Fraxel Laser for Extensive Facial Actinic Keratosis?

Efudex and CO2 laser skin resurfacing have been the gold standard for treatment of actinic keratosis. We offer fraxel laser treatments in our clinic, but I am not convinced that they are adequate for the treatment of AC. We also offer DOT laser treatments. At their highest setting I believe they would come close to the CO2 laser's effectiveness, but again the data isn not there.

If you want to do a laser for actinic keratosis, do an ablative treatment. Fractional or traditional CO2, or dermabrasion are the most effective options. Fraxel Restore is non-ablative and not that effective for AK. Fraxel Repair would be an option, as it is ablative. Non-procedural options are Aldara and Caroc. Your board certified dermatologist can best guide you regarding the pros and cons of your options. Good luck and remember your sunscreen to prevent new actinic keratoses.... more

There is much more evidence regarding the role of photodynamic therapy in the treatment of actnic keratoses than there is for Fraxel. In this treatment, a liquid is applied to the skin, Levulan, and then the patient is asked to sit in a waiting room where reading material and the gentle music enhance the PDT experience. After a half hour wait, the patient sits in front of a Blu-light. It is important to wear a sunscreen home and not go in the sun for two days. What is happening is... more

Hi Baz,   I'm going to assume that when you mention the "Fraxel" laser, you are referring to the Fraxel Re:pair (which is a fractionated "ablative" laser). . . The Fraxel Re:store is a fractionated nonablative laser, and, as such, does not treat the upper layers of the skin from which actinic keratoses arise.   Since the Fraxel is "fractionated," it is not treating/ablating 100% of the surface area of the epidermis (upper layer of skin)... more