Write a review

If You Can Only Afford 2 Treatments.....

Fraxel stands for Fractional Treatment which means...

Fraxel stands for Fractional Treatment which means 2 treatments won't do much if anything because you have only treated 20-30% of the total area of your skin. You have to do the 5 treatments a month apart! PLUS it's important to grasp the idea that the improvement is exponential, that is, with 4th and 5th treatments you will really see the difference and it keeps on improving for several months after that. Why? Because it takes that long for your body to make the new collagen stimulated by Fraxel and with each subsequent treatment you are not only improving the quality of your existing collagen, but you keep on making new collagen which every treatment you make over the new collagen it grows and grows. It will be a full year before you will know how much improvement has occurred.

I have had Fraxel personally and seen very pleasing results. At 58 I was really getting baggy around the eyes and that has almost gone now. I have also treated over 2000 patients with Fraxel and have no unhappy patients that have completed their course of 5 treatments.

Dr Michael Molton (self)

Was this review helpful? 16 others found this helpful

Comments (37)

Sort by

Your experience is dreadful. The debate about 'is it the device or the doctor' is the same for cars. Drive one like an idiot and someone gets hurt. Have you consulted your Attorney?
  • Reply
I just want to state emphatically that I believe that ANY DOCTOR who tells us that bad results from fraxel are rare and easily treatable is looking to make a buck. Period. Disgusts me.
  • Reply
You are right. Iam now 12months post fraxel repair and still no improvement with my PIH. Every doctors response is that it is temporary and reversible. What does that mean I have been told by a dermatologist with over 20 years experience that in his experience PIh due to laser is a mixture of dermal and epidermal and is very difficult to get rid treat let alone get rid off and he told me that on average if it is going to resolve it takes 18months and if it hasnt resolved by then , then it is permanant and that I should prepare my self for this ie psychologically
  • Reply
I understand. My advice is to seek a referral to a reputable dermatologist to manage your problem. Other than that I have no helpful suggestions.
  • Reply
The diagnosis of PIH is essentially that it is temporary. If it is not then by definition it is probably not PIH and pigmentation more likely to be driven by other factors of oestrogen production and solar free radicals or a combination of both. It is important to remember that sunscreens' effective time is only four hours so if you are applying this only once per day this is not sufficient. SPF 35+ is recommended and try to avoid creams containing PABA (paraaminobutyricacid).
  • Reply
Hi Dr Molton I never had pigmentation problems prior to this procedure, and Have had very little sun exposure throughout my life let alone recently. My face has a tinge of red still left on it from this laser and my skin is very hypersensitive now. Do you think that this tinge of redness is an indication that my face is still inflammed and hence irritating the PIH.
  • Reply
It is possible theoretically but the effects you have described are not typical.
  • Reply
Hi Dr Molton what do you suggest I do? I am desperate to rid myself of this problem. Thanks
  • Reply
So glad its working for you!
  • Reply
Hi Dr Molton I am 11 months post fraxel repair, and have PIH everywhere. I use to be a milky white colour. Hydroquinone does not work. I have used it in various strengths and with different combinations. Everyone keeps saying it is temporary. But what does that mean 10/20 years???? What other treatment options do you suggest? Thanks Mac
  • Reply
I finished my 3rd session of Fraxel 3 weeks ago. My issues were pore size, broken capillaries, a few age spots, hormone hyperpigmentation, "puppet mouth" lines and some crow's feet. I am 54 years old. I tolerated sessions 1 & 2 pretty well. My skin texture improved and the brown spots & hyper pigmentation faded by half. Session 3 was cranked up to 65 (70 being the highest). It was very uncomfortable. My eyes swelled, and my neck still prickles when I get hot. But my puppet lines are not obvious, my crows feet are practically gone, pores are tight and I can't wait to do session 4 (yeah , right!) 3-5 sessions were recommended. I see a definite improvement. My friend who had 3 also is 60 years old but looks 10 year younger. I developed a swollen undereye this time, and am waiting until it goes down. Is it worth it? I believe so. I still need an upper & lower eye job to take years off my looks, but my skin looks so much more even and healthier. (I don't dare go out in the sun without #75 on! Too much pain & money was spent to ruin this work.The first time in my life I am actually taken care of my skin!) I find Cetaphil cream compliments the work as it makes my skin dewy & soft. PS I had a dermatologist perform my Fraxel & he is an angel.
