates thousands of microscopic laser spots, each 70-100 microns in diameter. These laser spots (known as Microthermal Treatment Zones, or MTZs) are deep microscopic columns of coagulated tissue extending through the epidermis into the dermis. Just as important, however, are the areas of skin that are left untreated surrounding each treatment zone. For every MTZ the Fraxel laser creates, it leaves the surrounding skin unaffected and intact. This “fractional” treatment allows the skin to heal much faster than if the entire skin surface were treated at one time.

For many generalized resurfacing treatments, in skin types I-III, the fraction of treated skin ranges between 20% - 32%. Four treatment sessions are usually recommended. The results are progressive. Patients may not notice significant results after the first treatment, but they will notice improved results following each subsequent treatment session. Collagen remodeling will be ongoing during the treatment series and probably occurs for up to 3 months following the final treatment session.

We have had good experience with this laser and use it frequently for acne scarring and photoaging.

I don’t know what you are referring to when you state, “…that you don't actually know that your skin has been damaged by the laser for up to 6 months.” If the skin is damaged (e.g. burned) by the laser treatment you will know this almost immediately, or within the first 24 hours. We have never damaged any patient’s skin with this laser. So, without further details, I would say that statement is false.

Sun protection is important before, during, and after any laser program. Minimizing sun exposure reduces the risk for post-inflammatory hyperpigmentation (PIH), and this risk would be increased in individuals with dyspigmentation or darker skin types. Six months after your laser procedure, the risk of laser-related PIH is nonexistent. At that that point you should treat your skin like you would normally. However, you should always “fear the sun”; and sunscreen should be a routine part of your daily skin care program.

I hope this is helpful. Best wishes, Ken Dembny

You may begin using Hydroquinone 4% after laser procedures once the skin has completely healed. Following procedures such as the fractionated CO2 or YSGG the skin has usually re-epithelialized in about 7 days. Some individuals find the hydroquinone 4% a bit irritating and have to wait a few days longer. It is best to wait a few weeks before resuming your retinol, since this will be irritating if started too early. We typically have our patients resume their retinol about 4 weeks after their laser procedure; usually gradually by applying it every second or third day to make sure their skin is able to tolerate it. As always, sun avoidance is crucial to avoiding post-inflammatory hyperpigmentation and strict sun protection behaviors will go along way in helping to maintain your results.

Best wishes, Ken Dembny

The Fraxel laser is a fractional laser that treats only a (fraction) portion of the skin at one session. It therefore is associated with significantly less 'downtime' than more ablative and traditional laser resurfacing procedures. Following Fraxel treatment there is no oozing, no painful or lengthy recuperation, and less chance for infection, scarring, and hypopigmentation.
 
The Fraxel is a mid infra-red (Erbium Fiber, 1550nm) laser whose target is water. Using a robotic scanning mechanism, the individual laser beams create many microthermal zones (MTZs) of injury in the skin. Each is surrounded by small areas/amounts of untreated, normal epidermis. So each individual laser beam injury (MTZ) is an island of treatment surrounded by normal untreated skin. It is for this reason that the treatment is better tolerated and the recovery is faster. It is also for this reason that multiple treatment sessions are required to achieve a complete result.

Treatment is accomplished with the use of topical anesthesia and an external air cooling device for patient comfort. By design, each Fraxel laser treatment session usually targets about 25% of the skin’s surface.  Usually four treatments are therefore required to achieve at least 100% coverage of the skin surface. The skin surface is dry following treatment and can be treated similar to an intense sunburn. Flaking sometimes occurs, and the redness and swelling usually resolves in 5 -9 days depending upon the amount of treatment performed. Each Fraxel laser treatment session is spaced three to four weeks apart. Results are immediate and progressive. Sun protection is important between treatment sessions. After an initial full treatment series is complete, a maintenance treatment performed once to twice annually is helpful to maintain results. Areas that exhibit more sun damage, such as the face and décolleté, will look better with biannual maintenance as opposed to just a single maintenance treatment.

The Fraxel works well for acne and other types of scarring, as well as fine lines, wrinkles and photoaging. The Fraxel can be used on most skin types, and all over the face and body. It is good for off-face resurfacing of the neck and hands.

The Fraxel Laser is FDA approved for soft tissue coagulation, skin resurfacing procedures, and for the correction of periorbital lines and wrinkles and pigmented lesions, including age spots, melasma, sun spots and skin discoloration.