Fraxel treatment - when and why is it recommended?

Fraxel works well to improve the texture and tone of the skin, to improve acne scars, to address facial lines, and treat some sun-damaged skin (e.g. brown spots).

It is not as useful for rosacea, melasma, or stretch marks.

Like most modalities, the treatment's success is dependent on the expertise of the user and the ability to use the correct modality or to combine to have the correct mix of modalities for a given problem.

I agree with Lori Haney's comments.

I was looking to add an aggressive treatment to my cosmetic Dermatology practice for treatment of most common age related skin conditions (brown spots, deep wrinkles, loss of facial tone and elasticity) . I have been fortunate to have the ability to evaluate several treatment options before making my choice. Fraxel has done a great job marketing the product but my practice is not about marketing. I have to stand by my reccomendation and cannot recommend a procedure with less than 50% satisfaction rate.

I evaluated various lasers and treatments and decided to add Rhytec Plasma portrait to my practice for treatment of deep wrinkles, jowls, facial sagging, brown spots and superficial skin lesions. I am extremely pleased with my decision. I have met several physicians who previously owned fraxel and have now switched to Rhytec portrait due to patient dissatisfaction with fraxel. 

Over the last few months, I have evaluated and treated several patients who were less than satisfied with fraxel treatments. Common complaints are, the treatments are painful and do not produce satisfactory results. This is certainly not the case with all fraxel patients and all treatments have their share of unsatisfied patients, but in my opinion the rate of  less than 50% satisfaction is not acceptable for a treatment that costs a patient considerable amount of money and discomfort.

Whatever your skin problems are, make sure you get a good consultation with your physician on expectations regarding discomfort, improvements, number of treatments needed. It is always a good idea to review before and after photos of actual patients who had their treatment done at your dermatologist's office.

In the end each individual is unique and the response to treatment varies with your skin type and the technique of the user. I personally am not very impressed with Fraxel results

Fraxel repair works well at making patients look younger. It works well on wrinkles, brown spots, vascular dyschromias, pre-cancer skin lesions, acne scars, surgical scars, and on tightening the lax skin around the eyes and neck.

I moved from another frational resurfacing sysytem to Fraxel several months ago, and the difference in my patients' results have been dramatic. The newest Fraxel system is fast, and pain is definitely reduced. I find it is safe for more skin types.

I use Fraxel for aging skin to reduce the fine lines that are too shallow to fill, and the bonus is that since it stimulates your OWN collagen, the results last longer. Brown spots fade and the skin gets a dewy, luminous glow, even better than Intense Pulsed Light treatments achieve. Fraxel is also my first choice now for acne scars and the results rival dermabrasion, albeit it does require multiple sessions.

Fraxel was and continues to be an outstanding step forward in laser technology. It is an Erbium laser that, instead of putting out a solid beam that punches a big hole in the skin, puts out lots of microscopic beams that punch microscopic holes in the skin.

The normal, untreated tissue that is around a Fraxel beam helps in quick healing and skin normalization. Fraxel is today the standard of care for acne scarring around the world. It is, in my view, the only treatment that reliably improves acne scarred skin. It is not just marketing.

What Fraxel can treat:

1. Acne scars
2. Sun damaged skin - brown spots
3. Mild fine lines from aging

What Fraxel cannot treat:

1. Lines around the eyes and lips
2. Anything beyond the mildest age lines
3. Rosacea, red capillaries, any other vascular lesions
4. It will not appreciably tighten skin

Unfortunately, Fraxel does require more than one treatment for best effect (3 to 5 treatments is what we usually recommend - more for severe acne scarring). It also does hurt somewhat, although potent numbing creams, Vicodin and Xanax do take most of the pain away, and there are a couple days of downtime, followed by a week of redness.

I am looking forward to the Active Fx as an improvement on the Fraxel. It can already treat the lines under the eyes and above the lips that Fraxel cannot. Active Fx is also better at treating fine lines all over the face. The other advantage is that it is one treatment session, not 5.

The downtime seems similar to Fraxel and the pain level is less. I am still evaluating its ability to treat acne scars, but I expect it to be just as good as the Fraxel.

Dr. Gerrish makes some great points about Fraxel in his videos. Fractionated skin resurfacing lasers, such as the Fraxel SR 1500, do yield great results in the hands of an experienced physician. I normally recommend Fraxel treatment for:

• Improving fine lines and wrinkles at rest, especially around the eyes and mouth
• Decreasing brown spots
• Improving acne and chickenpox scars
• Limited tightening of skin (this is a secondary benefit, at best)

Fraxel, unlike many older laser skin resurfacing systems, treats only a fraction of the skin in a treatment area. The bad news: you’ll need multiple treatments. The good news: the healing time is much shorter, without weeks of redness, peeling and crusting that used to occur with CO2 skin resurfacing. Reasons for patient dissatisfaction are usually due to factors like:

• Practitioners moving the treatment head too fast
• Laser settings not deep enough
• Weak energy settings

Of course, every patient needs to be treated with settings customized to meet their needs. I believe in starting with lower, safer energies and stepping up treatment intensity over time. For best results with Fraxel, find a doctor who consults with and treats patients personally, and who has expertise with Fraxel. There are no guarantees in life or in medicine, but this will maximize your results with Fraxel.

We actually do not use the Fraxel laser at Celibre. One of the favorite blog posts on this site asks the question "Is Proactiv success about quality or marketing?" We would ask the same question about Fraxel.

In the last five years, we have seen a tremendous influx of lasers and cosmetic medical equipment into the marketplace and we do no yet see a correlation between the media buzz being generated by many of these companies and the actual patient outcomes. This is evidenced by our own experience with Fraxel patients as well as the 50% patient satisfaction rate for Fraxel treatment for users of this site, realself.com.

For a resurfacing treatment, we believe that 50% satisfaction is far too low and is significantly below the patient satisfaction rate achieved for laser resurfacing with Erbium lasers (80%). In addition, we have been told by our patients that have done both procedures that the downtime for Fraxel and Erbium resurfacing is the same.

Dr. Scott Gerrish praises Fraxel treatment results.