  • Reply
OK good feedback. It would be interesting to do a prospective double-blinded side by side trial! I agree IPL is not the modality of choice for me.
  • Reply
Michael, my experience with melasma is that Fraxel erbium does help - we reserve it for people not responding to bleaching formulae. Settings are typically lowish: energies 15 - 30 mJ, level 11 - 12. Improvement is unpredictable, but typically 30 - 75%. Q-switched YAG 1064 laser is also beneficial. Some Drs report good results with IPL, but this is not our experience. In respect of area treated, I recommend treating cosmetic units/areas, eg, cheek, chin, upper lip, etc, as rarely, a slight textural difference can be noted in treated versus untreated areas.
  • Reply
Should I be concerned if my doctor wants to treat only a part of my face with fractional laser? I have been on a course of hydroquinone 4% and retinoids for 6 months and have also had 4 IPL treatments. I have been pleased with the results -- except for a few stubborn age spots. The fractional would be to attempt to resolve the stubborn age spots and plump up minor acne scarring... I've asked if that will make just that part of my skin "look different" and he said "no" -- that this is the part of my face where I really need it done. I'm nervous and have not scheduled the treatment. My burning question I have is why NOT treat my entire face? I have had confidence in this doc and have been pleased with my treatment -- until now... Help. What other questions should I ask? I have to wonder if he's doing this on the "cheap" to save "tips" as you have described previously... Am I being overly cautious? I'm scared. I'm 46 and have decent skin -- with a few minor imperfections -- I just don't want to make it worse... Thanks!
  • Reply
I often do exactly what your doctor is recommending, in fact I have had this done to my own face without any problems on an age spot.
  • Reply
Interesting. I havent seen this.
  • Reply
Yes the pigmentation issue is temporary in my experience too. On the topic of melasma I would be interested in Dr Main's experiences in treating this and what settings he has used. I tell patients (obviously) that it will never disappear and that 30-50% improvement is possible provided they use 35+SPF twice a day (because it's the afternoon sun coming home that does the damage and I often prescribe 5% hydroquinone although the literature doesn't seem to support the efficacy of the latter in this application). Fraxel says 8 & 4 or even 3 every two weeks.
  • Reply
I certainly agree with Dr Molton's points. Our clinic has performed over 1200 Fraxel Restore treatments. We have had one small scar only in one patient, and none for the last 2 years. Results are really only begin to be seen after 3 treatments, and continue thereafter. We do see some temporary post-treatment hyperpigmentation in darker skin types, but no long-lasting PIH.
  • Reply
Hi Dr main on average how long does the PIH last for? I am 11 months post fraxel repair the PIH I have is not responding to hydroquinone of various strengths, I am now trying triluma. Any suggestions about what I should. Is this permanant?? thanks Mac
  • Reply
Dr Molton, do you think that using Tazorac before/after the treatments would help with the collagen rebuilding?
  • Reply
Its best to ask your treating doctor but retinoids I would not recommend in conjunction with Fraxel. Less is more so they say, too much 'fertiliser' burns the tomatoes!
  • Reply
Dr Michael Molton, What would be your tmt for 49 year old white female fair skin large pores, but not necessarily breakouts, hundreds of milia underneath and above eyes. if my skin was tighter the pores would be gone. that's what happens when I pull my skin back. I do not need a face lift yet, not enough sagging skin yet. Is the YAG laser a serious skin tightner or is that a waste of hard earned money?
  • Reply
Dr. Molton, is there any reason you couldn't repeat the Fraxel treatments every few years? Any limits to how many treatments you can have over a lifetime?
  • Reply
I don't think we have enough evidence yet to determine the answer to your question. CO2 laser resurfacing 15 years ago, although much more aggressive, would not be advisable to repeat due to pallor or blanching of the skin. I guess it depends on how aggressive the treatments have been with the Fraxel. If you are looking at the SR1500 and 70mJ/level 10, 8 passes, 5 treatments you'd have to be more concerned than at 35/5 8 passes and 5 treatments. I would make a decision with the patient on clinical examination of the individual
  • Reply
There isnt any clinical evidence that I know of on this. I just came back from Japan and a colleague there does upto 10 treatments in a year for some patients but not sure of the settings. I would encourage all users to get involved with their treatment getting to know what settings are being used each time and how many passes. I have quite a few patients that have come for a single maintenance treatment after two years but I havent done enough mileage with this scenario yet. Stay posted!
  • Reply