Active FX vs. Fraxel laser treatments - which is better?

I think Active FX and Fraxel are excellent treatments. I reserve those treatments for certain groups.

Active Fx works best in the light skinned patient (as the risk of hypo-pigmentation is diminished). Also with Active FX, I have found the need for a lesser number of treatments.

My biggest concern with Active FX is the potential risk of delayed hypopigmentation and therefore I am hesitant to offer this in darker skin types. Fraxel works nicely on all skin types including the darker skin types with minimal risk factors.

In summary, in lighter skin types I would choose Active Fx over Fraxel.

A study comparing 1 ActiveFX treatment vs. 5 Fraxel treatments should help clear this up. It was a split-face, prospective, randominzed study that looked at histologies and Visia photographs before the treatments and 6 months following the ActiveFX session or the Fraxel series.

The results showed similar findings for dyschromia (evening out uneven skin tones - dark spots, sun spots, etc.) but 50% more collagen with ActiveFX. Now that TotalFX is available by combining ActiveFX with DeepFX, the answer is clearly with Bridge Therapy (of which ActiveFX is one of the components).

There have also been studies performed using ActiveFX on darker skin types (Fitzpatrick IV-VI). However, more patients with these skin types have been treated with Fraxel.

There is slightly less downtime with a single Fraxel session than with ActiveFX. However, if you factor in the 5 times one needs to have Fraxel done to achieve 50% of the collagen enhancement results of ActiveFX, I would think more about the ActiveFX.

Currently, Fraxel is better at treating acne scars and Active Fx is better at treating fine lines, especially around the lips and eyes. They will both shrink pores and eliminate brown spots quite well, but Active Fx does have the advantage of being one treatment, as compared to the series of 3 to 5 treatments that Fraxel involves. Pricewise, Fraxel treatment is about $1000 per session, whereas Active Fx is about $3000 (prices will vary according to location, of course, I'm just quoting my own prices here). The downtime is about the same. Although you will be swollen for a day more with Active Fx (about 3 days) and you have more peeling in the short run, you are red for a total of less time about 4 days with Active Fx, compared to a week with Fraxel. Neither treatment should be done on darker skinned individuals, although there is more leeway with the Fraxel. I have successfully done Fraxel treatments on dark African skin, but I would not currently use the Active Fx on skin darker than Asian. So, that's the answer - it depends!

While both Fraxel and ActiveFX laser technologies function in a similar manner, they are two distinctively different lasers. Fraxel technology delivers fractionated Erbium laser energy while ActiveFX utlizes fractionated energy from a carbon dioxide laser. Even though the two are similar, the increased heat provided by the ActiveFX appears to result in more effective skin tightening and, overall, better results.